Section He-W 512.05 - Covered Services(a) ABP services for NHHPP participants who are medically frail or identify as members of federally recognized Indian tribes or Alaskan natives who choose to opt-out of the PAP shall include the following: (1) Services described in He-W 506.04(a) and (b) ;(2) Substance use disorder (SUD) services as described in He-W 513; and(3) Chiropractor services, which shall be provided as follows: a. Chiropractic services shall consist of spinal manipulation and manual medical intervention services, including: 1. Office visits for: (iii) Spinal adjustments;(v) Physiological therapy before or in conjunction with spinal adjustments; and2. Medically necessary diagnostic laboratory and x-ray tests;b. Chiropractic services shall not include wellness care; andc. Chiropractic services shall be limited to 12 visits per recipient, per state fiscal year.(b) Covered services for PAP participants enrolled with a QHP shall include the following categories of services from a QHP: (1) Ambulatory patient services;(4) Maternity and newborn care;(5) Mental health and substance use disorder services, including behavioral health treatment;(7) Rehabilitative and habilitate services and devices;(9) Preventive and wellness services and chronic disease management; and(10) Pediatric services including oral and vision care.(c) PAP participants shall receive benefits described in (b) above from a QHP, and shall be restricted to using the QHP provider networks except that PAP participants shall not be restricted in their choice of family planning providers if the family planning provider is enrolled with medicaid.(d) PAP participants shall receive fee for service wrap benefits as defined in He-W 512.02(l) above.N.H. Admin. Code § He-W 512.05
Amended by Volume XXXVI Number 01, Filed January 7, 2016, Proposed by #11012, Effective 1/1/2016, Expires 6/29/2016.Amended by Volume XXXVI Number 28, Filed July 14, 2016, Proposed by #11119, Effective 6/29/2016, Expires 6/29/2026.