Medicaid State Plan Public Notice Archive

5/23/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0004 Disproportionate Share Hospital (DSH) Payments

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

State Plan Amendment NH-23-0004: Disproportionate Share Hospital (DSH) Payments

The New Hampshire (NH) Department of Health and Human Services (the Department) makes Disproportionate Share Hospital (DSH) payments to hospitals that do not meet the definition of Critical Access Hospitals (CAHs) that provide essential access to hospital services. Each year the magnitude of these DSH payments is determined and announced via an amendment to the DSH provisions of the NH Medicaid State Plan. The Department proposes to amend its Medicaid State Plan to update the estimated values for state fiscal year 2023 annual funding levels and the interim payment amounts for all private hospital DSH Payments consistent with NH RSA 167:64.

The proposed state plan amendment amends the maximum aggregate payment amount available in state and federal fiscal year 2023 for the payment of qualifying uncompensated care costs to all qualifying disproportionate share hospitals to $214,188,629 consistent with NH RSA 167:64. 

The estimated aggregate fiscal impact of these proposed changes to the NH Medicaid program and its NH Medicaid State Plan in state and federal fiscal year 2023 is an increase of $17,071,770 in DSH payments combined, $9,389,473.00 in federal funds and $7,682,297 in state funds. The Department is seeking an effective date of May 24, 2023, for these proposed changes. 

Copies of the draft state plan pages describing these proposed updates to hospital Supplemental Access Payments and DSH payment amounts are available. Please contact Jody Farewell at (603) 271-9421 or via e-mail at jody.l.farwell@dhhs.nh.gov, to request copies. The amendments to the NH Medicaid 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 on June 6, 2023 and should 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.

5/10/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0022 Self-Directed Personal Assistance Services

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Self-Directed Personal Assistance 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 to include a 1915(j) Self-Directed Personal Assistance Services. This amendment is being submitted with a May 12, 2023, effective date. If approved by the Center for Medicaid Services (CMS) this amendment will allow legally responsible individuals to receive payment for personal assistance services rendered by a legally liable relative provider when the Department makes a reasonable assessment that the caregiver is capable of rendering such services. 

The Department estimates the following fiscal impact as a result of this amendment:

Copies of the draft State Plan pages describing the proposed updates are available. Please contact Dawn I. Tierney via e-mail at Dawn.I.Tierney@dhhs.nh.gov to request copies. The amendments to the NH Medicaid State Plan pages may undergo further revisions before and after submittal to the CMS based upon public comment or CMS feedback. Comments are welcome, and should be e-mailed to Dawn.I.Tierney@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: Dawn Tierney. 

5/4/23 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0018 COVID-19 Vaccines & Vaccine Administration, Testing, and Treatment

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

COVID-19 Vaccines & Vaccine Administration, Testing, and Treatment

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 assure cost sharing compliance for COVID-19 vaccines and administration of the vaccines, testing, and treatment in accordance with the American Rescue Plan Act and sections 1905(a)(4)(E) and 1905(a)(4)(F) of the Social Security Act. The coverage requirements and mandatory cost sharing exemptions begin March 11, 2021 and end on the last day of the first calendar quarter that begins one year after the last day of the emergency period described in section 1135(g)(1)(B) of the Social Security Act (the Act).

The amendment provides the following assurances: 

• Coverage of COVID-19 testing consistent with the Centers for Disease Control and Prevention (CDC) definitions of diagnostic and screening testing for COVID-19 and its recommendations for who should receive diagnostic and screening tests for COVID- 19 is provided to beneficiaries without cost-sharing pursuant to section 1916(a)(2)(I) and 1916A(b)(3)(B)(xiii) of the Act and that reimbursement to qualified providers for such coverage is not reduced by any cost sharing that would otherwise be applicable under the state plan. 
• Coverage for COVID-19 treatment for individuals who are diagnosed with or presumed to have COVID-19 (if otherwise covered under the state plan or waiver of such plan) is provided to beneficiaries without cost sharing, pursuant to section 1916(a)(2)(I) and section 1916A(b)(3)(B)(xiii) of the Act and that reimbursement to qualified providers for such coverage is not reduced by any cost sharing that would otherwise be applicable under the state plan. 
• Coverage of items and services for treatment of a condition that may seriously complicated the treatment of COVID-19 for individuals who are diagnosed with or presumed to have COVID-19 (if otherwise covered under the state plan or waiver of such plan) is provided to beneficiaries without cost sharing, pursuant to section 1916(a)(2)(I) and section 1916A(b)(3)(B)(xiii) of the Act and that reimbursement to qualified providers for such coverage is not reduced by any cost sharing that would otherwise be applicable under the state plan. 

No fiscal impact is anticipated in association of cost sharing compliance. The federal fiscal impact related to adding coverage of COVID-19 vaccines and administration of the vaccines, testing, and treatment is estimated to be $556,043 for FFY 2023 and $1,094,644 FFY 2024. 

Copies of draft State Plan pages are available for review. Please contact Jody Farwell at (603) 271-9343, 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 on the proposed changes are welcomed 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. 

