Medicaid State Plan Public Notice Archive
Public Notices for Medicaid State Plan Amendments (SPAs)
The NH Medicaid State Plan is an agreement between State and Federal governments describing how the State will administer its Medicaid program. As administrator for the Medicaid program in New Hampshire, when DHHS is planning to make a change to its program policy or operational approach, a State Plan Amendments (SPA) is sent to to the Centers for Medicare & Medicaid Services (CMS) for review and approval. Some types of changes to the NH Medicaid State Plan require a Public Notice. For example, any change to payment methodology must have a Public Notice before its proposed effective date. When a Public Notice is required, the notice will be posted to this page.
State Plan Amendments FFY 2024 MQIP
9/15/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendments FFY 2024 MQIP
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Medicaid Quality Improvement Program (MQIP) payments
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 reflect the amount of the quarterly MQIP supplemental pool available for dates of service in FFY 2024. The MQIP payments are to be allocated and paid to eligible licensed nursing facilities. As noted in the State Plan, eligible facilities will receive a calculation exhibit, which identifies each facility's calculated rate and supplemental payment for the applicable quarter. This change is estimated to increase funding for eligible nursing facilities as follows:
| Dates of Service | Payment Quarter | State Fiscal Impact | Federal Fiscal Impact | Total Fiscal Impact |
|---|---|---|---|---|
| 10/2023-12/2023 | Q1 2024 | $10,004,812 | $10,004,811 | $20,009,623 |
| 01/2024-03/2024 | Q2 2024 | $10,077,339 | $10,077,338 | $20,154,677 |
| 04/2024-06/2024 | Q3 2024 | $12,261,553 | $12,261,552 | $24,523,105 |
| 07/2024-09/2024 | Q4 2024 | $10,463,095 | $10,463,094 | $20,926,189 |
| Federal Fiscal Year 2024 | $42,806,797 | $42,806,795 | $85,613,592 | |
Copies of draft State Plan pages will be available by November 1, 2023. Please contact Sara Lacharite via e-mail at Sara.K.Lacharite@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 November 15, 2023 and should be e-mailed to Sara.K.Lacharite@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: Sara Lacharite.
NH 23-0038 Coverage of Donor Breast Milk (06/29/2023)
6/29/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendments (SPA): NH 23-0038 Coverage of Donor Breast Milk
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Coverage of Donor Breast Milk
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 and the Medicaid Alternative Benefit Plan in response to Chapter 79, Laws of 2023, whereby the NH Legislature appropriated funds to cover donor breast milk, effective July 1, 2023.
The Department is proposing to provide reimbursement for donor breast milk provided to an infant if prescribed by a physician, physician assistant, or an advanced practice registered nurse licensed in the state of NH with the following parameters:
(a) The infant is medically or physically unable to receive maternal breast milk or participate in breastfeeding or the infant's mother is medically or physically unable to produce maternal breast milk in quantities sufficient for the infant; and
(b) The infant:
(1) Was born at a birth weight of less than 1,500 grams;
(2) Has a gastrointestinal anomaly or metabolic or digestive disorder or is recovering from intestinal surgery and the infant's digestive needs require additional support;
(3) Is not appropriately gaining weight or growing;
(4) Has formula intolerance and is experiencing weight loss or difficulty feeding;
(5) Has low blood sugar;
(6) Has congenital heart disease;
(7) Has received or will receive an organ transplant; or
(8) Has another medical condition for which donor breast milk is medically necessary.
This proposed change will result in an estimated increase in federal expenditures of $2,500 for federal fiscal year 2023 and an estimated increase in federal expenditures of $10,000 in federal fiscal year 2024.
The State will update the Medicaid Alternative Benefit Plan (ABP; this is for Medicaid’s expansion group eligibility category, called Granite Advantage) 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.
Copies of draft State Plan pages will be available by August 15, 2023. Please contact Jody Farwell at (603) 271-9421, or via e-mail at jody.l.farwell@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 August 29, 2023 and should be e-mailed to jody.l.farwell@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: Jody Farwell.
NH 23-0037 Lactation Services (06/29/2023)
6/29/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendments (SPA): NH 23-0037 Lactation Services
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Lactation 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 and the Alternative Benefit Plan, in response to Chapter 79, Laws of 2023, whereby the NH Legislature appropriated funds to cover lactation services, effective July 1, 2023.
The proposed coverage of lactation support services will include education, counseling, and assistance for common breastfeeding issues.
This proposed change will result in an expected increase in federal expenditures of $3,000 for federal fiscal year 2023 and an estimated increase in federal expenditures of $12,000 in federal fiscal year 2024.
The State will update the Medicaid Alternative Benefit Plan (ABP; this is for Medicaid’s expansion group eligibility category, called Granite Advantage) 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.
Copies of draft State Plan pages will be available by August 15, 2023. Please contact Jody Farwell at (603) 271-9421, or via e-mail at jody.l.farwell@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 August 29, 2023 and should be e-mailed to jody.l.farwell@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: Jody Farwell.
NH 23-0036 Nicotine Cessation Counseling Services (06/29/2023)
6/29/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendments (SPA): NH 23-0036 Nicotine Cessation Counseling Services
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Nicotine Cessation Counseling 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 and the Medicaid Alternative Benefit Plan in response to Chapter 79, Laws of 2023, whereby the NH Legislature appropriated funds to cover nicotine cessation counseling, effective July 1, 2023.
The Department currently provides coverage for tobacco cessation counseling services rendered to pregnant beneficiaries and is proposing to expand this coverage to include nicotine cessation counseling services to all NH Medicaid beneficiaries.
This proposed change will result in an indeterminable expected increase in federal expenditures for federal fiscal year 2023 and federal fiscal year 2024.
The State will update the Medicaid Alternative Benefit Plan (ABP; this is for Medicaid’s expansion group eligibility category, called Granite Advantage) 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.
Copies of draft State Plan pages will be available by August 15, 2023. Please contact Jody Farwell at (603) 271-9421, or via e-mail at jody.l.farwell@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 August 29, 2023 and should be e-mailed to jody.l.farwell@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: Jody Farwell.
Medicaid Service Rate Increases (06/29/2023)
6/29/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendments (SPA): Medicaid Service Rate Increases
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Medicaid Service Rate Increases
Notice is hereby given that the New Hampshire Department of Health and Human Services ("the Department") is proposing to make several amendments to the Title XIX State Plan in response to Chapter 79, Laws of 2023, whereby the NH Legislature appropriated funds for Medicaid service rate increases effective July 1, 2023.
The proposed rate increases outlined below were mandated by the Legislature and will allow Medicaid recipients' continued access to necessary healthcare services as well as provide further incentives for providers to remain in the Medicaid program.
The aggregate fiscal impact to the Medicaid fee for service program as a result of the rate increase to service rates is estimated to be an increase in expenditures of $1,209,041 for the remainder of FFY 2023, which is made up of $629,006 in federal funds and $580,035 in non-federal funds, and $7,305,196 for FFY 2024 which is made up of $2,516,032 federal funds and $2,320,159 in non-federal funds.
The fiscal impact for each of the non-institutional services is estimated to be as follows:
| Federal Impact | Non-Federal Impact | |||
|---|---|---|---|---|
| FFY 2023 | FFY 2024 | FFY 2023 | FFY 2024 | |
| Adult Medical Day | $137 | $ 548 | $137 | $ 548 |
| SUD Services | $7,734 | $30,939 | $4,121 | $16,485 |
| Targeted Case Management | $72,223 | $288,890 | $71,557 | $286,229 |
| Freestanding Birth Centers | $2 | $10 | $2 | $10 |
| DCYF Services | $ 142,060 | $568,240 | $ 139,625 | $558,503 |
| Community Mental Health Center | $98,361 | $393,444 | $90,758 | $363,032 |
| 1915(I) Fast Forward And Supportive Housing | $28,770 | $115,080 | $28,770 | $115,080 |
| Dental | $ 111,806 | $447,224 | $89,291 | $357,166 |
| DME Services | $3 | $13 | $3 | $12 |
| Family-Centered Early Supports and Services | $40,941 | $163,763 | $37,393 | $149,574 |
| Medical Transportation | $3,513 | $14,054 | $3,128 | $12,512 |
| Extended Services To Pregnant Women | $1 | $ 5 | $1 | $ 5 |
| Home Health | $4,035 | $16,139 | $4,018 | $16,074 |
| Lab Services | $439 | $1,758 | $170 | $ 681 |
| Other Licensed Practitioners | $81,555 | $326,222 | $79,585 | $318,340 |
| Private Duty Nursing | $8,782 | $35,129 | $8,746 | $34,986 |
| Personal Care | $2,086 | $8,343 | $2,086 | $8,343 |
| Physician | $10,221 | $40,883 | $4,386 | $17,542 |
| Physical, Speech, and Occupational Therapy | $16,320 | $65,279 | $16,249 | $64,997 |
| X-Ray | $16 | $63 | $8 | $34 |
| RN for Newborns | $1 | $ 6 | $1 | $6 |
| Total Fiscal Impact | $629,006 | $2,516,032 | $580,035 | $2,320,159 |
The aggregate fiscal impact for the rate increase for Specialized Behavioral Long-Term Care Beds is estimated to be an increase in expenditures of $3,165 for the remainder of FFY 2023, which is made up of $1,583 in federal funds and $1,582 in non-federal funds, and $12,658 for FFY 2024 which is made up of $6,329 federal funds and $6,329 in non-federal funds.
