53-6-133. Eligibility determination. (1) The local office of public assistance shall promptly determine the eligibility of each applicant under this part in accordance with the rules of the department. Each applicant must be informed of the right to a fair hearing and of the confidential nature of the information given. The department, through the local office of public assistance, shall, after the hearing, determine whether or not the applicant is eligible for assistance under this part, and aid must be furnished promptly to eligible persons. Each applicant must receive written notice of the decision concerning the applicant’s application, and the right of appeal is secured to the applicant under the procedures of 53-2-606.

Terms Used In Montana Code 53-6-133

  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Applicant: means a person:

    (a)who has submitted an application for determination of medicaid eligibility to a medicaid agency on the person's own behalf or on behalf of another person; or

    (b)on whose behalf an application has been submitted. See Montana Code 53-6-155

  • Department: means the department of public health and human services provided for in 2-15-2201. See Montana Code 53-6-155
  • Medicaid: means the Montana medical assistance program established under Title 53, chapter 6. See Montana Code 53-6-155

(2)The local office of public assistance and the department may accept the federal social security administration’s determination of eligibility for supplemental security income, Title XVI of the Social Security Act, as qualifying the eligible individuals to receive medical assistance under this part.

(3)(a) The department shall verify the information provided on an application for medicaid under part 13 or under this part, using data sources allowed under federal law or regulation and Montana department of revenue information as required under subsection (3)(b), to confirm an applicant’s eligibility for the program before authorizing payment of benefits under the program.

(b)The department shall request income tax and wage income from the department of revenue as allowed under 15-30-2618 and 15-31-511 to verify the income information provided by applicants who may be eligible for coverage pursuant to 53-6-1304.

(4)The department shall establish by rule the documents to be used to verify that an applicant is a Montana resident. (Subsections (3) and (4) terminate June 30, 2025, on occurrence of contingency–sec. 48, Ch. 415, L. 2019.)