12/30/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0017 Medically Monitored Residential Withdrawal Management Rate Increase

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Medically Monitored Residential Withdrawal Management Rate Increase

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 increase the per diem Medicaid reimbursement rate for medically monitored residential withdrawal management provided in a residential treatment and rehabilitation facility from $350.87 to $577.07, effective January 1, 2023. 

The fiscal impact as a result of this rate increase is estimated to result in an increase in expenditures for federal fiscal year (FFY) 2023 and for FFY 2024 as follows:

Copies of draft State Plan pages will be available by February 15, 2023. Please contact Dawn Tierney at (603) 271-9315, or via e-mail at Dawn.I.Tierney@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 March 1, 2023 and should be e-mailed to Dawn.I.Tierney@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: Dawn Tierney. 

12/30/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0015 Individual Service Option (ISO) Service Rate Increase

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Individual Service Option (ISO) service rate increase

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 increase the Medicaid reimbursement rate for Individual Service Option (ISO) services, effective January 1, 2023.

This proposed rate increase includes continuation of an enhanced rate for intensive ISO foster care, previously authorized during the Public Health Emergency via Disaster Relief State Plan Amendment NH-22-0012, effective September 27, 2021.

The fiscal impact as a result of this rate increase is estimated to result in an increase in expenditures for the remainder of federal fiscal year (FFY) 2023 and for FFY 2024 as follows:

Copies of draft State Plan pages will be available by February 15, 2023. Please contact Dawn Tierney at (603) 271-9315, or via e-mail at Dawn.I.Tierney@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 March 1, 2023 and should be e-mailed to Dawn.I.Tierney@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: Dawn Tierney. 

12/30/22 PUBLIC NOTICE:  State Plan Amendment (SPA):  NH-22-0038 HCBC for High Risk Children with Severe Emotional Disturbance Renewal AMENDED

LEGAL NOTICE – AMENDED (updated following 12/29/22 public notice)
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

1915(i) HCBC for High Risk Children with Severe Emotional Disturbance Renewal 

The New Hampshire (NH) Department of Health and Human Services (the Department) is proposing to amend and renew its Section 1915(i) Title XIX State Plan in order to continue to provide services to children with serious behavioral health issues in order to achieve better outcomes. Children will continue to have available to them an enhanced array of services delivered through a coordinated model of practice and service delivery.  Proposed amendments include: updated language to include the youth 0-4 into the benefit, updated eligibility criteria for youth 0-4, clarifying role title to include NH Wraparound/Enhanced Care Coordination, updates to projected number of youth served, updates to certification requirements for Care Coordinator role, and updates to Peer Support Competencies. Rates for in-home respite care is based on rates paid for these same services; rates for out-of-home respite care is a per diem and are based on previously set departmental and/or grant rates, as well as age related clinical needs; the rate for wraparound facilitation/care coordination is a per diem based on a grant rate and cost data; the rate for family and youth peer support was based on cost data; and payment for customizable goods and services is based on actual cost and limited per recipient per year.

The proposed effective date for the state plan amendment and renewal is July 1, 2023.  Rates will be set as of July 1, 2023, and are effective for services provided on or after July 1, 2023.  

The public notice posted on December 29, 2022 incorrectly stated the fiscal impact.  The fiscal impact as a result of these changes and rate increase is estimated to result in an increase in expenditures for federal fiscal year (FFY) 2023 and for FFY 2024 as follows:

The proposed amendments were presented to our Medical Care Advisory Committee, which is open to the public, on October 7, 2022.  Comments were accepted and could be e-mailed to Daryll.C.Tenney@dhhs.nh.gov or Hannah.MaynardYung@dhhs.nh.gov. 

Copies of draft State Plan pages are available as of December 30, 2022. Please contact Dawn I. Tierney at (603) 271-9315, or via e-mail at Dawn.I.Tierney@dhhs.nh.gov, to request copies. The amendments to the State Plan pages may undergo further revisions after submittal to the Centers for Medicare and Medicaid Services (CMS) based upon CMS feedback. As required by federal requirements, the 1915(i) amendment and renewal request will be submitted to the Centers for Medicare & Medicaid Services (CMS) no later than December 30, 2022.

12/30/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0014 myChoice CDx Laboratory Genetic Test 

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

myChoice CDx Laboratory Genetic Test  (CPT code 0172U)

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 add coverage of the myChoice laboratory genetic test, effective January 1, 2023. This is a laboratory test done on a tumor tissue sample to help match a patient’s tumor to a specific drug or therapy.  

The fiscal impact as a result of this change is estimated to result in an increase in expenditures for FREESTANDING LAB SERVICES as follows:

Additionally the Department is hereby giving notice that clarifying language is being added to the State Plan to describe existing methodology: Quarterly updates to the Healthcare Common Procedure Coding System are incorporated into the fee schedule at 80% of the Medicare rate for Freestanding Laboratory Services and 60% of Medicare rate for Freestanding X-ray Services.