Copies of the draft state plan pages describing these proposed reimbursement changes will be available on August 1, 2023. Please contact Jody Farwell at (603) 271-9421, or via e-mail at Jody.L.Farwell@dhhs.nh.gov to request copies once they are available. The draft state plan pages may undergo further revisions before and after submittal to CMS based on public comment or CMS feedback. Comments should be submitted by August 15, 2023. They can be e-mailed to Jody.L.Farwell@dhhs.nh.gov or sent to the Department of Health and Human Services, Division of Medicaid Services, 129 Pleasant Street-Brown Building, Concord, NH 03301-3857, ATTN: Jody Farwell.
NH-23-0035 Budget Adjustment Factor (06/21/2023)
6/21/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0035 Budget Adjustment Factor
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Budget Adjustment Factor
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, 2023, the Department is applying a budget adjustment factor (BAF) of 21.82% rather than 21%, to the nursing facility per diem rate in order to arrive at rates within budget for providing nursing facility services in the Title XIX Program.
The fiscal impact as a result of the change in the nursing facility BAF is expected to result in a decrease in expenditures of $741,751 for the remainder of federal fiscal year 2023, and $2,967,005 for federal fiscal year 2024. The application of the new BAF in conjunction with legislative approved funding effective July 1, 2023, will however result in an increase to nursing facility reimbursement rates.
Copies of draft State Plan pages will be available by August 1, 2023. Please contact Jody Farwell at (603) 271-9421, or via e-mail at jody.l.farwell@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 August 15, 2023 and should be e-mailed to jody.l.farwell@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: Jody Farwell.
NH 23-0006 DME-IME-CAH Payment Suspension (06/21/2023)
6/21/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH 23-0006 DME-IME-CAH Payment Suspension
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Continued suspension of DME, IME, and catastrophic aid payments to hospitals
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 continue the suspension of direct graduate medical education (DME) payments, indirect graduate medical education (IME) payments, and catastrophic aid payments to hospitals for another biennium, as specified in the Department’s biennial budget for SFY 2024 and SFY 2025. Because this is a continued suspension, the fiscal impact is noted as zero.
Copies of draft State Plan pages will be available by August 1, 2023. Please contact Jody Farwell at (603) 271-9421, or via e-mail at jody.l.farwell@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 August 15, 2023 and should be e-mailed to jody.l.farwell@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: Jody Farwell.
NH- 23-0002 Sunset ProShare 1 and ProShare 2 CPE (06/21/2023)
6/21/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH- 23-0002 Sunset ProShare 1 and ProShare 2 CPE
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Sunset of Proportionate Share Incentive Adjustment 1
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 discontinue the Proportionate Share Incentive Adjustment 1 for Hillsborough County Nursing Facility. Beginning July 1, 2023, New Hampshire proposes that all county nursing facilities participate in a certified public expenditure (CPE) method of claiming Proportionate Share Incentive Adjustment 2. Use of a CPE method of claiming Proportionate Share Incentive Adjustment supports access to and viability of county nursing facilities with an equally compliant method.
This proposed change will result in an expected increase in federal expenditures of $1,127 for federal fiscal year 2023 and an estimated increase in federal expenditures of $3,381 in federal fiscal year 2024.
Copies of draft State Plan pages will be available by August 1, 2023. Please contact Jody Farwell at (603) 271-9421, or via e-mail at jody.l.farwell@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 August 15, 2023 and should be e-mailed to jody.l.farwell@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: Jody Farwell.
NH- 23-0033 and 23-0034: Critical Access Hospital Supplemental Payment – Inpatient and Outpatient (06/16/2023)
6/16/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH- 23-0033 and 23-0034: Critical Access Hospital Supplemental Payment – Inpatient and Outpatient
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Critical Access Hospital Supplemental Payment – Inpatient and Outpatient
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 Supplemental Hospital Payments. Based on dates of service beginning July 1, 2023, and dependent upon Federal funding, the Department will make annual Supplemental Access Payments to Critical Access Hospitals (CAHs) that provide essential access to hospital services. Each year the magnitude of these supplemental payments is determined and announced via an amendment to the CAH Supplemental Access Payment provisions of the NH Title XIX State Plan. If Federal funding is available these Supplemental Access Payments will be paid in May 2024.
Copies of draft State Plan pages will be available by September 1, 2023. Please contact Jody Farwell at (603) 271-9421, or via e-mail at jody.l.farwell@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 September 15, 2023, and should be e-mailed to jody.l.farwell@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: Jody Farwell.
NH-23-0032: Elimination of MEAD and MOAD Premiums (06/15/2023)
6/15/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0032: Elimination of MEAD and MOAD Premiums
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Elimination of MEAD and MOAD Premiums
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 eliminate the collection of premiums for Medicaid for Employment Adults with Disabilities (MEAD) and Medicaid for Older Adults with Disabilities (MOAD). This amendment is being submitted with an April 1, 2023 effective date. If approved by the Center for Medicaid Services (CMS), this amendment will allow individuals enrolled in Medicaid through the MEAD and MOAD programs to continue their eligibility without being subject to a monthly premium.
On July 21, 2020, NH Governor Christopher T. Sununu, issued Emergency Order #59, Temporary Modification of Health and Human Services Rules and Statutes Regarding MEAD Premium and Signature Requirements. Emergency Order #59 waived the statutory and administrative rules requiring collection of MEAD premiums effective March 1, 2020 and to resume billing the month following the month the National Public Health Emergency ends.
On March 31, 2021, the Department submitted a Medicaid State Plan amendment (#21-0024) to reflect the establishment and collection of monthly premium payments pursuant to NH RSA 167:6, IX-a, for participants to contribute to the cost of medical assistance provided within an eligibility category known as Medicaid for Employed Older Adults with Disabilities (MOAD). The purpose of the MOAD program, which began on September 1, 2020. On May 21, 2021 the Department received approval of SPA #21-0024 with an effective date of February 1, 2021.
Because SPA #21-0024 imposed a new premium to an already existing eligibility group, this premium would have been a new condition of eligibility for the MOAD category imposed during the public health emergency period and would have violated the maintenance of effort (MOE) requirement in section 6008(b)(1) of the FFCRA, therefore the Department did not implement collection of the MOAD premium as a condition of eligibility.
Chapter Laws 272:21 and 272:22 (Laws of 2022) removed the requirement that the Department charge premiums for medical assistance provided under the MEAD and MOAD categories, effective July 1, 2022, prior to the end of the public health emergency.
As a result of the Governor’s Emergency Order #59, the MOE requirements in section 6008(b)(1) and Chapter Laws 272:21 and 272:22 (Laws of 2022) , the Department did not collect, nor will be collecting premiums as a condition of eligibility for those enrolled in Medicaid under the MEAD and MOAD categories.
The federal fiscal impact of the proposed change to eliminate the collection of premiums as a condition of eligibility for the MEAD program, which is effective April 1, 2023 is estimated to be a decrease in federal expenditures for the remainder of FFY 2023 of $66,000 and for FFY 2024 $132,000.
Copies of draft State Plan pages are available for review. Please contact Jillian Landry at (603) 271-9343, or via e-mail at Jillian.R.Landry@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 on the proposed changes will be accepted through June 29, 2023, and should be emailed to Jillian.R.Landry@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: Jillian Landry.
