Revision: Dec. 30, 2019, 8:38 a.m.
HB 1686-FN-LOCAL - AS INTRODUCED
2020 SESSION
20-2614
06/01
HOUSE BILL 1686-FN-LOCAL
AN ACT relative to the Medicaid to schools program.
SPONSORS: Rep. Cordelli, Carr. 4; Rep. Ladd, Graf. 4; Rep. Weyler, Rock. 13; Rep. Marsh, Carr. 8
COMMITTEE: Education
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ANALYSIS
This bill adds medical services to the services eligible for the medicaid to schools program. This bill also requires the commissioner of the department of health and human services to submit an annual report regarding the Medicaid to schools program.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
20-2614
06/01
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty
AN ACT relative to the Medicaid to schools program.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Medicaid to Schools RSA 186-C:25 is repealed and reenacted to read as follows:
186-C:25 Medicaid to Schools Program Established.
I. There is established within the department of health and human services a Medicaid reimbursement program to be known as the "Medicaid to schools" program providing medical assistance for covered services furnished to children with disabilities. The purpose of the program is to seek Medicaid reimbursement for services provided by local school districts and school administrative units to children with disabilities which are reimbursable under federal law but which were previously fully funded by such districts or administrative units. The program shall be voluntary and is designed to assist children with disabilities by maintaining them in their own homes and communities. The program shall be voluntary and administered by the department in the same manner as the Medicaid to schools program established in RSA 167:3-k.
II. Eligible services may be provided to children with disabilities and may include, but shall not be limited to, the following:
(a) Screening, evaluation, and diagnostic services.
(b) Speech pathology and audiology.
(c) Occupational and physical therapy.
(d) Any other service which qualifies as a special education or related service under RSA 186-C or federal law and which also qualifies for reimbursement under Medicaid as a covered service.
III. Services provided under this subdivision shall:
(a) Offer the least restrictive setting for children receiving the services.
(b) Be provided to children in conformity with any medical criteria necessary for Medicaid reimbursement.
(c) Be in addition to any special education program as defined in the New Hampshire Rules for the Education of Children with Disabilities.
(d) Be provided only after obtaining informed parental consent.
(e) Be medical services, excluding classroom instruction and academic tutoring, ordered by a physician, physician assistant, or advanced practice registered nurse (APRN) and specified in the child's written care plan which includes an Individualized Education Program (IEP) or a plan under section 504 of the Rehabilitation Act of 1973, 29 U.S.C. section 701 et seq.
(f) In compliance with rules adopted by the commissioner of the department of health and human services, after consultation with the commissioner of the department of education, pursuant to RSA 167:3-k and RSA 541-A.
2 Medicaid to Schools for Medical Services Program. Amend RSA 167:3-k to read as follows:
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 eligible 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 federal law, 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. he 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] this chapter. 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.
VII. Beginning on September 1, 2018, the commissioner of the department of health and human services shall submit an annual report to the speaker of the house of representatives, the president of the senate, and the chairpersons of the house and senate finance committees regarding the total cost of the Medicaid to schools program, the number of students who received services through the program during the prior school year, the number of students with disabilities who received services as a result of an Individualized Education Program (IEP) during the school year, and propose legislation as needed.
3 Effective Date. This act shall take effect upon its passage.
20-2614
12/20/19
HB 1686-FN-LOCAL- FISCAL NOTE
AS INTRODUCED
AN ACT relative to the Medicaid to schools program.
FISCAL IMPACT:
Due to time constraints, the Office of Legislative Budget Assistant is unable to provide a fiscal note for this bill, as introduced, at this time. When completed, the fiscal note will be forwarded to the House Clerk's Office.