Copies of draft State Plan pages will be available by February 1, 2023. Please contact Sara Lacharite at (603) 271-9279, or via e-mail at Sara.K.Lacharite@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, 2023 and should be e-mailed to Sara.K.Lacharite@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: Sara Lacharite. 

12/29/22 PUBLIC NOTICE:  State Plan Amendment (SPA):  NH-22-0038 HCBC for High Risk Children with Severe Emotional Disturbance Renewal 

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

1915(i) HCBC for High Risk Children with Severe Emotional Disturbance Renewal 

Notice is hereby given that the New Hampshire (NH) Department of Health and Human Services (the Department) is proposing to amend and renew its Section 1915(i) Title XIX State Plan in order to continue to provide services to children with serious behavioral health issues in order to achieve better outcomes. Children will continue to have available to them an enhanced array of services delivered through a coordinated model of practice and service delivery.  Proposed amendments include: updated language to include the youth 0-4 into the benefit, updated eligibility criteria for youth 0-4, clarifying role title to include NH Wraparound/Enhanced Care Coordination, updates to projected number of youth served, updates to certification requirements for Care Coordinator role, and updates to Peer Support Competencies. Rates for in-home respite care is based on rates paid for these same services; rates for out-of-home respite care is a per diem and are based on previously set departmental and/or grant rates, as well as age related clinical needs; the rate for wraparound facilitation/care coordination is a per diem based on a grant rate and cost data; the rate for family and youth peer support was based on cost data; and payment for customizable goods and services is based on actual cost and limited per recipient per year.

The proposed effective date for the state plan amendment and renewal is July 1, 2023.  Rates will be set as of July 1, 2023, and are effective for services provided on or after July 1, 2023.  

The fiscal impact as a result of this rate increase is estimated to result in an increase in expenditures for federal fiscal year (FFY) 2023 and for FFY 2024 as follows:

The proposed amendments were presented to our Medical Care Advisory Committee, which is open to the public, on October 7, 2022.  Comments were accepted and could be e-mailed to Daryll.C.Tenney@dhhs.nh.gov or Hannah.MaynardYung@dhhs.nh.gov. 

Copies of draft State Plan pages are available as of December 30, 2022. Please contact Dawn I. Tierney at (603) 271-9315, or via e-mail at Dawn.I.Tierney@dhhs.nh.gov, to request copies. The amendments to the State Plan pages may undergo further revisions after submittal to the Centers for Medicare and Medicaid Services (CMS) based upon CMS feedback. As required by federal requirements, the 1915(i) amendment and renewal request will be submitted to the Centers for Medicare & Medicaid Services (CMS) no later than December 30, 2022.

12/19/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-23-0003: Swing Bed Methodology Modification and Rate Increase

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Swing Bed Methodology Modification and Rate Increase

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 swing bed methodology and to provide a rate increase.

Effective January 1, 2023, swing bed hospital providers will be reimbursed a prospective rate per patient day. The swing bed rate is determined and approved annually effective the start of the calendar year. The rate is set at 75% of the average budget adjusted Medicaid nursing facility per diem rate effective January 1st of the prior year.

The fiscal impact as a result of this rate increase is estimated to result in an increase in expenditures for federal fiscal year (FFY) 2023 and for FFY 2024 as follows:

Copies of draft State Plan pages will be available by February 1, 2023. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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, 2023 and should be e-mailed to janine.s.corbett@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: Janine Corbett. 

12/19/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0051, Adult Dental Benefit for Those Excluded from the Prepaid Ambulatory Health Plan (PAHP)

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

State Plan Amendment (SPA) NH-22-0051: Adult Dental Benefit for Those Excluded from the Prepaid Ambulatory Health Plan (PAHP)

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 update the Medicaid State Plan (via a State Plan Amendment; SPA) to include coverage of an adult dental benefit for beneficiaries age 21 and older.

Effective April 1, 2023, the Department proposes to provide an adult dental benefit for beneficiaries ages 21 and older in order to provide diagnostic, preventive, limited periodontics, restorative, and oral surgery services. A SPA will be submitted in December 2022 to meet the proposed effective date of April 1, 2023. Payment will be made in accordance with a fee schedule established by the Department. As of April 1, 2023, there will be separate fee schedules for the children’s dental benefit and for the adult dental benefit. Adult dental benefit rates will be set as of April 1, 2023, effective for services provided on or after that date.

The estimated fiscal impact for fee for service (FFS) provision of the adult dental benefit reflects only the costs associated with beneficiaries who are excluded from coverage under the Department’s 1915(b) waiver; this waiver establishes authority to enroll most beneficiaries into a managed care organization that is specifically for the adult dental benefit, called a Prepaid Ambulatory Health Plan (PAHP). Costs associated with beneficiaries who obtain their dental benefit services while enrolled in the PAHP are accounted for separately. The table below shows estimated fiscal impact for the small portion of beneficiaries who may be covered via FFS instead of via the PAHP.