NH-23-0016: State Government-Owned and Out-of-State Psychiatric Residential Treatment Facility (PRTF) Coverage, Rates, and Rate Methodology (06/07/2023 AMENDED PUBLIC NOTICE (updated following 05/24/2023 public notice))
6/7/23 AMENDED PUBLIC NOTICE (updated following 5/24/23 public notice): Public Comment Period for State Plan Amendment (SPA): NH-23-0016: State Government-Owned and Out-of-State Psychiatric Residential Treatment Facility (PRTF) Coverage, Rates, and Rate Methodology
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
State Plan Amendment NH-23-0016: State Government-Owned and Out-of-State Psychiatric Residential Treatment Facility (PRTF) Coverage, Rates and Rate Methodology
State Government Owned Psychiatric Residential Treatment Facility (PRTF)
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 coverage of and Medicaid reimbursement rate methodology for the State’s first Psychiatric Residential Treatment Facility (PRTF), effective May 30, 2023, following the June 2022 purchase of Hampstead Hospital and Residential Treatment Facility.
The Department estimates the following fiscal impact as a result of the purchase:
| Hampstead Hospital PRTF | Non-Federal Fiscal Impact | Federal Fiscal Impact | Total Fiscal Impact |
|---|---|---|---|
| (portion of) Federal Fiscal Year 2023 5/11/23 – 9/30/23 |
$745,513 | $745,513 | $1,491,026 |
| Federal Fiscal Year 2024 10/1/23 – 9/30/24 |
$2,212,294 | $2,212,294 | $4,424,588 |
Proposed rate: Effective May 30, 2023, the PRTF statewide per diem rate is $1,010.18.
Final rate: Final rates will be based upon audited costs.
Methodology: The PRTF statewide per diem rate is a prospective payment model for 24-hour treatment for services within a PRTF delivered to Medicaid recipients under age 21 (or under age 22 for those receiving services immediately before turning 21, and not exceeding the date the recipient reaches the age of 22). The PRTF per diem payment is for services provided to a PRTF resident, as described in Attachment 4.19-B of the Medicaid State Plan.
Payment of PRTF per diem rates does not include the costs of providing any non-coverable educational services or transitional case management services provided by an entity other than the PRTF to support a transition back to the community. Payment may not be duplicative of services for which payment is included in the PRTF’s per diem rate.
The sources used to develop the PRTF statewide per diem rate include:
- Budget forecasts and financial statements from private providers approved for contracted residential services within New Hampshire;
- Direct service providers’ compensation benchmarking statewide data from the Bureau of Labor Statistics; and
- A projected increase or decrease in the Centers for Medicare and Medicaid Services (CMS) Market Basket index for Inpatient Psychiatric Facilities was calculated for the 24 months between the mid-point of the base period and the midpoint of the rate year.
The PRTF statewide per diem rate is determined to reimburse for the following three categories:
- Child maintenance services, including 24-hour care; room and board; and administrative services;
- Medical and Rehabilitative services to meet the health and rehabilitative needs of a child to address their physical, intellectual, medical, and emotional needs.
- Registered nurse (RN) staffing on-site 24 hours per day, 7 days per week (24/7 coverage).
Provider reimbursement:
The PRTF statewide per diem rate shall be paid in full for costs associated with daily care, administrative services, and room and board.
Medically necessary services not otherwise included in the PRTF rate may be billed directly to Medicaid by providers delivering these services. Payment for necessary services not included in the PRTF statewide per diem rate is based on state-developed fee schedule rates, as applicable. All fee schedules are accessible at www.nhmmis.nh.gov, under the “documents and forms” tab under “documentation,” and apply to all public and private providers.
PRTF statewide per diem payments will be made to a PRTF provider for reserving a bed according to the methodology described in Attachment 4.19-C page 2 of the Medicaid State Plan.
Pursuant to 42 CFR § 431.52, PRTF services shall be provided in an out-of-state setting if medically necessary and if no suitable treatment option is found in New Hampshire. The reimbursement rate for PRTF services in out-of-state facilities will be negotiated between the Department and the facility providing the services.
State government-owned providers:
As calculated, the statewide PRTF per diem rate shall be paid as an interim rate to state government-owned PRTF providers. The reconciliation process of the interim rate shall be based on Medicare-audited costs from the Medicare cost report applied to the Medicaid Fee-for-Service (FFS) population.
Medicaid claim days and payments for FFS days with dates of service in the cost report year are taken from the Medicaid Management Information System (MMIS). The allowable inpatient routine service cost is multiplied by the total MMIS Medicaid claim days divided by the total days, resulting in the total allowable Medicaid FFS costs for the cost report year. The total payments made from the inpatient claims data, and any other payments made towards the applicable Medicaid service, including third-party payments and patient cost sharing, are deducted from the total audited allowable Medicaid FFS costs for the cost report year to identify unreconciled inpatient costs.
Overpayments as a result of a lower audited cost compared to payments received shall be recouped from the provider as a financial transaction in MMIS. Underpayments shall be paid as a financial transaction in MMIS to the provider. Reconciliations of costs are performed within 90 days of the Department’s receipt of the audited Medicare cost report.
Out-of-State PRTFs
Effective May 30, 2023, the Department is clarifying Medicaid State Plan language regarding payment for out-of-state PRTFs. This language addition clarifies the methodology already in place for payment for out-of-state PRTFs.
There is no fiscal impact expected as a result of this language revision.
Inpatient Psychiatric Facilities Services for Individuals Under 21 Years of Age Service Benefit
Effective May 30, 2023, the Department is clarifying Medicaid State Plan language regarding the service benefit category termed ‘Inpatient Psychiatric Facilities Services for Individuals Under 21 Years of Age.’ These services are limited to beneficiaries under the age of 21 or those receiving PRTF services immediately before turning 21, and not exceeding the date the beneficiary turns age 22. The benefit was previously located in Attachment 4.19-B of the Medicaid State Plan, along with other outpatient benefits, but following technical assistance with the CMS, it is being moved to Attachment 4.19-A, which covers inpatient benefits to reflect PRTFs’ provision of inpatient services, including room and board. In addition to the above, non-substantive edits were made to Attachment 4.19-C page 1, Attachment 3.1-A page 7a, and Attachment 3.1-B page 6a of the Medicaid State Plan, updating language to conform to modern terminology.
Copies of the draft State Plan pages describing the proposed updates will be available upon request. Please contact Jody Farwell at (603) 271-9421 or via e-mail to jody.l.farwell@dhhs.nh.gov to request copies. The amendments to the NH Medicaid State Plan pages may undergo further revisions before and after submittal to the CMS based upon public comment or CMS feedback. Comments will be due on or before June 13, 2023, and should be e-mailed to jody.l.farwell@dhhs.nh.gov or sent to the Department of Health and Human Services, Division of Medicaid Services, 129 Pleasant Street- Brown Building, Concord, NH 03301-3857, ATTN: Jody Farwell.
NH-23-0016: State Government-Owned and Out-of-State Psychiatric Residential Treatment Facility (PRTF) Rates and Rate Methodology (05/24/2023)
5/24/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0016: State Government-Owned and Out-of-State Psychiatric Residential Treatment Facility (PRTF) Rates and Rate Methodology
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
State Plan Amendment NH-23-0016: State Government-Owned and Out-of-State Psychiatric Residential Treatment Facility (PRTF) Rates and Rate Methodology
State Government Owned Psychiatric Residential Treatment Facility (PRTF)
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 the Medicaid reimbursement rate methodology for the State’s first Psychiatric Residential Treatment Facility (PRTF), effective May 30, 2023, following the June 2022 purchase of Hampstead Hospital and Residential Treatment Facility.
The Department estimates the following fiscal impact as a result of the purchase:
| Hampstead Hospital PRTF | Non-Federal Fiscal Impact | Federal Fiscal Impact | Total Fiscal Impact |
|---|---|---|---|
| (portion of) Federal Fiscal Year 2023 5/11/23 – 9/30/23 |
$745,513 | $745,513 | $1,491,026 |
| Federal Fiscal Year 2024 10/1/23 – 9/30/24 |
$2,212,294 | $2,212,294 | $4,424,588 |
Proposed rate: Effective May 30, 2023, the PRTF statewide per diem rate is $1,010.18.
Final rate: Final rates will be based upon audited costs.
Methodology: The PRTF statewide per diem rate is a prospective payment model for 24-hour treatment for services within a PRTF delivered to Medicaid recipients under age 21 (or under age 22 for those receiving services immediately before turning 21, and not exceeding the date the recipient reaches the age of 22). The PRTF per diem payment is for services provided to a PRTF resident, as described in Attachment 4.19-B of the Medicaid State Plan.
Payment of PRTF per diem rates does not include the costs of providing any non-coverable educational services or transitional case management services provided by an entity other than the PRTF to support a transition back to the community. Payment may not be duplicative of services for which payment is included in the PRTF’s per diem rate.
