Medicaid State Plan

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 reasons, such as changes to: eligibility, services or limits, provider types, prior authorization and 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 before posting.

The state plan does not contain extensive service details and requirements. This information is obtained through the Department’s rules listed on the State of New Hampshire Administrative Rules website or via the DHHS online eligibility policy manual. If knowledge is needed on pending state plan submissions, please contact us. 

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 Although most state plan pages are replaced with an entirely new and updated page when they are superseded, please note that pages related to eligibility and the Affordable Care Act are an exception to this process. These pages either superseded entire pages or partial pages.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.