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AGED, BLIND, AND DISABLED MEDICAID 806-1 Montana State Hospital Residents Supersedes: MA 907-1 (01/01/08); Bulletin MA 115 (11/01/14) Reference: 42 CFR 435.725, .832, and .1008-1009, & 441.151; ARM 37.82.101, .1301, .1305, .1306, .1312, .1313, .1321, .1330, .1331, .1336-.1338 Overview: Montana State Hospital at Warm Springs (MSH) residents who are over age 21 and under age 65 receive, are not eligible for Medicaid payment or ANY medical services, regardless of who provides or where the services are provided. However, Medicaid clients who are admitted to MSH for a continuous period beginning prior to their 21st birthday remain Medicaid eligible through the date of their 22nd birthday, unless they lose Medicaid eligibility for another reason (e.g., resources, disability, etc.) ADMISSION AND DISCHARGE: MSH contacts the Department and provides the patient’s admission date each time a Medicaid client is admitted. A part of the discharge plan, MSH contacts the Department to notify of the planned discharge date. CONVALESCENT LEAVE AND CONDITIONAL RELEASE: Because they are no longer considered MSH residents, individuals over age 21 who leave MSH on convalescent leave or conditional release may be Medicaid eligible for payment of services received during the leave/conditional release. A temporary release to obtain medical treatment is not considered conditional release. For individuals who turn 21 while residing at MSH, but are not yet 22, convalescent leave and conditional release are not considered the same as unconditional release from the facility and do not disrupt their status as continuously institutionalized. RESIDENTS UNDER AGE 21 AND AGE 65 OR OLDER: Medicaid coverage may be available to individuals under age 21 (or 22) and age 65 or older. Financial and nonfinancial criteria for nursing home residents apply to MSH residents, and may include: • Determination of liability toward cost of care; (ABD 805-2) • Home maintenance allowance