Medicaid State Plan Public Notices

Public Notices for Medicaid State Plan Amendments (SPAs)

Some types of changes to the NH Medicaid State Plan require Public Notice. For example, any change to payment methodology must have a Public Notice before its proposed effective date. DHHS publishes its Public Notices on this web page.

 

5/12/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0028 Single Case Agreements

LEGAL NOTICE

NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Notice is hereby given that the New Hampshire (NH) Department of Health and Human Services (the Department) is proposing to amend the Title XIX State Plan to: 1) provide description regarding coverage of single case agreement patient costs for inpatient hospital services, outpatient services, and nursing facility services; and 2) describe rate methodology for qualifying nursing facilities that receive a flat member-based per diem rate for residents with severe mental or neurological disorders who are receiving specialized services for such disorders. The single case agreements for nursing facility services for residents with severe metal or neurological disorders was established via a Disaster Relief State Plan Amendment, effective May 17, 2021; the proposed State Plan Amendment seeks to retain the flat member-based per diem rate for residents with severe mental or neurological disorders once existing contracts expire on May 16, 2022.

Single Case Agreements: inpatient hospital services, outpatient services, and nursing facility services

Effective May 17, 2022, the Department is describing how NH appropriately covers and pays for patient costs of items and services for beneficiaries under single case agreements, as may occur when there is a lack of providers with a specific clinical expertise able to provide necessary services. NH provides coverage of these costs already; the federal and non-federal fiscal impact associated with this proposed State Plan description is unknown. 

Single Case Agreements: nursing facility services for residents with severe mental or neurological disorders

Effective on or after May 17, 2022, the Department proposes to retain the flat member-based per diem rate of $289.12 for an estimated 27 residents with severe mental or neurological disorders once existing contracts expire on or after May 16, 2022. The fiscal impact as a result of the single case agreements for the specialized nursing facility rate is estimated to result in an increase in expenditures for the remainder of federal fiscal year (FFY) 2022 and for FFY 2023 as follows:

Dates of Service Non-Federal Fiscal Impact Federal Fiscal Impact Total Fiscal Impact
Remainder of FFY 2022:
5/17/2022—9/30/2022
$161,794.26 $161,794.26 $323,588.52
FFY 2023:
10/1/2022—9/30/2023
$431,057.70 $431,057.70 $862,115.40

 

Copies of draft State Plan pages will be available by May 12, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@dhhs.nh.gov, to request copies. The amendments to the State Plan pages may undergo further revisions before and after submittal to the Centers for Medicare and Medicaid Services (CMS) based upon public comment or CMS feedback. Comments will be due by May 26, 2022 and should be e-mailed to janine.s.corbett@dhhs.nh.gov or mailed to the Department of Health and Human Services, Division of Medicaid Services, 129 Pleasant Street–Brown Building, Concord, NH 03301-3857, ATTN: Janine Corbett. 

 

4/28/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0018 non-emergency medical transportation (NEMT) reimbursement methodology change  

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Notice is hereby given that the New Hampshire (NH) Department of Health and Human Services (the Department) is proposing to amend the Title XIX State Plan to change the non-emergency medical transportation (NEMT) reimbursement methodology from a per member per month (pmpm) risk capitated rate that includes the cost of transportation and administration to a flat monthly administrative rate and fee for service for direct transportation costs, based on a contract with the new transportation broker that is effective May 1, 2022. 

As a result of this methodology change, it is estimated there will be a decrease in expenditures of $36,765 in federal funds and $31,318 in non-federal funds for the remainder of federal fiscal year (FFY) 2022; it is estimated there will be a decrease in expenditures of $110,296 in federal funds and $93,955 in non-federal funds for FFY 2023.

Copies of draft State Plan pages will be available by May 2, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@dhhs.nh.gov, to request copies. The amendments to the State Plan pages may undergo further revisions before and after submittal to the Centers for Medicare and Medicaid Services (CMS) based upon public comment or CMS feedback. Comments will be due by May 16, 2022 and should be e-mailed to janine.s.corbett@dhhs.nh.gov or mailed to the Department of Health and Human Services, Division of Medicaid Services, 129 Pleasant Street–Brown Building, Concord, NH 03301-3857, ATTN: Janine Corbett. 