The federal and non-federal fiscal impact associated with the proposed adult dental benefit within FFS is estimated to be as follows:

Additionally, notice is hereby given that the Department is proposing to clarify existing payment methodology for beneficiaries under age 21 for dentures and orthodontia, as provided for under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit:

• Dentures for beneficiaries under age 21
  There is no fiscal impact expected as a result of the clarifying language revision that describes payment made in accordance with a fee schedule established by the Department.
   
• Comprehensive orthodontia under age 21
  There is no fiscal impact expected as a result of the clarifying language revision, necessitated by the American Dental Association retiring the CDT code for interceptive orthodontics and combining interceptive and limited orthodontics into one code titled “Limited Orthodontics.”

Copies of draft State Plan pages are available. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 30, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett. 

12/16/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0053: Cost Sharing for Adult Dental Benefit

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

State Plan Amendment (SPA) NH-22-0053: Cost Sharing for Adult Dental Benefit

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 effective April 1, 2023 to (a) maintain existing copayments for prescription drugs and (b) add copayment for the Adult Dental benefit for Medicaid recipients with income greater than 100 percent of the federal poverty level (FPL).  

These changes are being made in accordance with Chapters 285 and 319, Laws of 2022, requiring the Department to implement a comprehensive adult dental benefit by April 1, 2023.  This legislation requires the Department to include copayment of 10 percent per visit for restorative, oral surgery, and limited periodontic services. Medicaid recipients’ total cost sharing may not exceed 5 percent of the family income on a quarterly basis. The anticipated fiscal impact will result in federal and non-federal (state) savings, as estimated below:

Recipients who are identified by the Medicaid agency as having met their quarterly cap will be updated in the state eligibility system as no longer copay eligible for the remainder of the quarter and this update will be reflected in the eligibility files sent to managed care organization. This update will also generate a letter to the beneficiary to notify them that they are no longer copay eligible and specify when their copay eligibility will restart.

Medicaid providers are not permitted to require Medicaid recipients to pay copayments as a condition for receiving items or services.  However, the consequences for a recipient who does not pay the copayment is that the provider (a) may request the copayment each time a recipient needs an item or service; (b) may ask a recipient for outstanding copayments the next time the recipient comes in for an item or service, or (c) may send the recipient bills.

The Department 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 copayments 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 are available. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 30, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett. 

12/13/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0052: Addition of an Adult Dental Benefit within the Alternative Benefit Plan 

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

State Plan Amendment (SPA) NH-22-0052: Addition of an Adult Dental Benefit within the Alternative Benefit Plan

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 update the Medicaid Alternative Benefit Plan (ABP; this is for Medicaid’s expansion group eligibility category, called Granite Advantage) to include coverage of an adult dental benefit for beneficiaries age 21 and older.

Effective April 1, 2023, the Department proposes to provide an adult dental benefit for beneficiaries ages 21 and older in order to provide diagnostic, preventive, limited periodontics, restorative, and oral surgery services. Provision of the adult dental benefit within the ABP will align with provision of this benefit established via SPA NH-22-0051, for coverage under the Medicaid State Plan, as well as with cost sharing provisions established via SPA 22-0053; these SPAs will be submitted in December 2022 to meet the proposed effective date of April 1, 2023. (New Hampshire’s Medicaid State Plan and its ABP are fully aligned.)

The federal and non-federal fiscal impact associated with the proposed adult dental benefit within the ABP is estimated to be as follows:

This estimated fiscal impact reflects only the costs associated with ABP beneficiaries who are excluded from coverage under the Department’s 1915(b) waiver; this waiver establishes authority to enroll most beneficiaries into a managed care organization that is specifically for the adult dental benefit. Costs associated with beneficiaries who obtain their dental benefit services while enrolled in the dental managed care organization are accounted for separately. The above table shows estimated fiscal impact for the small portion of ABP beneficiaries who may be covered via fee for service (FFS) instead of via the dental managed care organization.

The State will 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 are available. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 27, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett. 

11/09/2022 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0046 State Government Owned Psychiatric Hospital DSH Methodology Clarification

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

State Plan Amendment NH-22-0046: State Government Owned Psychiatric Hospital DSH Methodology Clarification

The New Hampshire (NH) Department of Health and Human Services (the Department) makes Disproportionate Share Hospital (DSH) payments to state government owned psychiatric hospitals that provide essential access to hospital services. The Department proposes to amend its Medicaid State Plan to clarify its description of state government owned psychiatric hospitals that qualify for the DSH payments, and to clarify payment methodology for quarterly interim payment calculation.

The Department is seeking an effective date of November 10, 2022 for these proposed clarifications. 

The modification to the language clarifies the state government owned psychiatric hospital DSH payment methodology. There is no fiscal impact expected as a result of the clarifying language revision. However, Hampstead Hospital became a state government owned psychiatric hospital in June 2022, and the Department estimates the following fiscal impact as a result of the purchase:

Copies of the draft State Plan page describing the proposed updates are available. Please contact Janine Corbett at (603) 271-9421 or via e-mail at janine.s.corbett@dhhs.nh.gov to request copies. The amendments to the NH Medicaid 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 on or before November 28, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett.

