SB 414-FN – VERSION ADOPTED BY BOTH BODIES
03/13/14 0842s
30Apr2014… 1512h
2014 SESSION
04/09
SENATE BILL 414-FN
AN ACT relative to Medicaid-funded services provided as a part of a child’s individualized education program.
SPONSORS: Sen. Stiles, Dist 24; Sen. Kelly, Dist 10
COMMITTEE: Health, Education and Human Services
This bill provides that Medicaid-funded individualized education services that are provided outside of a child’s individualized education program shall not be considered duplicative services, as long as the services received both pursuant to and outside of the child’s individualized education program are medically necessary and not inconsistent with federal Medicaid law.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
03/13/14 0842s
30Apr2014… 1512h
14-2854
04/09
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Fourteen
AN ACT relative to Medicaid-funded services provided as a part of a child’s individualized education program.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Subdivision; Medicaid-Funded Services. Amend RSA 186-C by inserting after section 28 the following new subdivision:
186-C:29 Medicaid-Funded Services.
I. Medicaid-funded services that are provided as part of a child’s individualized education program (IEP) shall be provided for the sole purpose of enabling the child to benefit from special education or to receive a free and appropriate public education. If a child receives Medicaid-funded services as part of the child’s special education program and also receives the same or similar medical services outside of his or her special education program, the services that are provided outside of the child’s special education program shall not be considered to be duplicative provided such services are medically necessary and not inconsistent with federal Medicaid law. Medicaid-funded services that are provided as part of a child’s individualized education program shall not be considered to be duplicative services if the child receives the same or similar medical services outside of his or her special education program, provided both services are medically necessary and not inconsistent with federal Medicaid law.
II. Services are considered to be Medicaid-funded if they are funded in full or in part by Medicaid.
III. Medicaid providers, managed care providers, or private providers receiving full or partial payment through Medicaid shall not require a parent to provide a copy of a child’s individualized education program as a prerequisite to determining if a child is eligible for Medicaid-funded services that are not being provided as part of a child’s individualized education program.
IV. Upon request from the state Medicaid agency or its agent, the local education agency shall provide a list of related services specified in the child’s IEP that are eligible for Medicaid reimbursement.
2 Effective Date. This act shall take effect 60 days after its passage.
LBAO
14-2854 Amended 03/17/14
SB 414-FN FISCAL NOTE
AN ACT relative to Medicaid-funded services provided as a part of a child’s individualized education program.
FISCAL IMPACT:
The Department of Health and Human Services and Department of Education state this bill, as amended by the Senate (Amendment #2014-0842s), will have no fiscal impact on state, county, or local revenues and expenditures.
METHODOLOGY:
The Department of Health and Human Services, states this bill seeks to ensure that children obtain medically necessary services by designating medically necessary services provided outside a child’s individualized education program (IEP) as non-duplicative. The Department indicates the bill would have no fiscal impact on the Department because the Medicaid program already covers medically necessary services and the bill restates, but does not alter, current practice.
The Department of Education states it does not have a mechanism to determine whether or not the services are duplicative. The Department indicated requests for Medicaid reimbursement are submitted through a third party vendor to the DHHS and payments are made directly to the local education agency. The Department states the determination is made by the Department of Health and Human Services.