ARM 37.57.117. CSHS PROVIDER REQUIREMENTS

(1) In order to be a CSHS provider for a CSHS client, a provider must meet the following requirements: (a) A physician or surgeon must: (i) be currently licensed by the state of Montana pursuant to Title 37, chapter 3, MCA, to practice medicine as defined by state law if a Montana resident, or currently licensed to practice medicine in the state in which they reside; (ii) be board-eligible or board-certified in the specialty for the condition being treated, or working in cooperation with a physician who is, unless the provider submits a curriculum vitae to the department and the CSHS medical advisor approves the provider as a specialty provider; (iii) provide the department, upon request, with adequate documentation of credentials needed to prove program eligibility. (b) An orthodontist must: (i) be currently licensed as a dentist in the state of Montana or the state of residence; (ii) have completed two years of graduate or post-graduate orthodontic training recognized by the council of dental education of the American dental association or the American orthodontic association; and (iii) limit their practice to the area of orthodontics. (c) A pediatric dentist may treat a child or youth under the age of 10 for orthodontia and must: (i) be currently licensed as a dentist by the state of Montana or the state of residence; and (ii) have completed a minimum of two academic years of a graduate or post-graduate pediatric dentistry program accredited by the council on dental accreditation of the American dental association. (d) A hospital must be accredited by the joint commission of accreditation of healthcare organizations and be currently licensed and certified by the department, if in-state, or by the state in which it is located, if out-of-state. (e) Any provider other than those listed in (1) (a) through (1) (d) must: (i) be certified and/or licensed by the appropriate Montana authority, or if Montana has no certification or licensure requirements for the provider, be certified by a nationally recognized professional organization in the provider's area of expertise; and (ii) shall provide services as ordered or prescribed by the attending physician. (2) A provider must immediately supply the department with requested reports in order to permit effective evaluation of claims.