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NH Code of Administrative Rules, He-E 801 Choices for Independence Program

New HampshireregulationNew Hampshire Department of Health and Human Services

What this rule requires your agency to do

  • 1Upon review of the information provided in He-E 801.05(c) and within 6 business days, the department shall authorize services that meet the needs identified in the clinical assessment (He-E 801.06(a))(NH Code of Administrative Rules, He-E 801 Choices for Independence Program)
  • 2Providers shall submit all initial claims to the medicaid fiscal agent so that the fiscal agent receives the claims no later than one year from the earliest date of service on the claim (He-E 801.34(a))(NH Code of Administrative Rules, He-E 801 Choices for Independence Program)
  • 3All providers shall check the names of prospective or current employees, volunteers or subcontractors against the state registry pursuant to RSA 161-F:49, and shall report any participant suspected of being abused, neglected, exploited, or self-neglecting in accordance with RSA 161-F:46 (He-E 801.32(c)-(d))(NH Code of Administrative Rules, He-E 801 Choices for Independence Program)
  • 4Required documentation shall be maintained for a period of at least 6 years from the date of service or until the resolution of any legal action(s) commenced during the 6 year period, whichever is longer (He-E 801.33(g))(NH Code of Administrative Rules, He-E 801 Choices for Independence Program)
  • 5All providers shall be enrolled in NH medicaid as a CFI provider and meet the applicable licensing, certification, or other requirements of the specific service being provided (He-E 801.32(a))(NH Code of Administrative Rules, He-E 801 Choices for Independence Program)
  • 6The case manager assigned to the participant shall develop and maintain a comprehensive care plan through a person-centered planning process in accordance with He-E 805 (He-E 801.05(a))(NH Code of Administrative Rules, He-E 801 Choices for Independence Program)
  • 7The eligibility of each participant shall be subject to redetermination at least annually (He-E 801.07(a))(NH Code of Administrative Rules, He-E 801 Choices for Independence Program)
  • 8An individual is eligible for CFI waiver services only if he or she submits a signed and dated application, is at least 18 years of age, meets the financial and categorical requirements for medicaid, and meets the clinical eligibility requirements for nursing facility care in RSA 151-E:3, I(a) (He-E 801.03(a))(NH Code of Administrative Rules, He-E 801 Choices for Independence Program)

Applies to: CFI waiver applicants and participants; case management agencies; CFI waiver service providers; NH Department of Health and Human Services

Establishes eligibility requirements, clinical eligibility determination, service authorization, covered and non-covered services, service-specific standards, provider participation requirements, and participant protections for the Choices for Independence Medicaid home and community based services waiver program.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.