Section He-M 524.12 - Individual Goods and Services(a) Individual goods and services shall include equipment or supplies that address an identified need in the ISA, and meet at least one of the following requirements:(1) The good or service decreases the need for other Medicaid services;(2) The good or service promotes inclusion in the community; or(3) The good or service increases the individual's safety in the home environment.(b) Payment for individual goods and services shall be made through the home and community based services waiver if:(1) The individual and their family do not have the funds to purchase the item or service;(2) The item or service is not covered under the Medicaid State Plan; or(3) The item or service is not available through other sources.(c) Payment for experimental or prohibited treatments shall be prohibited.(d) Payment for individual goods and services shall not exceed $1,500 annually for an individual.(e) The bureau shall authorize individual goods and services in excess of the limitation in (d) above upon written request which shall include documentation supporting the need and the correlation of the request to the individual's service agreement.(f) Documentation related to the use of the item shall be maintained in monthly progress notes in accordance with He-M 524.24.(g) Individual goods and services shall have an anticipated finite period of time to be utilized.(h) The frequency of purchase of individual goods and services shall be determined in accordance with the documented continued need of the item and the ability of the item to continue to meet that need.N.H. Admin. Code § He-M 524.12
#7891, eff 5-20-03; ss by #9927, INTERIM, eff 5-21-11, EXPIRES: 11-17-11; ss by #10027, eff 11-17-11
Amended by Volume XLII Number 28, Filed July 14, 2022, Proposed by #13397, Effective 6/18/2022, Expires 6/18/2032