09/29/2022 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0050 Breast Pumps and Breast Pump Accessories Rate Increase

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Breast Pumps and Breast Pump Accessories Rate Increase

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 increase the Medicaid reimbursement rate for specific breast pumps and breast pump accessories, effective October 1, 2022.

The fiscal impact as a result of this rate increase is estimated to result in an increase in expenditures for federal fiscal year (FFY) 2023 and for FFY 2024 as follows:

Copies of draft State Plan pages will be available by October 7, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 October 21, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett. 

09/29/2022 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): 22-0007 Disability Determination Unit (DDU) Rate Increase

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Disability Determination Unit (DDU) Rate Increase

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 increase the Medicaid reimbursement rate for comprehensive exams performed by the Disability Determination Unit (DDU), effective October 1, 2022.

The fiscal impact as a result of this rate increase is estimated to result in an increase in expenditures for federal fiscal year (FFY) 2023 and for FFY 2024 as follows:

Copies of draft State Plan pages will be available by October 7, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 October 21, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett. 

9/16/2022 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): MQIP Payments for FFY 2023

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Medicaid Quality Improvement Program (MQIP) Payments for Federal Fiscal Year (FFY) 2023

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 reflect the amount of the quarterly MQIP supplemental pool available for dates of service in FFY 2023. The MQIP payments are to be allocated and paid to eligible licensed nursing facilities. As noted in the State Plan, eligible facilities will receive a calculation exhibit, which identifies each facility's calculated rate and supplemental payment for the applicable quarter. This change is estimated to increase funding for eligible nursing facilities as follows:

Copies of draft State Plan pages will be available by November 1, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 are due by November 15, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett. 

8/22/2022 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0019 Eyeglasses Rate Increase

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Eyeglasses Reimbursement Rate Increase

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 increase the reimbursement rate for eyeglasses.

Effective August 23, 2022, the Department is adjusting the reimbursement rate for eyeglasses based on terms of a new contract. There is no anticipated federal or non-federal fiscal impact for this contracted change for the remainder of federal fiscal year (FFY) 2022 (August 18 – September 30, 2022) nor for FFY 2023 (October 1, 2022 – September 30, 2023) due to increased enrollment in managed care organizations versus fee-for-service.

Copies of the draft State Plan page will be available by August 29, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 September 12, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett. 

6/28/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0042 Hospital-Based Birthing Services Rate Increase  July 1, 2022

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Hospital-based Birthing Services Rate Increase

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 increase the Medicaid reimbursement rate for hospital-based birthing services by 25% in the aggregate, based on the rate in effect on June 30, 2022, pursuant to House Bill 1661, Section 61, signed into law by Governor Sununu on June 24, 2022, and effective July 1, 2022. 

The fiscal impact as a result of this rate increase is estimated to result in an increase in expenditures for the remainder of federal fiscal year (FFY) 2022 and for FFY 2023 as follows:

Copies of draft State Plan pages will be available by August 15, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 August 29, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett.

6/23/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0009 Inpatient Governmental Psychiatric Hospital Services Methodology Change

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Inpatient Governmental Psychiatric Hospital Services Methodology Change

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 clarify the language for inpatient governmental psychiatric hospital services, effective July 1, 2022. A cost to charge ratio will be applied; this amount cannot exceed the Upper Payment Limit.

The fiscal impact as a result of the methodology change for inpatient governmental psychiatric hospital services is estimated to result in an increase in expenditures for the remainder of federal fiscal year (FFY) 2022 and for FFY 2023 as follows:

Copies of draft State Plan pages will be available by September 1, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 September 15, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett. 

06/17/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0040 Budget Adjustment Factor (BAF) for July 1, 2022

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 July 1, 2022, the Department adjusted the 22.08% budget adjustment factor (BAF) applied to the nursing facility per diem rates to an estimated 21.00%, subject to the 2022-2023 State Budget authorization. The fiscal impact for SFY 2023 as a result of the change in the nursing facility BAF is expected to result in an increase in expenditures of $5,250,000, which is made up of $2,625,000 in non-federal dollars and $2,625,000 in federal dollars.

Copies of draft State Plan pages will be available by August 1, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 August 15, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett. 

6/16/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0044 and NH-22-0045 Critical Access Hospital Supplemental Payment, Inpatient (22-0044) and Outpatient (22-0045)

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Critical Access Hospital Supplemental Payment – Inpatient and Outpatient 

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 update Supplemental Hospital Payments. Based on dates of service beginning July 1, 2022, the Department will make annual Supplemental Access Payments to Critical Access Hospitals (CAHs) that provide essential access to hospital services. Each year the magnitude of these supplemental payments is determined and announced via an amendment to the CAH Supplemental Access Payment provisions of the NH Title XIX State Plan. It is anticipated that these Supplemental Access Payments will be paid in May 2023. For state fiscal year 2023, supplemental payments will not exceed the upper payment limit demonstrations, which are estimated to be $23,638,221.

