Montana
LLC
Website link to register:
https://sosmt.gov/business
Naming conventions
Restricted words require extra documentation, such as licenses. Must include “Limited Liability Company,” “LLC,” or “L.L.C.” PLLC applies to professional medical services.
Licensing Requirements
PLLC members must hold licenses from the Montana Board of Medical Examiners. Malpractice insurance required. Specialized certifications for rural health services may be needed.
Required documentation for medical practices
Articles of Organization, Rural Health Certifications, Malpractice Insurance, Professional Licenses
Filing Fee: $35
Annual/Biennial Fee: $20
Additional Notes: Annual report due by April 15.
Medicaid
Program Name: Montana Medicaid
Official Website: https://dphhs.mt.gov/montanahealthcareprograms/
Legislation: Montana does not have specific DPC legislation; practices operate under general healthcare and insurance laws.
Private Contracting
Permitted; DPC practices should ensure compliance with state insurance regulations to avoid being classified as insurers.
Restrictions
No explicit restrictions for DPC providers; compliance with federal and state regulations is necessary.
Medicaid Program
Montana Medicaid provides health coverage to eligible low-income residents, including children.
Notification Requirements
Notification strongly recommended for Medicaid patient clarity.
Provider Enrollment Requirements
Providers must enroll with Montana Medicaid to serve beneficiaries directly or offer reimbursable services.
Enrollment Options
No "Ordering and Referring Only" status available.
Ordering, Referrals, and Testing
Non-enrolled providers may face challenges with Medicaid recognition for orders and referrals.
Designated PCP Restrictions
DPC physicians cannot act as Medicaid-designated PCPs.
Billing and Reimbursement
DPC practices typically do not bill Medicaid for services covered under private agreements.
Managed Care Plan Exemptions
Not specified.
Billing Clarity
Cannot bill Medicaid patients for covered services unless explicitly outlined.
CMS Guidance
CMS encourages streamlined enrollment for non-billing providers.
Opportunities for Collaboration
Opportunities may exist to collaborate with Medicaid Managed Care Organizations (MCOs) or state programs aimed at innovative healthcare delivery.
State-Specific Notes
Collaboration opportunities exist with Montana Medicaid for expanding access to primary care.
Dispensing Medication
Board of Pharmacy Official Link: https://boards.bsd.dli.mt.gov/pharmacy/
State Licensing
Physicians must register with the Montana Board of Pharmacy for dispensing controlled substances.
Scope of Practice
Dispensing medications is allowed for non-controlled and controlled substances; strict rules apply for controlled substances.
Inventory Management
Secure storage and detailed inventory tracking are required for all medications.
Record-Keeping
Records must comply with Montana state laws and HIPAA standards.
Dispensing Standards
Labels must meet Montana Board of Pharmacy requirements, including dosage and prescribing information.
Controlled Substances
DEA registration and reporting to Montana’s PDMP are mandatory for controlled substances.
Billing and Reimbursement
Billing practices must follow federal anti-kickback laws and Montana-specific regulations.
Federal Compliance
Physicians must comply with FDA, DEA, and Montana-specific pharmacy board rules for dispensing.
State Pharmacy Laws
Registration with the Montana Board of Pharmacy is required for controlled substances.
Patient Consent
Informed consent is mandatory prior to dispensing medications.
Insurance and Liability
Physicians must ensure liability insurance explicitly covers medication dispensing.
Training Requirements
Continuing education is encouraged for physicians dispensing controlled substances in Montana.
Audits and Inspections
Inspections by the Montana Board of Pharmacy ensure compliance, with penalties for non-compliance.