 
2/17/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0020 Private Non-Medical Institutions Rate Clarification

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Notice is hereby given that the New Hampshire (NH) Department of Health and Human Services (the Department) is proposing to amend the Title XIX State Plan to clarify the language on Private Non-Medical Institutions (PNMIs).

Effective February 18, 2022, the Department is modifying the language on the State Plan pages for Private NonMedical Institutions (PNMIs; also referred to as residential child care facilities). The modification to the language clarifies the PNMI calculation methodology for both in state and out of state providers of covered services. There is no fiscal impact expected as a result of the language revision. Copies of draft State Plan pages will be available by February 28, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@dhhs.nh.gov, to request copies. The amendments to the State Plan pages may undergo further revisions before and after submittal to the Centers for Medicare and Medicaid Services (CMS) based upon public comment or CMS feedback. Comments will be due by March 14, 2022 and should be e-mailed to janine.s.corbett@dhhs.nh.gov or mailed to the Department of Health and Human Services, Division of Medicaid Services, 129 Pleasant Street–Brown Building, Concord, NH 03301-3857, ATTN: Janine Corbett.

Prior SPA Notices

NH-22-0006: Clinical trial services coverage (posted 12/28/2021)

Public Comment Period for State Plan Amendment (SPA): NH-22-0006 Clinical trial services coverage
 

LEGAL NOTICE

NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Notice is hereby given that the New Hampshire (NH) Department of Health and Human Services (the Department) is proposing to amend the Title XIX State Plan to provide assurance regarding coverage of routine patient costs associated with participation in qualifying clinical trials on or after January 1, 2022. NH intends to submit any necessary State Plan Amendments (SPAs) resulting from the Consolidated Appropriations Act (CAA), 2021, clinical trial requirements to the Centers for Medicare and Medicaid Services (CMS) for review and approval. To the extent that the expected changes are modified as a result of the SPA submission and resulting negotiations with CMS or additional guidance from CMS, NH will update the public notice accordingly.

Effective January 1, 2022, the Department is clarifying that NH appropriately covers and pays for routine patient costs of items and services for beneficiaries enrolled in qualifying clinical trials, as newly required under amendments made by Section 210 of the CAA. NH provides coverage for these costs already—no new items or services are being covered, and no payment methodologies are being changed; therefore, there is no federal or non-federal fiscal impact associated with this proposed State Plan clarification.

CMS is finalizing template SPA pages that are specific to qualifying clinical trials, and as of the date of this public notice, it is unknown when these pages will be available prior to the March 31, 2022 SPA submittal deadline. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@dhhs.nh.gov, to request copies, and they will be provided as soon as they are made available by CMS. The SPA may undergo further revisions before and after submittal to CMS based upon public comment or CMS feedback. Comments will be due on or around March 16, 2022 (if template pages are available prior to that date) and should be e-mailed to janine.s.corbett@dhhs.nh.gov or mailed to the Department of Health and Human Services, Division of Medicaid Services, 129 Pleasant Street–Brown Building, Concord, NH 03301-3857, ATTN: Janine Corbett.

NH-22-0011: Clinical trial services coverage for the Alternative Benefit Plan (posted 12/28/2021)

Public Comment Period for State Plan Amendment (SPA): NH-22-0011 Clinical trial services coverage for the Alternative Benefit Plan

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Notice is hereby given that the New Hampshire (NH) Department of Health and Human Services (the Department) is proposing to amend the Title XIX State Plan to update the Medicaid Alternative Benefit Package (ABP; this is for Medicaid’s expansion group eligibility category, called Granite Advantage) in order to provide assurance regarding coverage of routine patient costs associated with participation in qualifying clinical trials on or after January 1, 2022. NH intends to submit any necessary State Plan Amendments (SPAs) resulting from the Consolidated Appropriations Act (CAA), 2021, clinical trial requirements to the Centers for Medicare and Medicaid Services (CMS) for review and approval. To the extent that the expected changes are modified as a result of the SPA submission and resulting negotiations with CMS or additional guidance from CMS, NH will update the public notice accordingly.

Effective January 1, 2022, the Department is clarifying that NH appropriately covers and pays for routine patient costs of items and services for beneficiaries enrolled in qualifying clinical trials, as newly required under amendments made by Section 210 of the CAA. NH provides coverage for these costs already—no new items or services are being covered, and no payment methodologies are being changed; therefore, there is no federal or non-federal fiscal impact associated with this proposed State Plan clarification.

