New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-M - Former Division of Mental Health and Developmental Services
Chapter He-M 1300 - SPECIALIZED SERVICES
Part He-M 1301 - MEDICAL ASSISTANCE SERVICES PROVIDED BY EDUCATION AGENCIES
Section He-M 1301.06 - Documentation and Payment for Services

Universal Citation: NH Admin Rules He-M 1301.06

Current through Register No. 52, December 26, 2024

(a) Reimbursement to LEAs and SAUs shall be the lesser of the following:

(1) One half of the actual cost, or

(2) The rate established by the department, in accordance with RSA 161:4, VI(a),

(b) LEAs and SAUs shall bill by unit of service and submit claims for payment that include the actual cost to the department's fiscal agent.

(c) LEAs and SAUs that provide covered services pursuant to He-M 1301.04 shall document each such service in each student's individual record, with such documentation to include:

(1) A copy of the IEP and evidence of implementation of the IEP as required by Ed 1109.04(b) ;

(2) The name of the student, the medical assistance ID number, and documentation demonstrating receipt of each unit of the covered service;

(3) The qualifications of persons delivering each covered service;

(4) The qualifications, names, and signatures of persons directing the covered services if required under He-M 1301.04.

(5) The name and signature, as defined in He-M 1301.02(p) , of individuals actually delivering each covered service;

(6) The type of covered service provided;

(7) The date of the provision of the covered service;

(8) The duration of the provision of the covered service;

(9) In the case of group services, documentation of the number of participants in the group who received the covered service regardless of the participants' eligibility under He-M 1301.03(c) ;

(10) A copy of a physician's or licensed practitioner's referral, order, or recommendation, if required pursuant to He-M 1301.04;

(11) In the case of services provided by personnel described pursuant to He-M 1301.04(o) (2), (t) (2), (ao) (3) , (ao) (4), or (ao) (5), documentation of the qualifications of the professional providing direction; and

(12) Documentation of the qualifications and the handwritten signature of the individual(s) attesting to the medical non-academic nature of the covered rehabilitative assistance provided pursuant to He-M 1301.04(ae) , in accordance with He-M 1301.04(ai) .

(d) For services provided to a group, the bill shall be prorated among the number of participants in the group, regardless of the participants' eligibility under He-M 1301.03(c) .

(e) An LEA or SAU shall only bill covered service time provided simultaneously by more than one qualified provider described in He-M 1301.04,(h) (1), (k), (o), (t), (x), (aa), (ad), (ao) , or (as) as follows:

(1) By dividing the total time of service by the number of qualified providers, and by billing each provider separately for an equal amount of service time, so that the total time billed equals the actual time the child received services;

(2) If rehabilitative assistance is provided pursuant to He-M 1301.04(ae) -(aj) simultaneously with another covered service, the rehabilitative assistance shall be billed in addition to the covered service; or

(3) If rehabilitative assistance is provided by more than one rehabilitative assistant simultaneously, each assistant's service shall be billed separately.

(f) In calculating the cost for transportation, the LEA or SAU may include the following actual costs related to the trip:

(1) Fuel;

(2) Insurance;

(3) Driver's salary and benefits;

(4) Salary and benefits of other persons working on the bus;

(5) Depreciation, and

(6) Maintenance.

(g) The total cost calculated in (f) above shall then be divided by the total number of miles for the trip both ways, and then divided by the total number of students on the bus, regardless of the students' eligibility under He-M 1031.03(c) to determine the cost per mile per student.

#4925, INTERIM, eff 8-31-90; ss by #5038, eff 12-28-90; ss by #5456, eff 9-1-92, EXPIRED: 9-1-98

New. #6861, INTERIM, eff 10-2-98, EXPIRED: 1-30-99

New. #6987, eff 4-27-99; ss by #8874, INTERIM, eff 4-25-07, EXPIRED 10-22-07

New. #9035, eff 11-22-07; amd by #10278, eff 2-23-13

The amended version of this section by New Hampshire Register Volume 38, Number 37, eff. 8/20/2018 is not yet available.

The amended version of this section by New Hampshire Register Volume 39, Number 37, eff.8/28/2019 is not yet available.

Disclaimer: These regulations may not be the most recent version. New Hampshire may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.