230.15 Termination of NHHPP/NHHPP-M SR 14-28, 08/14 (MAM-A)

Individuals are eligible for NH Health Protection Program (NHHPP/NHHPP-M) for up to 12 months, at which point the individual must participate in a redetermination of eligibility either online or by completing a paper reapplication.

Termination of NHHPP/NHHPP-M may occur at any time prior to or after that 12 months when the applicant or recipient:

• fails to complete the application or renewal process;

• fails to respond to requests for information or verification within timeframes;

• opens for another category of Medicaid;

• fails or refuses without good cause to provide within 30 days of the NH Health Insurance Premium Payment (HIPP) program’s request:

- the information necessary to determine the availability and cost-effectiveness of enrolling in employer sponsored insurance (ESI), if the individual has access to it either directly as an employee or indirectly through another individual who is eligible for it; or

- the good cause reason for not providing the information;

• fails or refuses to:

- enroll in ESI within 15 days of NH HIPP’s notification to the client that ESI is cost-effective; or

- provide verification of enrollment in ESI;

• disenrolls from ESI after NH HIPP has determined that ESI is cost-effective; or

• fails or refuses to enroll in the Marketplace Premium Assistance Program (PAP), once it becomes available in 2016.

Exception: Medical assistance will not be terminated for a child or a spouse who cannot enroll in ESI due to the household member with access to ESI failing to cooperate with NH HIPP program requirements.

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]