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All state Medicaid agencies are required to have an approved Title XIX/Medicaid State Plan. The state plan describes the nature and scope of its program and gives assurance that the state’s Medicaid program will operate in compliance with federal Medicaid regulations and other official federal issuances. Having an approved state plan ensures that the state will receive matching federal funds for its Medicaid program.

Amendments to the state plan are necessary for many types of changes to the Medicaid program, such as changes to eligibility requirements or groups, changes in the scope of services provided, the addition of new provider types, adding or eliminating prior authorization requirements, adding or removing service limits, and changing reimbursement amounts or methodologies. Details about state plan requirements, including the timing of submittals, can be found at 42 CFR 430, Subpart B. Proposed state plan amendments are submitted to the Centers for Medicare and Medicaid Services (CMS) for review and approval.

Please note that the state plan does not contain extensive service details and requirements. This information should be obtained through the Department’s rules listed on the State of New Hampshire Administrative Rules website or via the DHHS online eligibility policy manual. Also note that changes to the state plan are ongoing and that the submittal and approval can span a long period of time. Therefore, there may always be pending state plan amendments (SPA’s) that are not reflected in this posted document. If this knowledge is critical to your research, please contact us. This state plan will be updated as approvals occur.

New Hampshire’s Medicaid State Plan, like all State Plans, is constantly changing and improving to ensure that its citizens are served. If you are reviewing the State Plan on this web page and have any questions about program eligibility, please contact Dawn Landry at (603) 271-9315, or via email at dawn.landry@dhhs.nh.gov. For any other questions such as services and reimbursement, please contact Diane Peterson at (603) 271-4367, or via email at diane.peterson@dhhs.nh.gov.

Notes:

  1. The plan information listed here is for informational purposes only, and is not legally binding. The official plan is maintained by the Centers for Medicare and Medicaid Services, Region I, Boston, MA.
  2. Although most state plan pages are replaced with an entirely new and updated page when they are superseded, please note that pages related to eligibility and the Affordable Care Act are an exception to this process. These pages either superseded entire pages or partial pages. For reference the superseding document is included in these pages.

The following files are posted as of 04/25/2019 and will be updated as approvals occur:

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New Hampshire Department of Health and Human Services
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