ARM 37.86.5206. DISEASE MANAGEMENT PROGRAM: SCOPE OF SERVICES AND REIMBURSEMENT

(1) If a disease management program is provided by a DMO, the program must meet the following criteria: (a) the program requirements stated in the contract between the department and the DMO must be fulfilled; (b) the scope of practice must be appropriate for the provider of the health care service; and (c) the DMO must comply with all other applicable state and federal requirements. (2) Only a DMO contracted with the department may bill and be reimbursed for providing disease management services. Billing requirements and payment methodology will be described in a contract between the DMO and the department.