1. (1) Providers will enroll as a Community First Choice Services (CFCS)/Personal Care Services (PCS) provider, a CFCS/PCS personal emergency response system (PERS) provider, or both. Providers must enroll through the department's fiscal intermediary.
2. (2) CFCS/PCS providers must be a business entity formed or registered to do business under Montana law.
3. (3) CFCS/PCS providers must submit a description of the proposed service area, which must include, at a minimum, coverage of the entire area of at least one county or Indian reservation.
4. (4) CFCS/PCS providers must comply with onsite visit requirements both before and after enrollment, to verify information submitted to the department.

5. (5) CFCS/PCS providers must provide documentation to demonstrate the following:

   1. (a) general liability insurance with a minimum coverage of $1,000,000 per occurrence and $2,000,000 aggregate;
   2. (b) motor vehicle liability insurance with split limits of $500,000 per person for personal injury, $1,000,000 per accident occurrence for personal injury, and $100,000 per accident occurrence for property damage; or, combined single limits of $1,000,000 per occurrence to cover such claims as may be caused by any act, omission, or negligence of the provider or its agents, officers, representatives, assigns, or subcontractors;
   3. (c) current unemployment insurance and workers' compensation coverage; and
   4. (d) verification of completion of the department's mandatory CFCS/PCS training.
6. (6) CFCS/PCS providers must elect to deliver either the agency-based or self-directed CFCS/PCS option. Once a provider has completed a successful compliance review, the provider may enroll in the other service option.

7. (7) CFCS/PCS providers must use an Electronic Visit Verification (EVV) system to electronically document the delivery of services and submit claims.

   1. (a) In accordance with 42 U.S.C. 1396b(l), the EVV system must capture the following data elements:

      1. (i) the type of service performed;
      2. (ii) the member receiving the service;
      3. (iii) the date of the service;
      4. (iv) the location of service delivery;
      5. (v) the individual providing the service; and
      6. (vi) the time the service begins and ends;
   2. (b) The use of EVV is required for all members utilizing CFCS/PCS, including members for whom services are provided by a live-in caregiver.
8. (8) The department may contract with out-of-state agencies to provide CFCS/PCS for Montana Medicaid members temporarily living out of state.

Authorizing statute(s): 53-2-201, MCA

Implementing statute(s): 53-2-201, 53-6-113, MCA

History: NEW, 2014 MAR p. 3075, Eff. 12/25/14; AMD, 2025 MAR, Notice No. 280, Eff. 7/26/25.