Text to be removed highlighted in red.
376:1 New Paragraph; Commissioner of the Department of Health and Human Services; State Medicaid Plan Amendment Regarding Ambulance Services. Amend RSA 126-A:5 by inserting after paragraph XXXIV the following new paragraph:
XXXV. The commissioner shall submit to the Centers for Medicare and Medicaid Services (CMS) an amendment to the state Medicaid plan to provide reimbursement for ambulance services when care is provided in response to an emergency call to a member's home or on a scene, when an ambulance is dispatched, and treatment is provided to the patient without the patient being transported to another site.
(a) Providers shall be eligible for Medicaid reimbursement when the provider has documented that:
(1) The response originated through an emergency call; and
(2) The patient consents to evaluation and treatment, and one of the following outcomes has occurred:
(A) After the evaluation, and when indicated, treatment, the licensed paramedic or emergency medical technician (EMT) and the patient agree there is no need for transportation by ambulance;
(B) The patient does not request and actively refuses transport to an emergency department for evaluation; or
(C) The patient is stable for referral to the patient's physician, other community resource, and the patient has the ability, including mental capacity and transportation resources, to obtain assistance and medically indicated follow-up.
(b) Providers shall also be eligible for Medicaid reimbursement when the provider has documented that the response originated through an emergency call, resuscitation efforts were terminated, and the patient is deceased.
376:2 Contingency. Section 1 of this act shall take effect on the date the Centers for Medicare and Medicaid Services certifies the approval of the amendment to the state Medicaid plan to the director of legislative services and the secretary of state.
376:3 Appropriation; Department of Health and Human Services. The sum of $500,000 for the biennium ending June 30, 2025 is appropriated to the department of health and human services for the purposes of this act. The department may accept and expend any available matching federal funds without the approval of the fiscal committee of the general court. The governor is authorized to draw a warrant for said sum from any money in the treasury not otherwise appropriated.
376:4 Department of Health and Human Services; Individuals with Developmental Disabilities; Funding for Recreational Services.
I. Recreational activities typically provide an opportunity for individuals with developmental disabilities to participate in their community in preferred settings, where individuals are able to work on skill development to aid health, wellness, socialization, and safety goals. However, the department of health and human services has received clarification from the Centers for Medicare and Medicaid Services that supports and services that are recreational in nature are not reimbursable services under the Medicaid program.
II. In order to ensure that costs to access recreational services are covered, and that individuals with developmental disabilities are able to participate in recreational activities within their communities, the sum of $500,000 is appropriated to the department of health and human services for the biennium ending June 30, 2025. This appropriation is in addition to any other funds appropriated to the department of health and human services. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated. Any unexpended funds shall lapse to the general fund on June 30, 2025.
III. In order to be eligible to receive funds for recreational services under this section, an individual shall have graduated or exited the school system and be receiving services under the 1915(c) developmental disabilities or acquired brain disorder waiver and shall be requesting payment for an activity or service that cannot be covered by the New Hampshire Medicaid state plan or a 1915(c) home and community based waiver.
IV. The department of health and human services shall contract with one or more organizations, such as an area agency as defined in RSA 171-A, to assist in administering these funds. With the approval of the governor, the department may utilize a sole source procurement method to implement recreational services as quickly as possible.
V. Payment for recreational services shall be limited to $600 per individual.
VI. The department of health and human services shall include language in the contracts designated in paragraph IV to prioritize services previously included in individualized budgets.
VII. The department shall issue an interim report to the fiscal committee on or before April 1, 2025. The report shall include data on utilization, including the number of individuals seeking services in accordance with paragraphs I, II and III, the number of individuals provided services, the types of specific services provided, the total cost of the services provided, and other relevant information necessary to enable the legislature to assess the program.
VIII. The department shall issue a final report to the fiscal committee on or before September 30, 2025. The final report shall include all the information listed in paragraph VII.
376:5 Contingency. If SB 554 of the 2024 legislative session becomes law, RSA 126-A:5, XXXV as inserted by section 1 of this act shall be renumbered to read as RSA 126-A:5, XXXVI.
376:6 Effective Date.
I. Section 1 of this act shall take effect as provided in section 2 of this act.
II. The remainder of this act shall take effect upon its passage.
Approved: August 23, 2024
Effective Date:
I. Section 1 effective as provided in section 2
II. Remainder effective August 23, 2024
Text to be added highlighted in green.
