175.03 Inmates Who Become Inpatients in a Medical Facility While Incarcerated (MAM)

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Once the NH Department of Corrections (DOC) provides all required documentation of the inmate’s inpatient stay in a medical facility, the inmate is *eligible for *medical assistance during any period of time the inmate became an inpatient of a medical facility while incarcerated, as long as the inmate meets all categorical requirements of the requested medical assistance program.

·         If the inmate’s Medicaid is in suspension status because the inmate has already applied for Medicaid and been found eligible, Medicaid eligibility for the inpatient stay will be confirmed once the DOC has provided DHHS with the documentation verifying the inpatient stay.

·         If the inmate’s Medicaid is not in suspension status because the inmate has not applied for Medicaid, has not responded to DHHS requests, or has not completed renewals of his or her Medicaid case during renewal timeframes while incarcerated, the inmate will be required to reapply for Medicaid*. The DOC may initiate the application for retroactive medical assistance in this circumstance using the automated process in NH EASY or by completing all necessary forms. DHHS determines retroactive eligibility. If the paper process is used, the DOC must send all information, accompanied by DFA Form 786, Inmate Application Cover Sheet, directly to the District Office for DHHS to determine retroactive eligibility. See Section 109.09, Application for Retroactive Medical Assistance, for more information.

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References: He-W 624.01(a)(8); 42 CFR 435.1009; 42 CFR 435.1010