Section 167:68 - Medicaid Enhancement for Children and Pregnant Women The commissioner of the department of health and human services shall adopt rules under RSA 541-A which:
I. Establish by July 1, 1999, categorically needy coverage groups under RSA 167:6, VII and Title XIX of the Social Security Act, sections 1902(a)(10)(A)(i)(IV), 1902(a)(10)(A)(i)(VI) and 1902(a)(10)(i)(VII) and establish less restrictive income and resource methodologies under section 1902(r)(2) of Title XIX of the Social Security Act as necessary to increase the eligibility level for medicaid coverage to a minimum of 185 percent of the federal poverty level disregarding resources for a family size equal to the size of the family including the woman, infant or child. This includes:(a) Women during pregnancy and during the 60-day period beginning on the last day of the pregnancy; and(b) Infants under one year of age; and(c) Children who have attained one year of age but have not attained 6 years of age; and(d) Children born after September 30, 1983, who have attained 6 years of age but have not attained 19 years of age; and(e) Children born on or before September 30, 1983, who have not yet attained 19 years of age.II. Establish by January 1, 1994, procedures in the medical assistance program for improved outreach and enrollment for pregnant women and children. Such procedures shall include:(a) Implementing shortened, simplified medicaid-only application forms for the individuals covered under paragraphs I and II.(b) Providing for the receipt and initial processing of medicaid applications from individuals covered under paragraphs I and II at locations which are other than those used for the receipt and processing of applications for aid to families with dependent children and which include providers of Title V Maternal and Child Health Services, Title X Family Planning Services, the Special Supplemental Food Program for Women, Infants and Children and Early Intervention program sites, as well as those required under 42 U.S.C. 1396a(a)(55). Individuals submitting applications at sites, other than the department of health and human services district offices, shall not be required to subsequently visit the department of health and human services district office to complete the initial eligibility determination process.(c) Instituting a formal procedure for taking maternity-related medical assistance applications at the offices of "qualified providers" including the providers listed in RSA 167:68, III(b) and for making medicaid services available to a pregnant woman during a "presumptive eligibility period" as provided in 42 U.S.C. 1396r-1. Presumptive eligibility shall be made available to pregnant women applying at department of health and human services district offices as well as to pregnant women applying at non-district office sites.(d) Instituting an aggressive public education campaign regarding the availability of medicaid coverage for maternal and child health services, the existence of other publicly-funded health programs serving mothers and children, and the advantages of preventive health care.(e) Instituting a newborn home visiting program whereby a licensed health professional makes a home visit to targeted households with medicaid covered newborns within 60 days after birth to encourage families to participate in the Early and Periodic, Screening, Diagnosis and Treatment Program, to conduct a health screen, to better link the family with primary health care, and to better ensure continued medicaid coverage for the infant.III. Establish by January 1, 1994, procedures for improved coordination of the medicaid program for pregnant women and children with other publicly-funded health programs serving mothers and children, including Title V Maternal and Child Health, Title X Family Planning, and the Special Supplemental Food Program for Women, Infants and Children, and the Early Intervention Program. Such procedures shall include, to the extent permissible by federal law:(a) A common application form;(b) Medicaid eligibility technicians located at agencies providing these publicly-funded health care services; and(c) The continuation and completion of rulemaking and other measures designed to make medicaid reimbursement available to these publicly funded health programs for medically necessary case management and care coordination services provided by these agencies to medicaid eligible pregnant women and children.IV.(a) Pursuant to the state option under the section 5113 of the Consolidated Appropriations Act of 2023 to expand maternity care under Medicaid and section 1902(e)(16) of the Social Security Act (42 U.S.C. 1396a(e)) , the commissioner of the department of health and human services shall submit, no later than August 15, 2023, a Medicaid state plan amendment to the federal Centers for Medicare and Medicaid Services to establish and implement 12 months of continuous coverage for the entire postpartum period. This benefit shall be available to anyone who received medical assistance under the state plan for all pregnancy-related and postpartum medical assistance available under the state plan through the last day of the month in which the 60-day period (beginning on the last day of her pregnancy) ends, remain eligible under the state plan for medical assistance for the period beginning on the first day occurring after the end of such 60-day period and ending on the last day of the month in which the 12-month period (beginning on the last day of her pregnancy) ends.(b) The medical assistance provided for a pregnant or postpartum woman under this section shall, consistent with Section 1902(e)(16) include all items and services covered under the state plan that are not less in amount, duration, or scope, or are determined by the Secretary to be substantially equivalent, to the medical assistance available for an individual described in subsection (a)(10)(A)(i); and be provided for the individual while pregnant and during the 12-month period that begins on the last day of the individual's pregnancy and ends on the last day of the month in which such 12-month period ends.(c) The purpose of the program shall be, through ensuring continuous coverage for a 12-month postpartum period, to increase identification and mitigation of preventable pregnancy related and pregnancy associated morbidity and mortality, including those related to substance use disorder and mental illness.(d) On January 1, 2024, the commissioner shall begin submitting quarterly reports to the oversight committee on health and human services, the legislative committees with jurisdiction over health and human services, and the governor regarding the department's progress in obtaining and implementing the state plan amendment. The quarterly reports shall include the department's plans for reducing administrative burdens for enrollees and the department's efforts to expand access and participation to voluntary, evidence-based maternal home visiting programs, pursuant to subparagraph (a). Reports submitted under this subparagraph shall also be posted on the department's website.Amended by 2023, 79:412, eff. 7/1/2023.Amended by 2015 , 276: 152, eff. 7/1/2015.1993, 358:54. 1994, 409:1, 2. 1995, 190:8, eff. July 1, 1999; 310:122, 180, 182, eff. Nov. 1, 1995. 2015, 276 : 152 , eff. July 1, 2015.