376:1 New Paragraph; Commissioner of the Department of Health and Human Services; State Medicaid Plan Amendment Regarding Ambulance Services. Amend RSA 126-A:5 by inserting after paragraph XXXIV the following new paragraph:
XXXV. The commissioner shall submit to the Centers for Medicare and Medicaid Services (CMS) an amendment to the state Medicaid plan to provide reimbursement for ambulance services when care is provided in response to an emergency call to a member's home or on a scene, when an ambulance is dispatched, and treatment is provided to the patient without the patient being transported to another site.
(a) Providers shall be eligible for Medicaid reimbursement when the provider has documented that:
(1) The response originated through an emergency call; and
(2) The patient consents to evaluation and treatment, and one of the following outcomes has occurred:
(A) After the evaluation, and when indicated, treatment, the licensed paramedic or emergency medical technician (EMT) and the patient agree there is no need for transportation by ambulance;
(B) The patient does not request and actively refuses transport to an emergency department for evaluation; or
(C) The patient is stable for referral to the patient's physician, other community resource, and the patient has the ability, including mental capacity and transportation resources, to obtain assistance and medically indicated follow-up.
(b) Providers shall also be eligible for Medicaid reimbursement when the provider has documented that the response originated through an emergency call, resuscitation efforts were terminated, and the patient is deceased.
376:2 Contingency. Section 1 of this act shall take effect on the date the Centers for Medicare and Medicaid Services certifies the approval of the amendment to the state Medicaid plan to the director of legislative services and the secretary of state.
376:3 Appropriation; Department of Health and Human Services. The sum of $500,000 for the biennium ending June 30, 2025 is appropriated to the department of health and human services for the purposes of this act. The department may accept and expend any available matching federal funds without the approval of the fiscal committee of the general court. The governor is authorized to draw a warrant for said sum from any money in the treasury not otherwise appropriated.
376:4 Department of Health and Human Services; Individuals with Developmental Disabilities; Funding for Recreational Services.
I. Recreational activities typically provide an opportunity for individuals with developmental disabilities to participate in their community in preferred settings, where individuals are able to work on skill development to aid health, wellness, socialization, and safety goals. However, the department of health and human services has received clarification from the Centers for Medicare and Medicaid Services that supports and services that are recreational in nature are not reimbursable services under the Medicaid program.
II. In order to ensure that costs to access recreational services are covered, and that individuals with developmental disabilities are able to participate in recreational activities within their communities, the sum of $500,000 is appropriated to the department of health and human services for the biennium ending June 30, 2025. This appropriation is in addition to any other funds appropriated to the department of health and human services. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated. Any unexpended funds shall lapse to the general fund on June 30, 2025.
III. In order to be eligible to receive funds for recreational services under this section, an individual shall have graduated or exited the school system and be receiving services under the 1915(c) developmental disabilities or acquired brain disorder waiver and shall be requesting payment for an activity or service that cannot be covered by the New Hampshire Medicaid state plan or a 1915(c) home and community based waiver.
IV. The department of health and human services shall contract with one or more organizations, such as an area agency as defined in RSA 171-A, to assist in administering these funds. With the approval of the governor, the department may utilize a sole source procurement method to implement recreational services as quickly as possible.
V. Payment for recreational services shall be limited to $600 per individual.
VI. The department of health and human services shall include language in the contracts designated in paragraph IV to prioritize services previously included in individualized budgets.
VII. The department shall issue an interim report to the fiscal committee on or before April 1, 2025. The report shall include data on utilization, including the number of individuals seeking services in accordance with paragraphs I, II and III, the number of individuals provided services, the types of specific services provided, the total cost of the services provided, and other relevant information necessary to enable the legislature to assess the program.
VIII. The department shall issue a final report to the fiscal committee on or before September 30, 2025. The final report shall include all the information listed in paragraph VII.
376:5 Contingency. If SB 554 of the 2024 legislative session becomes law, RSA 126-A:5, XXXV as inserted by section 1 of this act shall be renumbered to read as RSA 126-A:5, XXXVI.
376:6 Effective Date.
I. Section 1 of this act shall take effect as provided in section 2 of this act.
II. The remainder of this act shall take effect upon its passage.
Approved: August 23, 2024
Effective Date:
I. Section 1 effective as provided in section 2
II. Remainder effective August 23, 2024