The sources used to develop the PRTF statewide per diem rate include:
- Budget forecasts and financial statements from private providers approved for contracted residential services within New Hampshire;
- Direct service providers’ compensation benchmarking statewide data from the Bureau of Labor Statistics; and
- A projected increase or decrease in the Centers for Medicare and Medicaid Services (CMS) Market Basket index for Inpatient Psychiatric Facilities was calculated for the 24 months between the mid-point of the base period and the midpoint of the rate year.
The PRTF statewide per diem rate is determined to reimburse for the following three categories:
- Child maintenance services, including 24-hour care; room and board; and administrative services;
- Medical and Rehabilitative services to meet the health and rehabilitative needs of a child to address their physical, intellectual, medical, and emotional needs.
- Registered nurse (RN) staffing on-site 24 hours per day, 7 days per week (24/7 coverage).
Provider reimbursement
The PRTF statewide per diem rate shall be paid in full for costs associated with daily care, administrative services, and room and board.
Medically necessary services not otherwise included in the PRTF rate may be billed directly to Medicaid by providers delivering these services. Payment for necessary services not included in the PRTF statewide per diem rate is based on state-developed fee schedule rates, as applicable. All fee schedules are accessible at www.nhmmis.nh.gov, under the “documents and forms” tab under “documentation,” and apply to all public and private providers.
PRTF statewide per diem payments will be made to a PRTF provider for reserving a bed according to the methodology described in Attachment 4.19-C page 2 of the Medicaid State Plan.
Pursuant to 42 CFR § 431.52, PRTF services shall be provided in an out-of-state setting if medically necessary and if no suitable treatment option is found in New Hampshire. The reimbursement rate for PRTF services in out-of-state facilities will be negotiated between the Department and the facility providing the services.
State government-owned providers
As calculated, the statewide PRTF per diem rate shall be paid as an interim rate to state government-owned PRTF providers. The reconciliation process of the interim rate shall be based on Medicare-audited costs from the Medicare cost report applied to the Medicaid Fee-for-Service (FFS) population.
Medicaid claim days and payments for FFS days with dates of service in the cost report year are taken from the Medicaid Management Information System (MMIS). The allowable inpatient routine service cost is multiplied by the total MMIS Medicaid claim days divided by the total days, resulting in the total allowable Medicaid FFS costs for the cost report year. The total payments made from the inpatient claims data, and any other payments made towards the applicable Medicaid service, including third-party payments and patient cost sharing, are deducted from the total audited allowable Medicaid FFS costs for the cost report year to identify unreconciled inpatient costs.
Overpayments as a result of a lower audited cost compared to payments received shall be recouped from the provider as a financial transaction in MMIS. Underpayments shall be paid as a financial transaction in MMIS to the provider. Reconciliations of costs are performed within 90 days of the Department’s receipt of the audited Medicare cost report.
Out-of-State PRTFs
Effective May 30, 2023, the Department is clarifying Medicaid State Plan language regarding payment for out-of-state PRTFs. This language addition clarifies the methodology already in place for payment for out-of-state PRTFs.
There is no fiscal impact expected as a result of this language revision.
Inpatient Psychiatric Facilities Services for Individuals Under 21 Years of Age Service Benefit
Effective May 30, 2023, the Department is clarifying Medicaid State Plan language regarding the service benefit category termed ‘Inpatient Psychiatric Facilities Services for Individuals Under 21 Years of Age.’ These services are limited to beneficiaries under the age of 21 or those receiving PRTF services immediately before turning 21, and not exceeding the date the beneficiary turns age 22. The benefit was previously located in Attachment 4.19-B of the Medicaid State Plan, along with other outpatient benefits, but following technical assistance with the CMS, it is being moved to Attachment 4.19-A, which covers inpatient benefits to reflect PRTFs’ provision of inpatient services, including room and board. In addition to the above, non-substantive edits were made to Attachment 4.19-C page 1 of the Medicaid State Plan, updating language to conform to modern terminology.
Copies of the draft State Plan pages describing the proposed updates will be available June 6, 2023. Please contact Jody Farwell at (603) 271-9421 or via e-mail to jody.l.farwell@dhhs.nh.gov to request copies. The amendments to the NH Medicaid State Plan pages may undergo further revisions before and after submittal to the CMS based upon public comment or CMS feedback. Comments will be due on or before June 13, 2023, and should be e-mailed to jody.l.farwell@dhhs.nh.gov or sent to the Department of Health and Human Services, Division of Medicaid Services, 129 Pleasant Street- Brown Building, Concord, NH 03301-3857, ATTN: Jody Farwell.
NH-23-0004 Disproportionate Share Hospital (DSH) Payments (05/23/2023)
5/23/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0004 Disproportionate Share Hospital (DSH) Payments
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
State Plan Amendment NH-23-0004: Disproportionate Share Hospital (DSH) Payments
The New Hampshire (NH) Department of Health and Human Services (the Department) makes Disproportionate Share Hospital (DSH) payments to hospitals that do not meet the definition of Critical Access Hospitals (CAHs) that provide essential access to hospital services. Each year the magnitude of these DSH payments is determined and announced via an amendment to the DSH provisions of the NH Medicaid State Plan. The Department proposes to amend its Medicaid State Plan to update the estimated values for state fiscal year 2023 annual funding levels and the interim payment amounts for all private hospital DSH Payments consistent with NH RSA 167:64.
The proposed state plan amendment amends the maximum aggregate payment amount available in state and federal fiscal year 2023 for the payment of qualifying uncompensated care costs to all qualifying disproportionate share hospitals to $214,188,629 consistent with NH RSA 167:64.
The estimated aggregate fiscal impact of these proposed changes to the NH Medicaid program and its NH Medicaid State Plan in state and federal fiscal year 2023 is an increase of $17,071,770 in DSH payments combined, $9,389,473.00 in federal funds and $7,682,297 in state funds. The Department is seeking an effective date of May 24, 2023, for these proposed changes.
Copies of the draft state plan pages describing these proposed updates to hospital Supplemental Access Payments and DSH payment amounts are available. Please contact Jody Farewell at (603) 271-9421 or via e-mail at jody.l.farwell@dhhs.nh.gov, to request copies. The amendments to the NH Medicaid 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 on June 6, 2023 and should be e-mailed to jody.l.farwell@dhhs.nh.gov or sent to the Department of Health and Human Services, Division of Medicaid Services, 129 Pleasant Street- Brown Building, Concord, NH 03301-3857, ATTN: Jody Farwell.
NH-23-0022 Self-Directed Personal Assistance Services (05/10/2023)
5/10/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0022 Self-Directed Personal Assistance Services
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Self-Directed Personal Assistance 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 a 1915(j) Self-Directed Personal Assistance Services. This amendment is being submitted with a May 12, 2023, effective date. If approved by the Center for Medicaid Services (CMS) this amendment will allow legally responsible individuals to receive payment for personal assistance services rendered by a legally liable relative provider when the Department makes a reasonable assessment that the caregiver is capable of rendering such services.
The Department estimates the following fiscal impact as a result of this amendment:
| Self-directed Personal Assistance Services | Non-Federal Fiscal Impact | Federal Fiscal Impact | Total Fiscal Impact |
|---|---|---|---|
| (portion of) Federal Fiscal Year 2023 5/11/23 – 9/30/23 |
$14,303 | $14,303 | $28,606 |
| Federal Fiscal Year 2024 10/1/23 – 9/30/24 |
$34,328 | $34,328 | $68,656 |
Copies of the draft State Plan pages describing the proposed updates are available. Please contact Dawn I. Tierney via e-mail at Dawn.I.Tierney@dhhs.nh.gov to request copies. The amendments to the NH Medicaid State Plan pages may undergo further revisions before and after submittal to the CMS based upon public comment or CMS feedback. Comments are welcome, and should be e-mailed to Dawn.I.Tierney@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: Dawn Tierney.
NH-23-0018 COVID-19 Vaccines & Vaccine Administration, Testing, and Treatment (05/04/2023)
5/4/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0018 COVID-19 Vaccines & Vaccine Administration, Testing, and Treatment
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
COVID-19 Vaccines & Vaccine Administration, Testing, and Treatment
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 assure cost sharing compliance for COVID-19 vaccines and administration of the vaccines, testing, and treatment in accordance with the American Rescue Plan Act and sections 1905(a)(4)(E) and 1905(a)(4)(F) of the Social Security Act. The coverage requirements and mandatory cost sharing exemptions begin March 11, 2021 and end on the last day of the first calendar quarter that begins one year after the last day of the emergency period described in section 1135(g)(1)(B) of the Social Security Act (the Act).
