175.03 Inmates Who Become Inpatients in a Medical Facility While Incarcerated SR 14-31, 12/14 (MAM-A)

Once all required documentation is provided, inmates of NH Department of Corrections (DOC) Correctional Facilities are retroactively eligible for *New Hampshire Health Protection Program (NHHPP/NHHPP-M) medical assistance during any period of time the inmate was incarcerated and became an inpatient of a medical facility. See Section 109.09, Application for Retroactive Medical Assistance, for more information.

Once the inmate has been released from the medical institution, the DOC initiates the application for retroactive medical assistance 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.

If an inmate is not retroactively eligible for NHHPP/NHHPP-M, determine retroactive eligibility for Aid to the Permanently and Totally Disabled (APTD), Aid to the Needy Blind (ANB), or Medicaid for Employed Adults with Disabilities (MEAD) medical assistance, requesting additional verification as needed.

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