HEART Waiver Tenancy Support: Application Fee and Security Deposit Assistance
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Defines eligibility, provider and service requirements, prior authorization and reimbursement rules for one-time application fee and security deposit assistance under the Montana HEART Waiver Tenancy Support Service (TSS). Affects Montana Medicaid-enrolled members and enrolled TSS providers who deliver Pre-Tenancy Services.
No material clinical or coverage changes in this revision.
Coverage Criteria: Application Fee and Security Deposit Assistance
Coverage criteria for application fee and security deposit assistance
Coverage is available when eligibility, provider, service, and prior authorization requirements are met.
ALL of the following
Eligibility
- Member is 18 years of age or older.
- Member is enrolled in Montana Medicaid.
- Member meets TSS eligibility per Policies 603 and 605.
- Member is actively participating in Pre-Tenancy Services with an approved provider.
- Member is not currently residing, or planning to reside, in a residential treatment facility or congregate living facility/setting.
ALL of the following
Provider requirements
- Provider is an approved and enrolled TSS provider seeking reimbursement for one-time transition and move-in costs.
- Provider maintains progress notes per Policy 602.
- Provider maintains a person-centered service plan from UR Independent Contractor that includes the prior authorization number.
- Provider retains receipt(s) for application fee(s).
- Provider retains signed receipt(s) for security deposit(s).
- Provider retains a copy of HUD quality health inspection or equivalent verifying housing and safety standards compliance.
- Provider retains a copy of the signed and dated lease.
ALL of the following
Service limits
- Application fee assistance up to $250.00 annually from the date prior authorization was granted.$250.00 annually
- Security deposit assistance up to $1,650.00 annually from the date of the security deposit payment to the landlord/property manager prior authorization was granted.$1,650.00 annually
ALL of the following
Prior authorization and utilization management
- Prior authorization is required.
- UR Independent Contractor issues an authorization number; the authorization number is valid for 12 months from the date of authorization.
- Prior authorization may be approved for up to 365 days.
ALL of the following
Billing requirement
- Provider must submit a clean claim to Montana Medicaid with the appropriate prior authorization number for approved services.
ALL of the following
Documentation retention
- Keep receipts, signed lease, HUD inspection or equivalent, person-centered service plan including prior authorization number, and progress notes.
Financial Assistance Items and Limits
| No codes listed |
Provider Requirements, Authorization, and Claims
Prior authorization required; authorization number valid 12 months
Prior authorization is required. The UR Independent Contractor will issue an authorization number for approval of application fee(s) and security deposit; the authorization number is valid for 12 months from the date of authorization. Prior authorization may be approved for up to 365 days.
Submit clean claim with prior authorization number
Providers must submit a clean claim to Montana Medicaid that includes the appropriate prior authorization number for the approved application fee(s) and/or security deposit services.
Be enrolled TSS provider and retain required documentation
Providers seeking reimbursement must be approved and enrolled TSS providers and must retain required documentation including the person-centered service plan with the prior authorization number, receipts for application fees, signed receipts for security deposits, HUD quality health inspection (or equivalent), and a copy of the signed lease.
- Be an approved and enrolled TSS provider
- Maintain progress notes per Policy 602
- Keep person-centered service plan from UR Independent Contractor with prior authorization number
- Retain receipt(s) for application fee(s) and signed receipt(s) for security deposit
- Retain HUD quality health inspection or equivalent and copy of signed lease
Definitions
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