The amendment provides the following assurances:
- Coverage of COVID-19 testing consistent with the Centers for Disease Control and Prevention (CDC) definitions of diagnostic and screening testing for COVID-19 and its recommendations for who should receive diagnostic and screening tests for COVID- 19 is provided to beneficiaries without cost-sharing pursuant to section 1916(a)(2)(I) and 1916A(b)(3)(B)(xiii) of the Act and that reimbursement to qualified providers for such coverage is not reduced by any cost sharing that would otherwise be applicable under the state plan.
- Coverage for COVID-19 treatment for individuals who are diagnosed with or presumed to have COVID-19 (if otherwise covered under the state plan or waiver of such plan) is provided to beneficiaries without cost sharing, pursuant to section 1916(a)(2)(I) and section 1916A(b)(3)(B)(xiii) of the Act and that reimbursement to qualified providers for such coverage is not reduced by any cost sharing that would otherwise be applicable under the state plan.
- Coverage of items and services for treatment of a condition that may seriously complicated the treatment of COVID-19 for individuals who are diagnosed with or presumed to have COVID-19 (if otherwise covered under the state plan or waiver of such plan) is provided to beneficiaries without cost sharing, pursuant to section 1916(a)(2)(I) and section 1916A(b)(3)(B)(xiii) of the Act and that reimbursement to qualified providers for such coverage is not reduced by any cost sharing that would otherwise be applicable under the state plan.
No fiscal impact is anticipated in association of cost sharing compliance. The federal fiscal impact related to adding coverage of COVID-19 vaccines and administration of the vaccines, testing, and treatment is estimated to be $556,043 for FFY 2023 and $1,094,644 FFY 2024.
Copies of draft State Plan pages are available for review. Please contact Jody Farwell at (603) 271-9343, or via e-mail at jody.l.farwell@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 on the proposed changes are welcomed and should be e-mailed to jody.l.farwell@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: Jody Farwell.
NH-23-0017 Medically Monitored Residential Withdrawal Management Rate Increase (12/30/2022)
12/30/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0017 Medically Monitored Residential Withdrawal Management Rate Increase
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Medically Monitored Residential Withdrawal Management Rate Increase
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 increase the per diem Medicaid reimbursement rate for medically monitored residential withdrawal management provided in a residential treatment and rehabilitation facility from $350.87 to $577.07, effective January 1, 2023.
The fiscal impact as a result of this rate increase is estimated to result in an increase in expenditures for federal fiscal year (FFY) 2023 and for FFY 2024 as follows:
| Dates of Service | Non-Federal Fiscal Impact | Federal Fiscal Impact | Total Fiscal Impact |
|---|---|---|---|
| FFY 2023: 01/01/2023—9/30/2023 |
$13,826 | $23,545 | $37,371 |
| FFY 2024: 10/1/2023—9/30/2024 |
$19,875 | $31,394 | $51,269 |
Copies of draft State Plan pages will be available by February 15, 2023. Please contact Dawn Tierney at (603) 271-9315, or via e-mail at Dawn.I.Tierney@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, 2023 and should be e-mailed to Dawn.I.Tierney@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: Dawn Tierney.
NH-23-0015 Individual Service Option (ISO) Service Rate Increase (12/30/2022)
12/30/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0015 Individual Service Option (ISO) Service Rate Increase
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Individual Service Option (ISO) service rate increase
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 increase the Medicaid reimbursement rate for Individual Service Option (ISO) services, effective January 1, 2023.
This proposed rate increase includes continuation of an enhanced rate for intensive ISO foster care, previously authorized during the Public Health Emergency via Disaster Relief State Plan Amendment NH-22-0012, effective September 27, 2021.
The fiscal impact as a result of this rate increase is estimated to result in an increase in expenditures for the remainder of federal fiscal year (FFY) 2023 and for FFY 2024 as follows:
| Dates of Service | Non-Federal Fiscal Impact | Federal Fiscal Impact | Total Fiscal Impact |
|---|---|---|---|
| FFY 2023: 01/01/2023—9/30/2023 |
$673,344 | $673,590 | $1,346,934 |
| FFY 2024: 10/1/2023—9/30/2024 |
$897,793 | $898,120 | $1,795,913 |
Copies of draft State Plan pages will be available by February 15, 2023. Please contact Dawn Tierney at (603) 271-9315, or via e-mail at Dawn.I.Tierney@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, 2023 and should be e-mailed to Dawn.I.Tierney@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: Dawn Tierney.
NH-22-0038 HCBC for High Risk Children with Severe Emotional Disturbance Renewal AMENDED (12/30/2022)
12/30/22 PUBLIC NOTICE: State Plan Amendment (SPA): NH-22-0038 HCBC for High Risk Children with Severe Emotional Disturbance Renewal AMENDED
LEGAL NOTICE – AMENDED (updated following 12/29/22 public notice)
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
1915(i) HCBC for High Risk Children with Severe Emotional Disturbance Renewal
The New Hampshire (NH) Department of Health and Human Services (the Department) is proposing to amend and renew its Section 1915(i) Title XIX State Plan in order to continue to provide services to children with serious behavioral health issues in order to achieve better outcomes. Children will continue to have available to them an enhanced array of services delivered through a coordinated model of practice and service delivery. Proposed amendments include: updated language to include the youth 0-4 into the benefit, updated eligibility criteria for youth 0-4, clarifying role title to include NH Wraparound/Enhanced Care Coordination, updates to projected number of youth served, updates to certification requirements for Care Coordinator role, and updates to Peer Support Competencies. Rates for in-home respite care is based on rates paid for these same services; rates for out-of-home respite care is a per diem and are based on previously set departmental and/or grant rates, as well as age related clinical needs; the rate for wraparound facilitation/care coordination is a per diem based on a grant rate and cost data; the rate for family and youth peer support was based on cost data; and payment for customizable goods and services is based on actual cost and limited per recipient per year.
The proposed effective date for the state plan amendment and renewal is July 1, 2023. Rates will be set as of July 1, 2023, and are effective for services provided on or after July 1, 2023.
The public notice posted on December 29, 2022 incorrectly stated the fiscal impact. The fiscal impact as a result of these changes and rate increase is estimated to result in an increase in expenditures for federal fiscal year (FFY) 2023 and for FFY 2024 as follows:
| Dates of Service | Non-Federal Fiscal Impact | Federal Fiscal Impact | Total Fiscal Impact |
|---|---|---|---|
| FFY 2023: 07/01/2023—9/30/2023 |
$478,397.48 | $478,397.48 | $956,794.96 |
| FFY 2024: 10/1/2023—9/30/2024 |
$1,913,589.90 | $1,913,589.90 | $3,827,179.80 |
The proposed amendments were presented to our Medical Care Advisory Committee, which is open to the public, on October 7, 2022. Comments were accepted and could be e-mailed to Daryll.C.Tenney@dhhs.nh.gov or Hannah.MaynardYung@dhhs.nh.gov.
Copies of draft State Plan pages are available as of December 30, 2022. Please contact Dawn I. Tierney at (603) 271-9315, or via e-mail at Dawn.I.Tierney@dhhs.nh.gov, to request copies. The amendments to the State Plan pages may undergo further revisions after submittal to the Centers for Medicare and Medicaid Services (CMS) based upon CMS feedback. As required by federal requirements, the 1915(i) amendment and renewal request will be submitted to the Centers for Medicare & Medicaid Services (CMS) no later than December 30, 2022.
NH-23-0014 myChoice CDx Laboratory Genetic Test (12/30/2022)
12/30/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0014 myChoice CDx Laboratory Genetic Test
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
myChoice CDx Laboratory Genetic Test (CPT code 0172U)
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 add coverage of the myChoice laboratory genetic test, effective January 1, 2023. This is a laboratory test done on a tumor tissue sample to help match a patient’s tumor to a specific drug or therapy.
The fiscal impact as a result of this change is estimated to result in an increase in expenditures for FREESTANDING LAB SERVICES as follows:
| Dates of Service | Non-Federal Fiscal Impact | Federal Fiscal Impact | Total Fiscal Impact |
|---|---|---|---|
| FFY 2023: 01/01/2023—9/30/2023 |
$4,545 | $4,545 | $9,090 |
| FFY 2024: 10/1/2023—9/30/2024 |
$6,060 | $6,060 | $12,120 |
Additionally the Department is hereby giving notice that clarifying language is being added to the State Plan to describe existing methodology: Quarterly updates to the Healthcare Common Procedure Coding System are incorporated into the fee schedule at 80% of the Medicare rate for Freestanding Laboratory Services and 60% of Medicare rate for Freestanding X-ray Services.
