53-6-711. Requests for proposals and contracts — review requirements — public notice and comment. (1) Before the department issues a request for proposals or awards a contract for the provision of services through a managed health care entity:

Terms Used In Montana Code 53-6-711

  • Contract: A legal written agreement that becomes binding when signed.
  • Department: means the department of public health and human services. See Montana Code 53-6-702
  • entity: means a health maintenance organization or an insurer regulated under Title 33 that:

    (i)contracts for an estimated annual value of $1 million or more of state and federal medicaid funds; or

    (ii)operates statewide or covers 20% or more of the medicaid population. See Montana Code 53-6-702

  • Program: means an element of the integrated health care system created by this part. See Montana Code 53-6-702
  • State: when applied to the different parts of the United States, includes the District of Columbia and the territories. See Montana Code 1-1-201

(a)the department shall meet the public notice, legislative presentation, and public comment requirements of 53-2-215;

(b)the legislative auditor’s office and the state auditor’s office, in consultation with the department, shall analyze the request for proposal and the proposed contract for:

(i)actuarial soundness;

(ii)network adequacy as provided for in Title 33, chapter 36, part 2; and

(iii)consumer choice; and

(c)within 60 days of receipt of the request for proposal and proposed contract, the legislative auditor’s office and state auditor’s office shall complete their analyses and publish the findings of their analyses.

(2)(a) Before the department may award a contract, it shall seek an independent analysis to verify that the potential vendor is able to comply with the goals of the proposed managed care program.

(b)The vendor shall pay the costs of the analysis.

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