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Proposed Amendment

The proposed amendment seeks to effect the following modification:
Modify eligibility to require that newly eligible adults who are unemployed be eligible to receive benefits if DHHS finds that the individual is engaging in work or a combination of other clearly outlined activities for at least 20 hours per week upon application of benefits, 25 hours per week after receiving 12 months of benefits over the lifetime of the applicant and 30 hours per week after receiving 24 months of benefits over the lifetime of the applicant.

Update: November 3, 2017
On November 2, 2017, CMS notified the Department that CMS had completed a preliminary review of the amendment request Adobe Acrobat Reader Symbol and determined that the Department’s amendment request has met the requirements for a complete amendment. The federal public comment period is open from November 2, 2017 through December 2, 2017. The amendment is posted on the Medicaid.gov website.

Opportunity for Public Input

Public comments may be submitted until midnight on September 29, 2017.

Comments may be submitted by email to NHPremiumAssistanceAmendment@dhhs.nh.gov, or by regular mail to:

Dawn Landry
NH Department of Health and Human Services
129 Pleasant Street
Concord, NH 03301-3857

Public Hearings

The State will host two public hearings during the public comment period.

  • September 14, 2017
    1:00 - 2:30
    Manchester Health Department
    1528 Elm St
    Manchester, NH 03010
  • September 21, 2017
    11:00 – 12:30
    New Hampshire Department of Health and Human Services
    Brown Auditorium
    129 Pleasant St,
    Concord, NH 03301

Waiver and Expenditure Authorities
Existing waiver and expenditure authorities will be not modified.

 

On March 27, 2014, Governor Maggie Hassan signed into law Senate Bill 413, an Act relative to health insurance coverage (the “Act”), (2014 NH Laws Chap. 3) establishing the New Hampshire Health Protection Program to expand health coverage in New Hampshire for adults with incomes up to 133% of the Federal Poverty Level. The New Hampshire Health Protection Program includes several components: (1) a mandatory Health Insurance Premium Payment Program (HIPP) for individuals with access to cost-effective employer-sponsored insurance; (2) a bridge program to cover the new adult group in Medicaid managed care plans through December 31, 2015; and (3) a mandatory individual qualified health plan (QHP) premium assistance program beginning on January 1, 2016. The New Hampshire Department of Health and Human Services, as the single state Medicaid agency, seeks Section 1115 Waiver authority from the Centers for Medicare and Medicaid Services to implement the third part of the new law, the mandatory QHP premium assistance program.

Under the Demonstration, the State will implement a mandatory premium assistance program (“Premium Assistance Program” or “Program”) through which the State will purchase QHPs that have been certified for sale in the individual market on the federally facilitated New Hampshire Health Insurance Marketplace for the new adult group. The Demonstration intends to use private market insurance to ensure consistent access to coverage, rationalize provider reimbursement, and enhance integration and efficiency of public and private coverage in New Hampshire. Ultimately, the Demonstration will provide truly integrated coverage for low-income New Hampshire residents regardless of their income or source of coverage.

This page contains material developed by the Department regarding its application for a Section 1115 Demonstration Waiver. Contents include public notices, draft application documents, and dates, times, and locations for related public hearings. To learn more about Section 1115 Demonstration Waivers, please visit the CMS website.

Premium Assistance Carrier Information

Review of Documents and Submission of Documents
This notice, waiver documents, and information about the New Hampshire Health Protection Program (NHHPP) Premium Assistance Demonstration are available below. To reach all stakeholders, non-electronic copies of all the aforementioned documents are available by contacting the Department of Health and Human Services, Dawn Landry.

 

September 21, 2017
DHHS will hold a third hearing on the proposal to allow for additional public input.

The hearing will be held on Tuesday October 3, 2017 from 6:00-7:30pm at the NH Department of Health and Human Services, Brown Building Auditorium, 129 Pleasant Street, Concord, NH.

The Public notice period has been extended and comments on the waiver amendment are being accepted until midnight on October 3, 2017.

Comments may be submitted by email to NHPremiumAssistanceAmendment@dhhs.nh.gov, or by mail to Dawn Landry, NH Department of Health and Human Services, 129 Pleasant Street, Concord, NH 03301-3857.

