230.13 Verification: NHHPP/NHHPP-M SR 16-03, 09/15 (MAM-A)

NH Health Protection Program (NHHPP/NHHPP-M) uses modified adjusted gross income (MAGI) rules in the eligibility determination process. This means that MAGI rules about verification are also used. See Chapters 300 and 400 for verification rules on such topics as residency, citizenship, SSN, identity, and income.

Additional verification that must be provided by NHHPP/NHHPP-M applicants and recipients, if requested, and within the timeframes noted in the request, might be:

• any information requested by the NH Health Insurance Premium Payment (NH HIPP) program to determine eligibility for or the cost-effectiveness of employer sponsored insurance (ESI), such as, but not limited to:

- NH HIPP applications and renewals;

- proof of name change, if applicable, and other changes in employment or health insurance coverage;

- proof of health insurance information, which may include copies of the front and back of the applicant/recipient’s current insurance card, premium rate sheet, Summary of Benefits, and recent paystubs to show proof of the premium payment; and

- bank information for direct deposit, which may include a voided check;

• Proof that the applicant or recipient has enrolled in employer sponsored insurance (ESI) if NH HIPP has indicated that enrollment in ESI is cost-effective, or good cause for not enrolling.

Unless questionable or problematic, self-attestation is acceptable for the following information: Medicaid Identification number (MID) and the employer’s company name, phone number, Federal Employer Identification Number (FEIN), and address.

References: He-W 511-512, He-W 841.01, He-W 841.08, RSA 126-A:5,XXIII-XXVI, RSA 126-A:5-b, RSA 126-A:67, 42 CFR 435.119, Section 1902(a)(10)(A)(i)(VIII) of the Social Security Act (SSA) [42 USC 1396a(a)(10)(A)(i)(VIII)], Section 1906 of the SSA [42 USC 1396e], Section 1937 of the SSA [42 USC 1396u-7]