Section He-C 6344.05 - Compliance Requirements for Private Providers(a) Private providers shall comply with: (1) All applicable licensing and registration requirements prior to applying for certification;(2) The medical assistance requirements of He-W 500 and He-M 426;(3) The statutes regarding confidentiality, including RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA 170-B:19, RSA 170-C:14, and RSA 170-G:8-a; and(4) The child abuse and neglect reporting requirements of RSA 169-C:29-30.(b) All providers, prior to beginning their work with children, and thereafter on an annual basis, shall review the sections of RSA 169 on definitions, immunity from liability and persons required to report.(c) Private providers shall not have a conflict of interest, as defined in He-C 6344.03.(d) Private providers shall maintain professional and general liability insurance.(e) When domestic or family violence is identified as an issue for a family, each private provider shall follow the "Mental Health Domestic Violence Protocols," 1996, prepared by the NH governor's commission on domestic violence and available directly from the NH department of justice or on-line as listed in Appendix A.(f) The provider shall provide services or care without discrimination as required by 42 U.S.C 2000d et seq., as amended, and without discrimination on the basis of handicap as required by 29 U.S.C 794, as amended.(g) Private providers shall: (1) Be an enrolled NH medicaid provider;(2) Accept medicaid payment as payment in full;(3) Submit their medicaid number to DCYF; and(4) Participate with one or more of the NH managed care organizations (MCO) .(h) The requirement in (g) (1) above shall be waived if the provider holds only a LADC license.(i) Private providers shall verify recipient eligibility for and bill all third party sources of reimbursement, including private health insurance, and medicaid, or MCO, prior to billing DCYF.(j) Private providers shall request prior authorization for services in advance for recipients covered by third party insurance.(k) Private providers shall request prior authorization for psychotherapy services for medicaid or MCO eligible recipients requiring more than 12 visits per fiscal year as outlined in He-W 530.(l) Private providers shall submit a monthly progress report to CPSW or JPPO.N.H. Admin. Code § He-C 6344.05
(See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08
Amended by Volume XXXVII Number 28, Filed July 13, 2017, Proposed by #12206, Effective 6/10/2017, Expires 6/10/2027.