Advocates Sought on Medicaid Administrative Rules

The administrative rules that govern Medicaid State Plan Home Health services are set to expire this Fall.  NH DHHS is beginning the process of revising the rules and has requested the Association’s input.  I’m looking for a few volunteers who are willing to review the rules and make recommendations that HCANH can submit to DHHS.

 Here’s what the rules regulate:

  • Definitions for Medicaid home health skilled nursing and home health aide serves
  • Beneficiary eligibility
  • Provider participation
  • Documentation standards
  • List of covered and non-covered services
  • Payments and rate-setting

Here’s what you need to know:

  • These rules apply to “straight Medicaid” currently covered by MCOs  (The MCOs are obligated to follow these rules.)
  • The rules do not apply to Medicaid private duty nursing or Choices for Independence (CFI)
  • At this time, NH DHHS is not addressing changes to the payment and rate-setting portions of the rule because those sections will not expire in the fall.  However, DHHS has pledged to review those sections with HCANH in the next few months.

Please let me know by the end of this week if there is someone from your agency who would be willing to review the rules and then participate in a conference call in the next few weeks.

Link to: HE-W 553 Medicaid Home Health