The bill establishes a framework for presumptive eligibility under the Montana Medicaid program specifically for certain home and community-based services aimed at individuals with physical disabilities and the elderly. It outlines a screening process that must be completed to grant presumptive eligibility, which includes an application, self-attestation of income and residency requirements, and a functional assessment to create an in-home care plan. The bill specifies that eligible services include those necessary to prevent institutionalization or to facilitate a successful transition from a hospital or other institutional setting.

Additionally, the bill introduces new provisions that allow the Department of Public Health and Human Services to grant time extensions for the application process and service periods, as well as exceptions to the limit on the frequency of presumptive eligibility determinations. It also mandates that the department submit necessary waiver applications to implement the program and requires notification to tribal governments regarding the new eligibility provisions. The effective date of the bill is contingent upon the approval of the relevant waiver applications by the Centers for Medicare and Medicaid Services.