Copies of draft State Plan pages will be available by February 1, 2023. Please contact Sara Lacharite at (603) 271-9279, or via e-mail at Sara.K.Lacharite@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 February 15, 2023 and should be e-mailed to Sara.K.Lacharite@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: Sara Lacharite.
NH-22-0038 HCBC for High Risk Children with Severe Emotional Disturbance Renewal (12/29/2022)
12/29/22 PUBLIC NOTICE: State Plan Amendment (SPA): NH-22-0038 HCBC for High Risk Children with Severe Emotional Disturbance Renewal
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
1915(i) HCBC for High Risk Children with Severe Emotional Disturbance Renewal
Notice is hereby given that the New Hampshire (NH) Department of Health and Human Services (the Department) is proposing to amend and renew its Section 1915(i) Title XIX State Plan in order to continue to provide services to children with serious behavioral health issues in order to achieve better outcomes. Children will continue to have available to them an enhanced array of services delivered through a coordinated model of practice and service delivery. Proposed amendments include: updated language to include the youth 0-4 into the benefit, updated eligibility criteria for youth 0-4, clarifying role title to include NH Wraparound/Enhanced Care Coordination, updates to projected number of youth served, updates to certification requirements for Care Coordinator role, and updates to Peer Support Competencies. Rates for in-home respite care is based on rates paid for these same services; rates for out-of-home respite care is a per diem and are based on previously set departmental and/or grant rates, as well as age related clinical needs; the rate for wraparound facilitation/care coordination is a per diem based on a grant rate and cost data; the rate for family and youth peer support was based on cost data; and payment for customizable goods and services is based on actual cost and limited per recipient per year.
The proposed effective date for the state plan amendment and renewal is July 1, 2023. Rates will be set as of July 1, 2023, and are effective for services provided on or after July 1, 2023.
The fiscal impact as a result of this rate increase is estimated to result in an increase in expenditures for federal fiscal year (FFY) 2023 and for FFY 2024 as follows:
| Dates of Service | Non-Federal Fiscal Impact | Federal Fiscal Impact | Total Fiscal Impact |
|---|---|---|---|
| FFY 2023: 07/01/2023—9/30/2023 |
$239,198 | $239,198 | $478,397 |
| FFY 2024: 10/1/2023—9/30/2024 |
$956,795 | $956,795 | $1,913,590 |
The proposed amendments were presented to our Medical Care Advisory Committee, which is open to the public, on October 7, 2022. Comments were accepted and could be e-mailed to Daryll.C.Tenney@dhhs.nh.gov or Hannah.MaynardYung@dhhs.nh.gov.
Copies of draft State Plan pages are available as of December 30, 2022. Please contact Dawn I. Tierney at (603) 271-9315, or via e-mail at Dawn.I.Tierney@dhhs.nh.gov, to request copies. The amendments to the State Plan pages may undergo further revisions after submittal to the Centers for Medicare and Medicaid Services (CMS) based upon CMS feedback. As required by federal requirements, the 1915(i) amendment and renewal request will be submitted to the Centers for Medicare & Medicaid Services (CMS) no later than December 30, 2022.
NH-23-0003: Swing Bed Methodology Modification and Rate Increase (12/19/2022)
12/19/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0003: Swing Bed Methodology Modification and Rate Increase
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Swing Bed Methodology Modification and Rate Increase
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 swing bed methodology and to provide a rate increase.
Effective January 1, 2023, swing bed hospital providers will be reimbursed a prospective rate per patient day. The swing bed rate is determined and approved annually effective the start of the calendar year. The rate is set at 75% of the average budget adjusted Medicaid nursing facility per diem rate effective January 1st of the prior year.
The fiscal impact as a result of this rate increase is estimated to result in an increase in expenditures for federal fiscal year (FFY) 2023 and for FFY 2024 as follows:
| Dates of Service | Non-Federal Fiscal Impact | Federal Fiscal Impact | Total Fiscal Impact |
|---|---|---|---|
| (Portion of) FFY 2023: 01/01/2023—9/30/2023 |
$47,051 | $47,051 | $94,102 |
| FFY 2024: 10/1/2023—9/30/2024 |
$62,735 | $62,735 | $125,470 |
Copies of draft State Plan pages will be available by February 1, 2023. 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 February 15, 2023 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-22-0051: Adult Dental Benefit for Those Excluded from the Prepaid Ambulatory Health Plan (PAHP) (12/19/2022)
12/19/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0051, Adult Dental Benefit for Those Excluded from the Prepaid Ambulatory Health Plan (PAHP)
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
State Plan Amendment (SPA) NH-22-0051: Adult Dental Benefit for Those Excluded from the Prepaid Ambulatory Health Plan (PAHP)
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 State Plan (via a State Plan Amendment; SPA) to include coverage of an adult dental benefit for beneficiaries age 21 and older.
Effective April 1, 2023, the Department proposes to provide an adult dental benefit for beneficiaries ages 21 and older in order to provide diagnostic, preventive, limited periodontics, restorative, and oral surgery services. A SPA will be submitted in December 2022 to meet the proposed effective date of April 1, 2023. Payment will be made in accordance with a fee schedule established by the Department. As of April 1, 2023, there will be separate fee schedules for the children’s dental benefit and for the adult dental benefit. Adult dental benefit rates will be set as of April 1, 2023, effective for services provided on or after that date.
The estimated fiscal impact for fee for service (FFS) provision of the adult dental benefit reflects only the costs associated with beneficiaries who are excluded from coverage under the Department’s 1915(b) waiver; this waiver establishes authority to enroll most beneficiaries into a managed care organization that is specifically for the adult dental benefit, called a Prepaid Ambulatory Health Plan (PAHP). Costs associated with beneficiaries who obtain their dental benefit services while enrolled in the PAHP are accounted for separately. The table below shows estimated fiscal impact for the small portion of beneficiaries who may be covered via FFS instead of via the PAHP.
The federal and non-federal fiscal impact associated with the proposed adult dental benefit within FFS is estimated to be as follows:
| Dates of Service | Non-Federal Fiscal Impact | Federal Fiscal Impact | Total Fiscal Impact |
|---|---|---|---|
| Federal Fiscal Year 2023: 04/01/2023—9/30/2023 |
$3,568 | $9,748 | $13,316 |
| Federal Fiscal Year 2024: 10/1/2023—9/30/2024 |
$7,136 | $19,496 | $26,632 |
Additionally, notice is hereby given that the Department is proposing to clarify existing payment methodology for beneficiaries under age 21 for dentures and orthodontia, as provided for under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit:
- Dentures for beneficiaries under age 21
There is no fiscal impact expected as a result of the clarifying language revision that describes payment made in accordance with a fee schedule established by the Department.
- Comprehensive orthodontia under age 21
There is no fiscal impact expected as a result of the clarifying language revision, necessitated by the American Dental Association retiring the CDT code for interceptive orthodontics and combining interceptive and limited orthodontics into one code titled “Limited Orthodontics.”
Copies of draft State Plan pages are available. 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 30, 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-22-0053: Cost Sharing for Adult Dental Benefit (12/16/2022)
12/16/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0053: Cost Sharing for Adult Dental Benefit
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
State Plan Amendment (SPA) NH-22-0053: Cost Sharing for Adult Dental Benefit
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 effective April 1, 2023 to (a) maintain existing copayments for prescription drugs and (b) add copayment for the Adult Dental benefit for Medicaid recipients with income greater than 100 percent of the federal poverty level (FPL).
These changes are being made in accordance with Chapters 285 and 319, Laws of 2022, requiring the Department to implement a comprehensive adult dental benefit by April 1, 2023. This legislation requires the Department to include copayment of 10 percent per visit for restorative, oral surgery, and limited periodontic services. Medicaid recipients’ total cost sharing may not exceed 5 percent of the family income on a quarterly basis. The anticipated fiscal impact will result in federal and non-federal (state) savings, as estimated below:
| Dates of Service | Non-Federal Fiscal Impact | Federal Fiscal Impact | Total Fiscal Impact |
|---|---|---|---|
| Federal Fiscal Year 2023: 04/23/2023—9/30/2023 |
-$21,818 | -$218,176 | -$239,994 |
| Federal Fiscal Year 2024: 10/1/2023—9/30/2024 |
-$43,636 | -$436,352 | -$479,988 |
Recipients who are identified by the Medicaid agency as having met their quarterly cap will be updated in the state eligibility system as no longer copay eligible for the remainder of the quarter and this update will be reflected in the eligibility files sent to managed care organization. This update will also generate a letter to the beneficiary to notify them that they are no longer copay eligible and specify when their copay eligibility will restart.
