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2019 New Hampshire Revised Statutes
Title XII - Public Safety and Welfare
Chapter 167 - Public Assistance to Blind, Aged, or Disabled Persons, and to Dependent Children
Section 167:3-k - Medicaid to Schools For Medical Services Program.
Universal Citation: NH Rev Stat § 167:3-k (2019)
167:3-k Medicaid to Schools For Medical Services Program. –
I. There is established within the department of health and human services a Medicaid reimbursement program to be known as the "Medicaid to schools for medical services" program providing medical assistance for covered services furnished to children in public schools. The purpose of the program is to seek Medicaid reimbursement for services provided by local school districts and school administrative units to children which are reimbursable under federal law but which would otherwise be fully funded by such districts or administrative units. General fund dollars allocated to the department of health and human services shall not be used for matching the federal financial participation for Medicaid reimbursement. All matching dollars for Medicaid to schools medical services shall come from the local school districts or school administrative units. The program shall be voluntary and administered by the department in the same, or similar, manner as the Medicaid to schools program established in RSA 186-C:25. This section shall not be construed to increase school district responsibility or liability beyond what is required by other state or federal law.
II. Eligible services may be provided to Medicaid-eligible children and may include services defined through rulemaking pursuant to paragraph IV under the following conditions:
(a) The service is a covered Medicaid service, provided in accordance with the approved state plan methodologies, including coverage under the Early and Periodic Screening Diagnostic and Treatment benefit provided to children.
(b) The provider is a Medicaid-participating provider and meets all federal and state provider qualification requirements.
(c) The state plan contains a payment methodology for determining rates that are consistent with efficiency, economy, and quality of care.
(d) Third party liability requirements are met.
(e) Medicaid payment does not duplicate other specific payments for the same service.
(f) The state and provider maintain auditable documentation to support claims for federal financial participation (FFP).
(g) The state conducts appropriate financial oversight of provider billing practices.
(h) All other federal and state program requirements for the service, payment, and associated claiming are met.
III. Services provided under this section shall:
(a) Be provided to children in conformity with any medical criteria necessary for Medicaid reimbursement.
(b) Be provided only after obtaining informed parental consent.
IV. The commissioner of the department of health and human services, after consultation with the commissioner of the department of education, shall adopt rules, pursuant to RSA 541-A, relative to:
(a) Further defining services eligible for Medicaid reimbursement under this section. In defining such services, the commissioner shall, to the extent practicable, seek to maximize the availability of federal financial assistance to local school districts and school administrative units.
(b) State plans and reimbursement procedures necessary for local school districts or school administrative units to receive appropriate Medicaid reimbursement for eligible services under paragraph II that are provided or paid for by school districts or school administrative units.
(c) Monitoring mechanisms to ensure that services provided under this section meet the requirements of paragraph III. Monitoring responsibilities shall be consistent with the jurisdiction of the different departments.
(d) A financial mechanism by which the federal mandatory matching requirement is met through collection, or other means, of 50 percent of the cost of allowable services from local school districts and/or school administrative units.
V. Billing for services in accordance with this section shall not commence until the administrative rulemaking procedure required under paragraph IV is complete and shall be for services provided on or after the effective date of such rules.
VI. New Hampshire local school districts or school administrative units shall be the enrolled Medicaid providers for the purpose of administration and billing.
I. There is established within the department of health and human services a Medicaid reimbursement program to be known as the "Medicaid to schools for medical services" program providing medical assistance for covered services furnished to children in public schools. The purpose of the program is to seek Medicaid reimbursement for services provided by local school districts and school administrative units to children which are reimbursable under federal law but which would otherwise be fully funded by such districts or administrative units. General fund dollars allocated to the department of health and human services shall not be used for matching the federal financial participation for Medicaid reimbursement. All matching dollars for Medicaid to schools medical services shall come from the local school districts or school administrative units. The program shall be voluntary and administered by the department in the same, or similar, manner as the Medicaid to schools program established in RSA 186-C:25. This section shall not be construed to increase school district responsibility or liability beyond what is required by other state or federal law.
II. Eligible services may be provided to Medicaid-eligible children and may include services defined through rulemaking pursuant to paragraph IV under the following conditions:
(a) The service is a covered Medicaid service, provided in accordance with the approved state plan methodologies, including coverage under the Early and Periodic Screening Diagnostic and Treatment benefit provided to children.
(b) The provider is a Medicaid-participating provider and meets all federal and state provider qualification requirements.
(c) The state plan contains a payment methodology for determining rates that are consistent with efficiency, economy, and quality of care.
(d) Third party liability requirements are met.
(e) Medicaid payment does not duplicate other specific payments for the same service.
(f) The state and provider maintain auditable documentation to support claims for federal financial participation (FFP).
(g) The state conducts appropriate financial oversight of provider billing practices.
(h) All other federal and state program requirements for the service, payment, and associated claiming are met.
III. Services provided under this section shall:
(a) Be provided to children in conformity with any medical criteria necessary for Medicaid reimbursement.
(b) Be provided only after obtaining informed parental consent.
IV. The commissioner of the department of health and human services, after consultation with the commissioner of the department of education, shall adopt rules, pursuant to RSA 541-A, relative to:
(a) Further defining services eligible for Medicaid reimbursement under this section. In defining such services, the commissioner shall, to the extent practicable, seek to maximize the availability of federal financial assistance to local school districts and school administrative units.
(b) State plans and reimbursement procedures necessary for local school districts or school administrative units to receive appropriate Medicaid reimbursement for eligible services under paragraph II that are provided or paid for by school districts or school administrative units.
(c) Monitoring mechanisms to ensure that services provided under this section meet the requirements of paragraph III. Monitoring responsibilities shall be consistent with the jurisdiction of the different departments.
(d) A financial mechanism by which the federal mandatory matching requirement is met through collection, or other means, of 50 percent of the cost of allowable services from local school districts and/or school administrative units.
V. Billing for services in accordance with this section shall not commence until the administrative rulemaking procedure required under paragraph IV is complete and shall be for services provided on or after the effective date of such rules.
VI. New Hampshire local school districts or school administrative units shall be the enrolled Medicaid providers for the purpose of administration and billing.
Source. 2017, 187:1, eff. Aug. 28, 2017.
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