Copies of draft State Plan pages will be available by September 1, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 September 15, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett.

5/31/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0036 Mandatory Coverage of Medication Assisted Treatment (MAT) under the Alternative Benefit Plan 

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Mandatory Medicaid State Plan Coverage of Medication Assisted Treatment (MAT) under the Alternative Benefit Plan

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 update the Medicaid Alternative Benefit Plan (ABP; this is for Medicaid’s expansion group eligibility category, called Granite Advantage) in order to comply with requirements of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) that requires states to provide mandatory Medicaid coverage of certain drugs and biological products and related counseling services and behavioral therapy (referred to as Medication Assisted Treatment, or MAT) for the period beginning October 1, 2020 through September 30, 2025.  

On January 12, 2021 the Department submitted an additional 1135 waiver to request flexibility in meeting the regulatory State Plan Amendment submission and public notice timelines due to NH’s response to the COVID-19 pandemic, which delayed the Department’s ability to submit a State Plan Amendment to fulfill the requirements outlined in section 1006(b) of the SUPPORT Act.

Effective October 1, 2020, the Department is clarifying that NH appropriately covers and pays MAT services, as required under the SUPPORT Act. NH provided coverage for these costs prior to the SUPPORT Act—no new items or services are being covered, and no payment methodologies are being changed; therefore, there is no federal or non-federal fiscal impact associated with this proposed State Plan clarification.

The State will 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 June 3, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 June 17, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett. 

5/24/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0017 Disproportionate Share Hospital (DSH) Payments - AMENDMENT

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

The New Hampshire (NH) Department of Health and Human Services (the Department) makes Disproportionate Share Hospital (DSH) payments to hospitals that do not meet the definition of Critical Access Hospitals (CAHs) that provide essential access to hospital services. Each year the magnitude of these DSH payments is determined and announced via an amendment to the DSH provisions of the NH Medicaid State Plan. The Department proposes to amend its Medicaid State Plan to update the values for state fiscal year 2022 annual funding levels and the payment amounts for all private hospital DSH Payments consistent with NH RSA 167:64.

The proposed State Plan Amendment amends the maximum aggregate payment amount available in state and federal fiscal year 2022 for the payment of qualifying uncompensated care costs to all qualifying disproportionate share hospitals to $197,116,859 consistent with NH RSA 167:64. 

The estimated aggregate fiscal impact of these proposed changes to the NH Medicaid program and its NH Medicaid State Plan in state and federal fiscal year 2022 is an increase of $31,972,463 in DSH payments combined ($17,968,524.20 in federal funds and $14,003,938.80 in state funds). The Department is seeking an effective date of May 25, 2022, for these proposed changes. 

Copies of the draft State Plan pages describing these proposed updates are available. Please contact Janine Corbett at (603) 271-9421 or via e-mail at janine.s.corbett@dhhs.nh.gov, to request copies. The amendments to the NH Medicaid 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 on or before June 9, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett.

5/23/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0017 Disproportionate Share Hospital (DSH) Payments   

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Disproportionate Share Hospital (DSH) Payments

The New Hampshire (NH) Department of Health and Human Services (the Department) makes Disproportionate Share Hospital (DSH) payments to hospitals that do not meet the definition of Critical Access Hospitals (CAHs) that provide essential access to hospital services. Each year the magnitude of these DSH payments is determined and announced via an amendment to the DSH provisions of the NH Medicaid State Plan. The Department proposes to amend its Medicaid State Plan to update the values for state fiscal year 2022 annual funding levels and the payment amounts for all private hospital DSH Payments consistent with NH RSA 167:64.

The proposed State Plan Amendment amends the maximum aggregate payment amount available in state and federal fiscal year 2022 for the payment of qualifying uncompensated care costs to all qualifying disproportionate share hospitals to $196,866,859 consistent with NH RSA 167:64. 

The estimated aggregate fiscal impact of these proposed changes to the NH Medicaid program and its NH Medicaid State Plan in state and federal fiscal year 2022 is an increase of $31,722,463 in DSH payments combined ($17,828,024.20 in federal funds and $13,894,438.80 in state funds).  The Department is seeking an effective date of May 24, 2022, for these proposed changes. 

Copies of draft State Plan pages describing these proposed updates are unavailable. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@dhhs.nh.gov, to request copies. The amendments to the NH Medicaid 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 June 8, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett. 

5/12/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0028 Single Case Agreements

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, outpatient services, and nursing facility services; and 2) describe rate methodology for qualifying nursing facilities that receive a flat member-based per diem rate for residents with severe mental or neurological disorders who are receiving specialized services for such disorders. The single case agreements for nursing facility services for residents with severe metal or neurological disorders was established via a Disaster Relief State Plan Amendment, effective May 17, 2021; the proposed State Plan Amendment seeks to retain the flat member-based per diem rate for residents with severe mental or neurological disorders once existing contracts expire on May 16, 2022.