August 30, 2017
Notice is hereby given that the New Hampshire Department of Health and Human Services (DHHS) seeks to amend its Section 1115(a) Research and Demonstration Waiver, #11-W-00298/1 entitled, the New Hampshire Health Protection Program (NHHPP) Premium Assistance, with such amendment to be in place by April 30, 2018. View Public Notice Adobe Acrobat Reader Symbol

 

Notice of Amendment to Demonstration Authority

Notice is hereby given that the New Hampshire Department of Health and Human Services (DHHS) seeks to amend its Section 1115(a) Research and Demonstration Waiver, #11-W-100298/1 entitled, the New Hampshire Health Protection Program (NHHPP) Premium Assistance, with such amendment to be effective January 1, 2017.

Summary of Demonstration
Under the NHHPP Premium Assistance demonstration, New Hampshire uses premium assistance to support the purchase of health insurance coverage for beneficiaries eligible under the new adult group provided via certain qualified health plans (QHPs) doing business in the individual market through the Marketplace. The demonstration affects individuals in the new adult group covered under Title XIX of the Social Security Act who are adults from age 19 up to and including age 64 with incomes up to and including 133 percent of the federal poverty level (FPL) who are neither enrolled in (nor eligible for) Medicare or enrolled in the state’s Health Insurance Premium Payment (HIPP) program.

Proposed Amendment
The proposed amendment seeks to effect the following modifications:

  • Modify eligibility to be inclusive and consistent with the federal Temporary Assistance for Needy Families (TANF) Program, 42 U.S.C. section 607 (d), as well as require that newly eligible adults who are unemployed be eligible to receive benefits if the Department of Health and Human Services finds that the individual is engaging in at least 30 hours per week of one or a combination of other clearly outlined activities.
  • Modify eligibility such that a participant cannot be eligible for coverage unless such person verifies his or her United States citizenship by 2 forms of identification and proof of New Hampshire residency by either a New Hampshire driver’s license or a non-driver’s picture identification card.
  • Modify cost-sharing requirements such that newly eligible adults who participate in the demonstration who visit the emergency room for non-emergency purposes shall be required to make a co-payment of $8 for the first visit and $25 for each and every non-emergency visit thereafter.
  • Provide that all veterans who are current New Hampshire residents shall receive medical and medical-related services from any hospital in the state providing services to the newly eligible Medicaid population.
  • Waive comparability in cost-sharing requirements for the medically frail NHHPP participants under managed care and NHHPP participants who are in the Premium Assistance Program demonstration.

WAIVER & EXPENDITURE AUTHORITIES
Existing waiver and expenditure authorities will be not modified. However, the following will be added:

  • Section 1902(a)(17) comparability of cost sharing in order to allow for different co-payments between NHHPP medically frail and the NHHPP PAP demonstration participants.
  • Section 1902(a)(10)(A)(i)(VIII) requirements related to eligibility to add as a condition of eligibility individuals who are veterans may be eligible and those who are unemployed must engage in at least 30 hours per week in one or a combination of the activities defined in 42 U.S.C. Section 607 (d).
  • Sections 1137, 1902(a)(46)(B), 1902(ee), and 1903(x) of the Act which governs verification of citizenship and immigration status.

Opportunity for Public Input

The complete version of the current draft of the Demonstration application is available for public review at www.dhhs.nh.gov/pap-1115-waiver/. Public comments may be submitted until midnight on August 1, 2016. Comments may be submitted by email to deborah.fournier@dhhs.nh.gov or by regular mail to Department of Health and Human Services, 129 Pleasant Street, Concord, NH 03301-3857. Comments should be addressed to Deborah Fournier, Deputy Medicaid Director.

Draft Waiver Amendment for Premium Assistance Demonstration Adobe Acrobat Reader Symbol

REVIEW OF DOCUMENTS & SUBMISSION OF DOCUMENTS
This notice, waiver documents, and information about the New Hampshire Health Protection Program (NHHPP) Premium Assistance Demonstration are available at: www.dhhs.nh.gov/pap-1115-waiver/. To reach all stakeholders, non-electronic copies of all the aforementioned documents are available by contacting the Department of Health and Human Services, Deborah Fournier, Deputy Medicaid Director at 603-271-9434.

The State will host one public hearing during the public comment period.

Tuesday, July 12 , 2016
1:00PM-3:00 PM
New Hampshire Department of Health and Human Services
Brown Auditorium
129 Pleasant St,
Concord, NH 03301

NH Premium Assistance Waiver Amendment Request

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New Hampshire Department of Health and Human Services
129 Pleasant Street | Concord, NH | 03301-3852


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