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Overview of Current Managed Care Programs Introduced in 1993, the states PCCM program is called Passport to Health. Enrollment is mandatory for most Medicaid beneficiaries throughout the state.
The state enters into agreements with primary care providers to serve as care managers/medical homes in the Passport program. The state permits any provider with primary care within his or her professional scope of practice to become a Passport PCP. All Passport PCPs are also Team Care providers.
Medicaid expansion took effect in Montana in 2016, and more than 115,000 people were enrolled as of 2022. Montana enacted legislation to extend Medicaid expansion through Jun 2025, but with a work requirement.
Children account for more than four in ten (43%) of all Medicaid enrollees, and the elderly and people with disabilities account for about one in four enrollees.
Nearly all states have some form of managed care in place comprehensive risk-based managed care and/or primary care case management (PCCM) programs.

People also ask

Need help finding your local Office of Public Assistance, Enrolled Medicaid Provider, or Passport Provider? Call Montana Healthcare Programs, Member Help Line 1-800-362-8312, M-F, 8am-5pm, for assistance.
Montana Medicaid and HMK Plus pays for services that are: Medically necessary, Provided by a Montana Medicaid/HMK Plus enrolled provider, and. Medicaid/HMK Plus covered services.
TIMELY FILING GUIDELINES Print Straight Medicaid claims must be filed within 12 months of the date of service. KIDMED claims must be filed within 60 days from the date of service.
Refer to the NPI claims instructions on the Provider Information website to determine the reason your claims are denying, then correct and resubmit them within the 365-day timely filing limit. If you have questions, contact Provider Relations at 1.800. 624.3958 or 406.442. 1837, by fax at 406.442.
Some prescription drugs may need prior authorization. To find out if a drug you need is covered or to find out if a drug needs prior authorization, talk to your pharmacist or the person who prescribed the drug. Medicaid will pay for a 34-day supply of drugs.

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