Single Case Agreements: inpatient hospital services, outpatient services, and nursing facility services

Effective May 17, 2022, the Department is describing how NH appropriately covers and pays for patient costs of items and services for beneficiaries under single case agreements, as may occur when there is a lack of providers with a specific clinical expertise able to provide necessary services. NH provides coverage of these costs already; the federal and non-federal fiscal impact associated with this proposed State Plan description is unknown. 

Single Case Agreements: nursing facility services for residents with severe mental or neurological disorders

Effective on or after May 17, 2022, the Department proposes to retain the flat member-based per diem rate of $289.12 for an estimated 27 residents with severe mental or neurological disorders once existing contracts expire on or after May 16, 2022. The fiscal impact as a result of the single case agreements for the specialized nursing facility rate is estimated to result in an increase in expenditures for the remainder of federal fiscal year (FFY) 2022 and for FFY 2023 as follows:

Copies of draft State Plan pages will be available by May 12, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 May 26, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett. 

4/28/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0018 non-emergency medical transportation (NEMT) reimbursement methodology change  

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN 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 to change the non-emergency medical transportation (NEMT) reimbursement methodology from a per member per month (pmpm) risk capitated rate that includes the cost of transportation and administration to a flat monthly administrative rate and fee for service for direct transportation costs, based on a contract with the new transportation broker that is effective May 1, 2022. 

As a result of this methodology change, it is estimated there will be a decrease in expenditures of $36,765 in federal funds and $31,318 in non-federal funds for the remainder of federal fiscal year (FFY) 2022; it is estimated there will be a decrease in expenditures of $110,296 in federal funds and $93,955 in non-federal funds for FFY 2023.

Copies of draft State Plan pages will be available by May 2, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 May 16, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett. 

2/17/22 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0020 Private Non-Medical Institutions Rate Clarification

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN 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 to clarify the language on Private Non-Medical Institutions (PNMIs).

Effective February 18, 2022, the Department is modifying the language on the State Plan pages for Private NonMedical Institutions (PNMIs; also referred to as residential child care facilities). The modification to the language clarifies the PNMI calculation methodology for both in state and out of state providers of covered services. There is no fiscal impact expected as a result of the language revision. Copies of draft State Plan pages will be available by February 28, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 March 14, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett.

6/30/2022 PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA): NH-22-0043 Ambulance Rate Increase  July 1, 2022 

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Ambulance Services Rate Increase

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 increase the Medicaid reimbursement rate for ambulance services to be equal to 50% of the Medicare rate for ambulance services, based on the rate in effect as of June 30, 2022, pursuant to House Bill 1256, Sections 8 and 9.  These rates would be effective July 1, 2022 contingent upon Governor Sununu signing this legislation into law. 

The fiscal impact as a result of this rate increase is estimated to result in an increase in expenditures for the remainder of federal fiscal year (FFY) 2022 and for FFY 2023 as follows:

Copies of draft State Plan pages will be available by August 1, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 August 15, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett.

Public Comment Period for State Plan Amendment (SPA): NH-22-0006 Clinical trial services coverage
 

LEGAL NOTICE

NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN 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 to provide assurance regarding coverage of routine patient costs associated with participation in qualifying clinical trials on or after January 1, 2022. NH intends to submit any necessary State Plan Amendments (SPAs) resulting from the Consolidated Appropriations Act (CAA), 2021, clinical trial requirements to the Centers for Medicare and Medicaid Services (CMS) for review and approval. To the extent that the expected changes are modified as a result of the SPA submission and resulting negotiations with CMS or additional guidance from CMS, NH will update the public notice accordingly.

Effective January 1, 2022, the Department is clarifying that NH appropriately covers and pays for routine patient costs of items and services for beneficiaries enrolled in qualifying clinical trials, as newly required under amendments made by Section 210 of the CAA. NH provides coverage for these costs already—no new items or services are being covered, and no payment methodologies are being changed; therefore, there is no federal or non-federal fiscal impact associated with this proposed State Plan clarification.

CMS is finalizing template SPA pages that are specific to qualifying clinical trials, and as of the date of this public notice, it is unknown when these pages will be available prior to the March 31, 2022 SPA submittal deadline. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@dhhs.nh.gov, to request copies, and they will be provided as soon as they are made available by CMS. The SPA may undergo further revisions before and after submittal to CMS based upon public comment or CMS feedback. Comments will be due on or around March 16, 2022 (if template pages are available prior to that date) and should be e-mailed to janine.s.corbett@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: Janine Corbett.

Public Comment Period for State Plan Amendment (SPA): NH-22-0011 Clinical trial services coverage for the Alternative Benefit Plan

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN 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 to update the Medicaid Alternative Benefit Package (ABP; this is for Medicaid’s expansion group eligibility category, called Granite Advantage) in order to provide assurance regarding coverage of routine patient costs associated with participation in qualifying clinical trials on or after January 1, 2022. NH intends to submit any necessary State Plan Amendments (SPAs) resulting from the Consolidated Appropriations Act (CAA), 2021, clinical trial requirements to the Centers for Medicare and Medicaid Services (CMS) for review and approval. To the extent that the expected changes are modified as a result of the SPA submission and resulting negotiations with CMS or additional guidance from CMS, NH will update the public notice accordingly.

