Section He-C 6348.04 - Requirements for Provider of Health Care and Laboratory Services Enrollment(a) DCYF shall authorize payment for preventative or corrective health care services for children ineligible for Medicaid, pursuant to a court order.(b) DCYF shall authorize payment for Medicaid ineligible laboratory services pursuant to a court order.(c) Prior to applying for certification, a provider shall be licensed or registered as required by the state licensing entity, and shall maintain compliance with all applicable New Hampshire rules and laws including: (1) For dentists and dentistry, comply with RSA 317;(2) For physicians, including psychiatrists and surgeons, comply with RSA 329;(3) For hospitals and clinics, comply with RSA 151;(4) For optometrists, comply with RSA 327;(5) For chiropractors, comply with RSA 316-A;(6) For pharmacists and pharmacies, comply with RSA 318;(7) For podiatrists, comply with RSA 315;(8) For radiologists, comply with RSA 329;(9) For emergency medical services, comply with RSA 151;(10) For laboratory testing services providers, comply with RSA 151:2; and(11) For any other health care providers, comply with their respective New Hampshire law or rule.(d) Prior to applying for certification, any out of state provider shall be licensed or registered as required by the state licensing entity, and shall maintain compliance with all laws and rules to be authorized to practice in his or her state.(e) All providers shall comply with: (1) The confidentiality statutes of RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA 170-B:23, RSA 170-C:14, and RSA 170-G:8-a;(2) The child abuse and neglect reporting requirements of RSA 169-C:29-30; and(3) All applicable provisions of the health insurance portability and accountability act (HIPAA) .(f) A provider of health care services shall meet medical assistance requirements of He-W 500 and He-M 426.(g) The provider and his or her employees and subcontractors shall not have a conflict of interest, as defined in RSA 21-G:21, II.(h) The provider shall maintain general and professional liability insurance.(i) Laboratory services shall be provided by a laboratory service which holds a current New Hampshire license pursuant to RSA 151:2. The laboratory service shall subcontract only to a laboratory service provider which has a valid New Hampshire license or is licensed in the state in which it operates.(j) Failure to comply with the rules of this chapter shall result in: (1) Denial of an applicant pursuant to He-C 6348.13;(2) Revocation of certification for payment pursuant to He-C 6348.13; or(3) Denial of reimbursement.N.H. Admin. Code § He-C 6348.04
(See Revision Note at part heading for He-C 6348) #9267, eff 9-20-08
Amended by Volume XXXVII Number 15, Filed April 13, 2017, Proposed by #12127, Effective 3/10/2017, Expires 3/10/2027.