The State will assure compliance with 42 CFR 440.345 to provide full access to Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services for individuals in the expansion population who are under age 21 as required by law and regulation, and consistent with current state policy regarding the delivery of these services. Any EPSDT services not included in the Medicaid managed care plan benefit package will be provided through the State’s fee-for-service Medicaid program. Other covered services will include medically necessary services as prior authorized, as well as other services required to be covered pursuant to state or federal law, regulation or policy. The State will describe the process to access these benefits in notices sent to all individuals receiving the ABP benefit package.

The State also assures compliance with the provisions of Section 5006 (e) of the American Recovery and Reinvestment Act of 2009 regarding certain protections for American Indian/Alaskan Native (AI/AN) populations. This includes sending notice to individuals who are AI/AN and informing them that they are exempt from co-payments if they are eligible for or have ever received services from an Indian Health Care Provider. Notice shall also include information about the continuing ability to receive care from Indian Health Care providers in or out of state and/or the managed care provider network.

CMS is finalizing template SPA pages that are specific to qualifying clinical trials, and as of the date of this public notice, it is unknown when these pages will be available prior to the March 31, 2022 SPA submittal deadline. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@dhhs.nh.gov, to request copies, and they will be provided as soon as they are made available by CMS. The SPA may undergo further revisions before and after submittal to CMS based upon public comment or CMS feedback. Comments will be due on or around March 16, 2022 (if template pages are available prior to that date) and should be e-mailed to janine.s.corbett@dhhs.nh.gov or mailed to the Department of Health and Human Services, Division of Medicaid Services, 129 Pleasant Street–Brown Building, Concord, NH 03301-3857, ATTN: Janine Corbett.

NH-22-0003: Durable Medical Equipment Changes (posted 12/21/2021)

Public Comment Period for State Plan Amendment (SPA): NH-22-0003 Durable Medical Equipment Changes 

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Notice is hereby given that the New Hampshire (NH) Department of Health and Human Services (the Department) is proposing to amend the Title XIX State Plan to modify the durable medical equipment benefit to: 1) increase the reimbursement rate for non-sterile gloves; and 2) add a new product—Peristeen pumps.

Non-Sterile Gloves—reimbursement rate increase
Effective January 1, 2021, the Department is adjusting the reimbursement rate for non-sterile gloves from $8.51 per box of 100 count to $10.12 per box of 100 count. The federal fiscal impact for this proposed change is estimated to be $1,778 for the remainder of federal fiscal year (FFY) 2022 (January 1 – September 30, 2022) and $2,371 for FFY 2023 (October 1, 2022 – September 30, 2023). The non-federal fiscal impact for this proposed change is estimated to be $1,778 for the remainder of FFY 2022 and $2,371 for FFY 2023.

Peristeen Pumps—new product coverage
Effective January 1, 2021, the Department will provide coverage for a new product, Peristeen pumps. The federal fiscal impact for this proposed change is estimated to be $181,150 for the remainder of FFY 2022 and $241,533 for FFY 2023. The non-federal fiscal impact for this proposed change is estimated to be $181,150 for the remainder of FFY 2022 and $241,533 for FFY 2023.

Copies of draft State Plan pages will be available by February 1, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@dhhs.nh.gov, to request copies. The amendments to the State Plan pages may undergo further revisions before and after submittal to the Centers for Medicare and Medicaid Services (CMS) based upon public comment or CMS feedback. Comments will be due by March 1, 2022 and should be e-mailed to janine.s.corbett@dhhs.nh.gov or mailed to the Department of Health and Human Services, Division of Medicaid Services, 129 Pleasant Street–Brown Building, Concord, NH 03301-3857, ATTN: Janine Corbett.

NH-22-0005: Budget Adjustment Factor (BAF) for January 1, 2022 (posted 12/17/2021)

Public Comment Period for State Plan Amendment (SPA): NH-22-0005 Budget Adjustment Factor (BAF) for January 1, 2022 

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Notice is hereby given that the New Hampshire (NH) Department of Health and Human Services (the Department) is proposing to amend the Title XIX State Plan to modify the nursing home reimbursement methodology by revising the Budget Adjustment Factor (BAF).