Effective January 1, 2022, the Department is clarifying that NH appropriately covers and pays for routine patient costs of items and services for beneficiaries enrolled in qualifying clinical trials, as newly required under amendments made by Section 210 of the CAA. NH provides coverage for these costs already—no new items or services are being covered, and no payment methodologies are being changed; therefore, there is no federal or non-federal fiscal impact associated with this proposed State Plan clarification.

The State will 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.

CMS is finalizing template SPA pages that are specific to qualifying clinical trials, and as of the date of this public notice, it is unknown when these pages will be available prior to the March 31, 2022 SPA submittal deadline. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@dhhs.nh.gov, to request copies, and they will be provided as soon as they are made available by CMS. The SPA may undergo further revisions before and after submittal to CMS based upon public comment or CMS feedback. Comments will be due on or around March 16, 2022 (if template pages are available prior to that date) and should be e-mailed to janine.s.corbett@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: Janine Corbett.

Public Comment Period for State Plan Amendment (SPA): NH-22-0003 Durable Medical Equipment Changes 

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN 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 to modify the durable medical equipment benefit to: 1) increase the reimbursement rate for non-sterile gloves; and 2) add a new product—Peristeen pumps.

Non-Sterile Gloves—reimbursement rate increase
Effective January 1, 2021, the Department is adjusting the reimbursement rate for non-sterile gloves from $8.51 per box of 100 count to $10.12 per box of 100 count. The federal fiscal impact for this proposed change is estimated to be $1,778 for the remainder of federal fiscal year (FFY) 2022 (January 1 – September 30, 2022) and $2,371 for FFY 2023 (October 1, 2022 – September 30, 2023). The non-federal fiscal impact for this proposed change is estimated to be $1,778 for the remainder of FFY 2022 and $2,371 for FFY 2023.

Peristeen Pumps—new product coverage
Effective January 1, 2021, the Department will provide coverage for a new product, Peristeen pumps. The federal fiscal impact for this proposed change is estimated to be $181,150 for the remainder of FFY 2022 and $241,533 for FFY 2023. The non-federal fiscal impact for this proposed change is estimated to be $181,150 for the remainder of FFY 2022 and $241,533 for FFY 2023.

Copies of draft State Plan pages will be available by February 1, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 March 1, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett.

Public Comment Period for State Plan Amendment (SPA): NH-22-0005 Budget Adjustment Factor (BAF) for January 1, 2022 

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN 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 to modify the nursing home reimbursement methodology by revising the Budget Adjustment Factor (BAF).

Effective July 1, 2021, the Department adjusted the 28.76% budget adjustment factor (BAF) applied to the nursing facility per diem rates to an estimated 25.16%, subject to the 2022-2023 State Budget authorization. The fiscal impact for SFY 2022 as a result of the change in the nursing facility BAF is expected to result in an increase in expenditures of $5,250,000, which is made up of $2,625,000 in non-federal dollars and $2,625,000 in federal dollars.

Effective January 1, 2022, the Department is adjusting the 23.62% BAF applied to the nursing facility per diem rates to an estimated 22.08% due to calculated changes in NF costs and utilization. Fiscal impacts are tied to the 2022-2023 State Budget authorization, which went through public process in July 2021.

Copies of draft State Plan pages will be available by February 1, 2022. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 March 1, 2022 and should be e-mailed to janine.s.corbett@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: Janine Corbett.

Public Comment Period for State Plan Amendment (SPA): NH-21-0054 Newborn Genetic Testing Rate Increase

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN 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 to include $75 to address the cost of genetic testing for each live birth that occurs in an instate hospital, effective November 20, 2021.

The fiscal impact expected as a result of the change is estimated to be an increase in expenditures of $2,063 for the remainder of Federal Fiscal Year (FFY) 2022, which is made up of $1,031 in federal funds and $1,032 in non-federal funds.

Copies of draft State Plan pages will be available by November 15, 2021. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 are due by December 6, 2021 and should be e-mailed to janine.s.corbett@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: Janine Corbett.

Public Comment Period for State Plan Amendment (SPA): NH-21-0053 Hospice Services Rate Clarification

LEGAL NOTICE
NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN 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 to clarify the language on the Hospice Services page.

Hospice Services: Effective October 1, 2021, the Department is modifying the language of the Hospice Services State Plan Amendment Page. The modification to the language will make clear the rate in effect beginning January 1, 2021, will remain in place until the Medicare rate surpasses it, or, there are further legislative changes regarding Medicaid Rates.

There is no fiscal impact expected as a result of the language revision.

Copies of draft State Plan pages will be available by November 29, 2021. Please contact Janine Corbett at (603) 271-9421, or via e-mail at janine.s.corbett@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 13, 2021 and should be e-mailed to janine.s.corbett@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: Janine Corbett.