Medicaid State Plan Public Notices
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.
Related Resources
3/14/2024 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): Community-Based Mobile Crisis Intervention Services, effective April 1, 2024
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Community-Based Mobile Crisis Intervention 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, to demonstrate and ensure that community-based mobile crisis intervention services provided to New Hampshire Medicaid beneficiaries support the provisions and meet the statutory requirements of qualifying for the community-based mobile crisis intervention services programs outlined in section 9813 of the American Rescue Plan Act of 2021 (ARPA) (Pub. L. 117-2). The proposed amendment is being submitted with an April 1, 2024, effective date.
Section 9813 of the ARPA amends Title XIX of the Social Security Act (the Act) to add a new section 1947. Section 1947(d) provides the opportunity for an increased Federal Medical Assistance Percentage (FMAP) of 85 percent for 12 fiscal quarters in which the state’s community-based mobile crisis intervention services program complies with the statutory requirements in section 1947(d). This enhanced FMAP is estimated to result in an increase in federal expenditures in the amount of $303,676 for federal fiscal year 2024 and $607,351 in federal fiscal year 2025.
This service is also available to beneficiaries in the Medicaid Alternative Benefit Plan (ABP; is for Medicaid’s Adult Group described in 42 CFR 435.119). The state will update the ABP to 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 April 15, 2024. 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 April 29, 2024, 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.
1/11/24 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): DCYF ISO In-Home Provider, effective January 15, 2024
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
DCYF Individual Service Option (ISO) In-Home Provider
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. The Title XIX State Plan currently specifies the reimbursement methodology for the Division of Children Youth and Families Individual Service Option (ISO) In-Home services on a per diem basis in accordance with a fee schedule established by the Department. Beginning January 15, 2024, an additional provider will be added to the fee schedule with a provider-specific rate.
There is no expected federal or non-federal fiscal impact associated with the addition of this provider due to utilization remaining consistent with current levels.
Copies of draft State Plan pages will be available by February 19, 2024. 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 February 29, 2024, 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.
12/22/2023 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): 24-0024 Rate Increase Budget Adjustment Factor, effective January 1, 2024
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 January 1, 2024, the Department is applying a budget adjustment factor (BAF) of 25% rather than 21.82%, 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 an increase in expenditures of $7,016,969 for the remainder of federal fiscal year 2024.
Copies of draft State Plan pages will be available by February 1, 2024. 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 February 15, 2024 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.
12/22/2023 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): 24-0023 Single Case Agreements, effective January 1, 2024
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 for instances where an enrolled member needs emergency out-of-state care or in circumstances when there is a lack of providers with a specific clinical expertise in New Hampshire able to provide the necessary services; (2) describe rate methodology for non-enrolled out-of-state providers or enrolled providers with clinical expertise that are not able to bill or accept the NH Medicaid rate or rate methodology, effective date January 1, 2024.
The federal and non-federal fiscal impact associated with this proposed State Plan description is unknown.
Copies of draft State Plan pages will be available by December 4, 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 December 14, 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.
12/22/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): Medicaid Service Rate Increases effective January 1, 2024
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Medicaid Service Rate Increases effective January 1, 2024
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 January 1, 2024.
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 $5,561,590.00 for FFY 2024 which is made up of $2,845,146.00 federal funds and $2,716,444.00 in non-federal funds.
The fiscal impact for each of the services are estimated to be as follows:
|
Federal |
Non-Federal |
|
|---|---|---|
|
Targeted Case Management |
$168,189.00 |
$168,188.00 |
|
Adult Medical Day |
$12,114.00 |
$12,113.00 |
|
Home Health |
$7,500.00 |
$7,499 .00 |
|
Community Mental Health Services |
$890,181.00 |
$797,637.00 |
|
Physician Services |
$23,616.00 |
$22,320.00 |
|
Other Licensed Practitioners |
$77,188.00 |
$74,386.00 |
|
Early Support Services |
$1,321,723.00 |
$1,321,723.00 |
|
Private Duty Nursing |
$221,422.00 |
$221,422.00 |
|
Medication Assisted Treatment (MAT) – |
$6,773.00 |
$3,850.00 |
|
SUD Evaluation |
$4,196.00 |
$2,255.00 |
|
SUD Treatment |
$6,595.00 |
$4,836.00 |
|
SUD Crisis |
$53.00 |
$17.00 |
|
SUD Intensive |
$6,743.00 |
$4,373.00 |
|
SUD Partial Hospitalization |
$49,026.00 |
$34,207.00 |
|
Rehabilitative Residential Treatment |
$29,287.00 |
$21,078.00 |
|
Opioid Treatment Provider (OTP) Services |
$20,540.00 |
$20,540.00 |
|
Total Fiscal Impact |
$2,845,146.00 |
$2,716,444 .00 |
Copies of the draft state plan pages describing these proposed reimbursement changes will be available on February 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 February 15, 2024. 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.
9/28/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): Medicaid Service Rate Increases effective October 1, 2023
LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES
Medicaid Service Rate Increases effective October 1, 2023
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 October 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 $5,710,873.50 for FFY 2024 which is made up of $2,927,931.00 federal funds and $2,782,942.50 in non-federal funds.
The fiscal impact for each of the non-institutional services are estimated to be as follows:
| Federal FFY 2024 |
Non-Federal FFY 2024 |
|
|---|---|---|
| Ambulance | $256,082.00 | $176,484.00 |
| Home Health | $187,812.00 | $187,812.00 |
| Personal Care Aids | $182,652.00 | $182,652.00 |
| Freestanding Birthing Centers | $598.00 | $597.00 |
| Midwives | $155.00 | $155.00 |
| Physician Services and Other Licensed Practitioners – OB only | $4,859.00 | $2,429.50.00 |
| Children’s Dental | $2,222,836.00 | $2,196,671.00 |
| FQHC/RHC/LALs | $79,938.00 | $36,142.00 |
| Total Fiscal Impact | $2,927,931.00 | $2,782,942.50 |
Copies of the draft state plan pages describing these proposed reimbursement changes will be available on November 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 November 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.
The CMS Medicaid State Plan Amendment site has a complete searchable listing of NH's recently approved State Plan Amendments.