Medicaid providers are not permitted to require Medicaid recipients to pay copayments as a condition for receiving items or services. However, the consequences for a recipient who does not pay the copayment is that the provider (a) may request the copayment each time a recipient needs an item or service; (b) may ask a recipient for outstanding copayments the next time the recipient comes in for an item or service, or (c) may send the recipient bills.
The Department 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 copayments 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.
Copies of draft State Plan pages are available. 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 30, 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-22-0052: Addition of an Adult Dental Benefit within the Alternative Benefit Plan (12/13/2022)
12/13/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0052: Addition of an Adult Dental Benefit within the Alternative Benefit Plan
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
State Plan Amendment (SPA) NH-22-0052: Addition of an Adult Dental Benefit within the Alternative Benefit Plan
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 Plan (ABP; this is for Medicaid’s expansion group eligibility category, called Granite Advantage) to include coverage of an adult dental benefit for beneficiaries age 21 and older.
Effective April 1, 2023, the Department proposes to provide an adult dental benefit for beneficiaries ages 21 and older in order to provide diagnostic, preventive, limited periodontics, restorative, and oral surgery services. Provision of the adult dental benefit within the ABP will align with provision of this benefit established via SPA NH-22-0051, for coverage under the Medicaid State Plan, as well as with cost sharing provisions established via SPA 22-0053; these SPAs will be submitted in December 2022 to meet the proposed effective date of April 1, 2023. (New Hampshire’s Medicaid State Plan and its ABP are fully aligned.)
The federal and non-federal fiscal impact associated with the proposed adult dental benefit within the ABP is estimated to be as follows:
| Dates of Service | Non-Federal Fiscal Impact (10%) |
Federal Fiscal Impact (90%) |
Total Fiscal Impact |
|---|---|---|---|
| Federal Fiscal Year 2023: 04/01/2023—9/30/2023 |
$772 | $6,953 | $7,725 |
| Federal Fiscal Year 2024: 10/1/2023—9/30/2024 |
$1,545 | $13,905 | $15,450 |
This estimated fiscal impact reflects only the costs associated with ABP beneficiaries who are excluded from coverage under the Department’s 1915(b) waiver; this waiver establishes authority to enroll most beneficiaries into a managed care organization that is specifically for the adult dental benefit. Costs associated with beneficiaries who obtain their dental benefit services while enrolled in the dental managed care organization are accounted for separately. The above table shows estimated fiscal impact for the small portion of ABP beneficiaries who may be covered via fee for service (FFS) instead of via the dental managed care organization.
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.
Copies of draft State Plan pages are available. 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 27, 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-22-0046 State Government Owned Psychiatric Hospital DSH Methodology Clarification (11/09/2022)
11/09/2022 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0046 State Government Owned Psychiatric Hospital DSH Methodology Clarification
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
State Plan Amendment NH-22-0046: State Government Owned Psychiatric Hospital DSH Methodology Clarification
The New Hampshire (NH) Department of Health and Human Services (the Department) makes Disproportionate Share Hospital (DSH) payments to state government owned psychiatric hospitals that provide essential access to hospital services. The Department proposes to amend its Medicaid State Plan to clarify its description of state government owned psychiatric hospitals that qualify for the DSH payments, and to clarify payment methodology for quarterly interim payment calculation.
The Department is seeking an effective date of November 10, 2022 for these proposed clarifications.
The modification to the language clarifies the state government owned psychiatric hospital DSH payment methodology. There is no fiscal impact expected as a result of the clarifying language revision. However, Hampstead Hospital became a state government owned psychiatric hospital in June 2022, and the Department estimates the following fiscal impact as a result of the purchase:
| Dates of Service | Non-Federal Fiscal Impact | Federal Fiscal Impact | Total Fiscal Impact |
|---|---|---|---|
| FFY 2023: 10/1/2022 — 09/30/2023 |
$1,804,883 | $1,804,883 | $3,609,766 |
| FFY 2024: 10/1/2023 — 09/30/2024 |
$1,665,577 | $1,665,577 | $3,331,154 |
Copies of the draft State Plan page describing the proposed updates are available. 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 NH Medicaid 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 on or before November 28, 2022 and should be e-mailed to janine.s.corbett@dhhs.nh.gov or sent 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-22-0050 Breast Pumps and Breast Pump Accessories Rate Increase (09/29/2022)
09/29/2022 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0050 Breast Pumps and Breast Pump Accessories Rate Increase
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Breast Pumps and Breast Pump Accessories Rate Increase
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 increase the Medicaid reimbursement rate for specific breast pumps and breast pump accessories, effective October 1, 2022.
The fiscal impact as a result of this rate increase is estimated to result in an increase in expenditures for federal fiscal year (FFY) 2023 and for FFY 2024 as follows:
| Dates of Service | Non-Federal Fiscal Impact | Federal Fiscal Impact | Total Fiscal Impact |
|---|---|---|---|
| FFY 2023: 10/1/2022—9/30/2023 |
$376.29 | $376.29 | $752.58 |
| FFY 2024: 10/1/2023—09/30/2024 |
$470.36 | $470.36 | $940.72 |
Copies of draft State Plan pages will be available by October 7, 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 October 21, 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-22-0007 Disability Determination Unit (DDU) Rate Increase (09/29/2022)
09/29/2022 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): 22-0007 Disability Determination Unit (DDU) Rate Increase
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Disability Determination Unit (DDU) Rate Increase
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 increase the Medicaid reimbursement rate for comprehensive exams performed by the Disability Determination Unit (DDU), effective October 1, 2022.
The fiscal impact as a result of this rate increase is estimated to result in an increase in expenditures for federal fiscal year (FFY) 2023 and for FFY 2024 as follows:
| Dates of Service | Non-Federal Fiscal Impact | Federal Fiscal Impact | Total Fiscal Impact |
|---|---|---|---|
| FFY 2023: 10/1/2022—9/30/2023 |
$870 | $870 | $1,740 |
| FFY 2024: 10/1/2023—9/30/24 |
$3,479 | $3,479 | $6,958 |
Copies of draft State Plan pages will be available by October 7, 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 October 21, 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.
MQIP Payments for FFY 2023 (09/16/2022)
9/16/2022 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): MQIP Payments for FFY 2023
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Medicaid Quality Improvement Program (MQIP) Payments for Federal Fiscal Year (FFY) 2023
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 reflect the amount of the quarterly MQIP supplemental pool available for dates of service in FFY 2023. The MQIP payments are to be allocated and paid to eligible licensed nursing facilities. As noted in the State Plan, eligible facilities will receive a calculation exhibit, which identifies each facility's calculated rate and supplemental payment for the applicable quarter. This change is estimated to increase funding for eligible nursing facilities as follows:
| Dates of Service | Payment Quarter | State Fiscal Impact | Federal Fiscal Impact | Total Fiscal Impact |
|---|---|---|---|---|
| 10/2022—12/2022 | Q1 2023 | $9,339,688 | $9,339,687 | $18,679,375 |
| 01/2023—03/2023 | Q2 2023 | $10,003,061 | $10,003,061 | $20,006,122 |
| 04/2023—06/2023 | Q3 2023 | $11,936,176 | $11,936,176 | $23,872,352 |
| 07/2023—09/2023 | Q4 2023 | $9,961,998 | $9,961,998 | $19,923,995 |
| Federal Fiscal Year 2023 | $41,420,923 | $41,240,921 | $82,481,844 | |
Copies of draft State Plan pages will be available by November 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 are due by November 15, 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-22-0019 Eyeglasses Rate Increase (8/22/2022)
8/22/2022 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0019 Eyeglasses Rate Increase
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Eyeglasses Reimbursement Rate Increase
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 increase the reimbursement rate for eyeglasses.
Effective August 23, 2022, the Department is adjusting the reimbursement rate for eyeglasses based on terms of a new contract. There is no anticipated federal or non-federal fiscal impact for this contracted change for the remainder of federal fiscal year (FFY) 2022 (August 18 – September 30, 2022) nor for FFY 2023 (October 1, 2022 – September 30, 2023) due to increased enrollment in managed care organizations versus fee-for-service.