Effective July 1, 2021, the Department adjusted the 28.76% budget adjustment factor (BAF) applied to the nursing facility per diem rates to an estimated 25.16%, subject to the 2022-2023 State Budget authorization. The fiscal impact for SFY 2022 as a result of the change in the nursing facility BAF is expected to result in an increase in expenditures of $5,250,000, which is made up of $2,625,000 in non-federal dollars and $2,625,000 in federal dollars.

Effective January 1, 2022, the Department is adjusting the 23.62% BAF applied to the nursing facility per diem rates to an estimated 22.08% due to calculated changes in NF costs and utilization. Fiscal impacts are tied to the 2022-2023 State Budget authorization, which went through public process in July 2021.

Copies of draft State Plan pages will be available by February 1, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@dhhs.nh.gov, to request copies. The amendments to the State Plan pages may undergo further revisions before and after submittal to the Centers for Medicare and Medicaid Services (CMS) based upon public comment or CMS feedback. Comments will be due by March 1, 2022 and should be e-mailed to janine.s.corbett@dhhs.nh.gov or mailed to the Department of Health and Human Services, Division of Medicaid Services, 129 Pleasant Street–Brown Building, Concord, NH 03301-3857, ATTN: Janine Corbett.

NH-21-0054: Newborn Genetic Testing Rate Increase (10/21/2021)

Public Comment Period for State Plan Amendment (SPA): NH-21-0054 Newborn Genetic Testing Rate Increase

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Notice is hereby given that the New Hampshire (NH) Department of Health and Human Services (the Department) is proposing to amend the Title XIX State Plan to include $75 to address the cost of genetic testing for each live birth that occurs in an instate hospital, effective November 20, 2021.

The fiscal impact expected as a result of the change is estimated to be an increase in expenditures of $2,063 for the remainder of Federal Fiscal Year (FFY) 2022, which is made up of $1,031 in federal funds and $1,032 in non-federal funds.

Copies of draft State Plan pages will be available by November 15, 2021. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@dhhs.nh.gov, to request copies. The amendments to the State Plan pages may undergo further revisions before and after submittal to the Centers for Medicare and Medicaid Services (CMS) based upon public comment or CMS feedback. Comments are due by December 6, 2021 and should be e-mailed to janine.s.corbett@dhhs.nh.gov or mailed to the Department of Health and Human Services, Division of Medicaid Services, 129 Pleasant Street–Brown Building, Concord, NH 03301-3857, ATTN: Janine Corbett.

NH-21-0053: Hospice Services Rate Clarification (posted 09/30/2021)

Public Comment Period for State Plan Amendment (SPA): NH-21-0053 Hospice Services Rate Clarification

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Notice is hereby given that the New Hampshire (NH) Department of Health and Human Services (the Department) is proposing to amend the Title XIX State Plan to clarify the language on the Hospice Services page.

Hospice Services: Effective October 1, 2021, the Department is modifying the language of the Hospice Services State Plan Amendment Page. The modification to the language will make clear the rate in effect beginning January 1, 2021, will remain in place until the Medicare rate surpasses it, or, there are further legislative changes regarding Medicaid Rates.

There is no fiscal impact expected as a result of the language revision.

Copies of draft State Plan pages will be available by November 29, 2021. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@dhhs.nh.gov, to request copies. The amendments to the State Plan pages may undergo further revisions before and after submittal to the Centers for Medicare and Medicaid Services (CMS) based upon public comment or CMS feedback. Comments will be due by December 13, 2021 and should be e-mailed to janine.s.corbett@dhhs.nh.gov or mailed to the Department of Health and Human Services, Division of Medicaid Services, 129 Pleasant Street–Brown Building, Concord, NH 03301-3857, ATTN: Janine Corbett.

New Hampshire’s Medicaid State Plan is an agreement between NH and the Federal government describing how NH administers its Medicaid program. When DHHS is planning to make a change to its program policies or operational approach, DHHS sends State Plan Amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. New Hampshire also submits SPAs to request permissible program changes, make corrections, or update the NH Medicaid State Plan with new information.

The CMS Medicaid State Plan Amendment site has a complete searchable listing of NH's recently approved State Plan Amendments.