Copies of the draft State Plan page will be available by August 29, 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 September 12, 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-22-0042 Hospital-Based Birthing Services Rate Increase July 1, 2022 (06/28/2022)
6/28/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0042 Hospital-Based Birthing Services Rate Increase July 1, 2022
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Hospital-based Birthing Services Rate Increase
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 increase the Medicaid reimbursement rate for hospital-based birthing services by 25% in the aggregate, based on the rate in effect on June 30, 2022, pursuant to House Bill 1661, Section 61, signed into law by Governor Sununu on June 24, 2022, and effective July 1, 2022.
The fiscal impact as a result of this rate increase 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: 7/1/2022—9/30/2022 |
$81,627 | $90,701 | $172,328 |
| FFY 2023: 10/1/2022—9/30/2023 |
$326,508 | $362,805 | $689,313 |
Copies of draft State Plan pages will be available by August 15, 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 August 29, 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-22-0009 Inpatient Governmental Psychiatric Hospital Services Methodology Change (06/23/2022)
6/23/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0009 Inpatient Governmental Psychiatric Hospital Services Methodology Change
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Inpatient Governmental Psychiatric Hospital Services Methodology Change
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 for inpatient governmental psychiatric hospital services, effective July 1, 2022. A cost to charge ratio will be applied; this amount cannot exceed the Upper Payment Limit.
The fiscal impact as a result of the methodology change for inpatient governmental psychiatric hospital services 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: 7/1/2022—9/30/2022 |
$30,676 | $33,419 | $64,095 |
| FFY 2023: 10/1/2022—9/30/2023 |
$122,702 | $133,676 | $256,379 |
Copies of draft State Plan pages will be available by September 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 September 15, 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-22-0040 Budget Adjustment Factor (BAF) for July 1, 2022 (06/17/2022)
06/17/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0040 Budget Adjustment Factor (BAF) for July 1, 2022
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Budget Adjustment Factor
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, 2022, the Department adjusted the 22.08% budget adjustment factor (BAF) applied to the nursing facility per diem rates to an estimated 21.00%, subject to the 2022-2023 State Budget authorization. The fiscal impact for SFY 2023 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.
Copies of draft State Plan pages will be available by August 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 August 15, 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-22-0044 and NH-22-0045 Critical Access Hospital Supplemental Payment, Inpatient (22-0044) and Outpatient (22-0045) (06/16/2022)
6/16/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0044 and NH-22-0045 Critical Access Hospital Supplemental Payment, Inpatient (22-0044) and Outpatient (22-0045)
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Critical Access Hospital Supplemental Payment – Inpatient and Outpatient
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 Supplemental Hospital Payments. Based on dates of service beginning July 1, 2022, the Department will make annual Supplemental Access Payments to Critical Access Hospitals (CAHs) that provide essential access to hospital services. Each year the magnitude of these supplemental payments is determined and announced via an amendment to the CAH Supplemental Access Payment provisions of the NH Title XIX State Plan. It is anticipated that these Supplemental Access Payments will be paid in May 2023. For state fiscal year 2023, supplemental payments will not exceed the upper payment limit demonstrations, which are estimated to be $23,638,221.
Copies of draft State Plan pages will be available by September 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 September 15, 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-22-0036 Mandatory Coverage of Medication Assisted Treatment (MAT) under the Alternative Benefit Plan (05/31/2022)
5/31/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0036 Mandatory Coverage of Medication Assisted Treatment (MAT) under the Alternative Benefit Plan
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Mandatory Medicaid State Plan Coverage of Medication Assisted Treatment (MAT) under the Alternative Benefit Plan
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 Plan (ABP; this is for Medicaid’s expansion group eligibility category, called Granite Advantage) in order to comply with requirements of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) that requires states to provide mandatory Medicaid coverage of certain drugs and biological products and related counseling services and behavioral therapy (referred to as Medication Assisted Treatment, or MAT) for the period beginning October 1, 2020 through September 30, 2025.
On January 12, 2021 the Department submitted an additional 1135 waiver to request flexibility in meeting the regulatory State Plan Amendment submission and public notice timelines due to NH’s response to the COVID-19 pandemic, which delayed the Department’s ability to submit a State Plan Amendment to fulfill the requirements outlined in section 1006(b) of the SUPPORT Act.
Effective October 1, 2020, the Department is clarifying that NH appropriately covers and pays MAT services, as required under the SUPPORT Act. NH provided coverage for these costs prior to the SUPPORT Act—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.
Copies of draft State Plan pages will be available by June 3, 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 June 17, 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-22-0017 Disproportionate Share Hospital (DSH) Payments - AMENDMENT (05/24/2022)
5/24/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0017 Disproportionate Share Hospital (DSH) Payments - AMENDMENT
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
The New Hampshire (NH) Department of Health and Human Services (the Department) makes Disproportionate Share Hospital (DSH) payments to hospitals that do not meet the definition of Critical Access Hospitals (CAHs) that provide essential access to hospital services. Each year the magnitude of these DSH payments is determined and announced via an amendment to the DSH provisions of the NH Medicaid State Plan. The Department proposes to amend its Medicaid State Plan to update the values for state fiscal year 2022 annual funding levels and the payment amounts for all private hospital DSH Payments consistent with NH RSA 167:64.
The proposed State Plan Amendment amends the maximum aggregate payment amount available in state and federal fiscal year 2022 for the payment of qualifying uncompensated care costs to all qualifying disproportionate share hospitals to $197,116,859 consistent with NH RSA 167:64.
The estimated aggregate fiscal impact of these proposed changes to the NH Medicaid program and its NH Medicaid State Plan in state and federal fiscal year 2022 is an increase of $31,972,463 in DSH payments combined ($17,968,524.20 in federal funds and $14,003,938.80 in state funds). The Department is seeking an effective date of May 25, 2022, for these proposed changes.
Copies of the draft State Plan pages describing these proposed updates are available. 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 NH Medicaid 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 on or before June 9, 2022 and should be e-mailed to janine.s.corbett@dhhs.nh.gov or sent 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-22-0017 Disproportionate Share Hospital (DSH) Payments (05/23/2022)
5/23/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0017 Disproportionate Share Hospital (DSH) Payments
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Disproportionate Share Hospital (DSH) Payments
The New Hampshire (NH) Department of Health and Human Services (the Department) makes Disproportionate Share Hospital (DSH) payments to hospitals that do not meet the definition of Critical Access Hospitals (CAHs) that provide essential access to hospital services. Each year the magnitude of these DSH payments is determined and announced via an amendment to the DSH provisions of the NH Medicaid State Plan. The Department proposes to amend its Medicaid State Plan to update the values for state fiscal year 2022 annual funding levels and the payment amounts for all private hospital DSH Payments consistent with NH RSA 167:64.
The proposed State Plan Amendment amends the maximum aggregate payment amount available in state and federal fiscal year 2022 for the payment of qualifying uncompensated care costs to all qualifying disproportionate share hospitals to $196,866,859 consistent with NH RSA 167:64.
The estimated aggregate fiscal impact of these proposed changes to the NH Medicaid program and its NH Medicaid State Plan in state and federal fiscal year 2022 is an increase of $31,722,463 in DSH payments combined ($17,828,024.20 in federal funds and $13,894,438.80 in state funds). The Department is seeking an effective date of May 24, 2022, for these proposed changes.
Copies of draft State Plan pages describing these proposed updates are unavailable. 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 NH Medicaid 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 June 8, 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-22-0028 Single Case Agreements (05/12/2022)
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
Single Case Agreements
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.
NH-22-0018: Non-emergency medical transportation (NEMT) reimbursement methodology change (04/28/2022)
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.
NH-22-0043 Ambulance Rate Increase July 1, 2022 (03/30/2022)
6/30/2022 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0043 Ambulance Rate Increase July 1, 2022
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Ambulance Services Rate Increase
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 increase the Medicaid reimbursement rate for ambulance services to be equal to 50% of the Medicare rate for ambulance services, based on the rate in effect as of June 30, 2022, pursuant to House Bill 1256, Sections 8 and 9. These rates would be effective July 1, 2022 contingent upon Governor Sununu signing this legislation into law.
The fiscal impact as a result of this rate increase 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: 7/1/2022—9/30/2022 |
$136,341 | $148,423 | $284,764 |
| FFY 2023: 10/1/2022—9/30/2023 |
$545,363 | $593,692 | $1,139,055 |
Copies of draft State Plan pages will be available by August 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 August 15, 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-22-0020 Private Non-Medical Institutions Rate Clarification (posted 02/17/2022)
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.
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.