Current through Register No. 40, October 3, 2024
(a) All SUD treatment and recovery support
service providers shall be enrolled as a New Hampshire medicaid
provider.
(b) SUD treatment and
recovery support service practitioners shall meet the provider requirements in
He-W 531.05 for
the services they are enrolling to provide.
(c) Individual practitioners delivering
services as part of a medicaid enrolled outpatient SUD program or medicaid
enrolled comprehensive SUD program shall be allowed to delegate, in accordance
with scope of law and practice, the performance of SUD treatment and recovery
support services to individuals under their supervision in such program, and
subject to the following restrictions:
(1)
With the exception of those licensed alcohol and drug counselors (LADCs) who
are permitted to engage in independent practice in accordance with Chapter Law
189:2, II, Laws of 2008, and Chapter Law 249:24, V, Laws of 2010, LADCs shall
only provide SUD treatment and recovery support services under the supervision
of:
a. A master licensed alcohol and drug
counselor (MLADC) who is on the staff of a medicaid enrolled outpatient SUD
program or comprehensive SUD program;
b. A LADC who is permitted to engage in
independent practice in accordance with Chapter Law 189:2, II, Laws of 2008,
and Chapter Law 249:24, V, Laws of 2010, who also is a licensed clinical
supervisor (LCS), and who is on the staff of a medicaid enrolled outpatient SUD
program or comprehensive SUD program; or
c. A licensed mental health provider who is
on the staff of a medicaid enrolled outpatient SUD program or comprehensive SUD
program;
(2) Supervision
requirements for SUD recovery support services shall be as follows:
a. A certified recovery support worker (CRSW)
shall be supervised by one of the following:
1. An MLADC who is on the staff of or under
contract with a medicaid enrolled outpatient SUD program, comprehensive SUD
program, or peer recovery program;
2 A LADC who is permitted to engage in independent practice
in accordance with Chapter Law 189:2, II, Laws of 2008, and Chapter Law 249:24,
V, Laws of 2010, who also is an LCS and who is on the staff of or under
contract with a medicaid enrolled outpatient SUD program, comprehensive SUD
program, or peer recovery program;
3. A LADC who is on the staff of or under
contract with a medicaid enrolled outpatient SUD program, comprehensive SUD
program, or peer recovery program;
4. A CRSW who has been certified for one year
and has taken 6 hours of supervisory training and 6 hours of practical training
which has been approved by the board pursuant to
Alc
409.01; or
5. A licensed mental health provider who is
on the staff of or under contract with a medicaid enrolled outpatient SUD
program, comprehensive SUD program, or peer recovery program;
b. A LADC delivering recovery
support services shall be supervised by an MLADC who is on the staff of or
under contract with a medicaid enrolled outpatient SUD program, comprehensive
SUD program, or peer recovery program; and
c An MLADC delivering recovery support services shall not
require supervision;
(3) Individuals who meet the following
criteria shall only provide services under the supervision of an MLADC or
licensed mental health provider who is on the staff of a medicaid enrolled
outpatient SUD program or comprehensive SUD program:
a. The individual shall be enrolled in a
formal internship for at least a master's degree in a clinical discipline that
meets the requirements for initial licensing as an MLADC pursuant to
RSA
330-C:16, I, or
b. The individual shall:
1. Have completed at least one year of work
in the field of substance use disorders treatment under the supervision of an
MLADC or licensed mental health provider;
2. Have at least a master's degree in a
clinical discipline that meets the requirements for initial licensing as an
MLADC pursuant to
RSA
330-C:16, I; and
3. Be working to accumulate the work
experience required for licensure;
(4) Individuals who meet the criteria below
shall only provide services under the supervision of a psychologist who is on
the staff of a medicaid enrolled outpatient SUD program or comprehensive SUD
program:
a. The individual shall be enrolled
in a formal internship for at least a master's program that meets the
requirements for initial licensure by the NH board of psychologists pursuant to
RSA 329-B; or
b. The individual
shall:
1. Have completed at least one year of
work in the field of substance use disorders treatment under the supervision of
a person licensed by the NH board of psychologists;
2. Have at least a master's degree that meets
the requirements for initial licensure by the NH board of psychologists
pursuant to RSA 329-B; and
3. Be
working to accumulate the work experience required for licensure;
(5) Individuals who
meet the criteria below shall only provide services under the supervision of a
psychotherapist who is on the staff of a medicaid enrolled outpatient SUD
program or comprehensive SUD program:
a. The
individual shall be enrolled in a formal internship for at least a master's
program that meets the requirements for initial licensure by the NH board of
mental health practice pursuant to RSA 330-A; or
b. The individual shall:
1. Have completed at least one year of work
in the field of substance use disorders treatment under the supervision of a
psychotherapist;
2. Have at least a
master's degree that meets the requirements for initial licensure by the NH
board of mental health practice pursuant to RSA 330-A; and
3. Be working to accumulate the work
experience required for licensure;
(6) Individuals who qualify to provide
services pursuant to He-W 513.04(c) (3) - (5) above and who hold at least a
master's degree shall have ongoing supervision of at least 2 hours per month as
follows:
a. There shall be direct,
individual, or group supervision of at least one hour per month by the
supervising practitioner noted in (3) -(5) above; and
b. The second hour of supervision may be peer
review or case review, such as client-centered conferences;
(7) Individuals who qualify to
provide services pursuant to He-W 513.04(c) (3) - (5) above and who are
enrolled in a formal internship shall receive direct supervision as follows:
a. There shall be direct supervision of at
least one hour per week;
b. The
supervisor shall write and sign a weekly note in the intern's supervisory
record stating his or her observations and recommendations relative to the
intern's performance; and
c. The
supervisor shall write and sign a monthly note in the intern's supervisory
record summarizing his or her evaluation;
(8) The medicaid program shall reimburse the
outpatient or comprehensive SUD program only if the supervision required in
accordance with He-W 513.04(c) (3) - (7) occurs and is documented;
(9) The delegated services shall be billed by
the outpatient or comprehensive SUD program; and
(10) A LADC who is permitted to engage in
independent practice in accordance with Chapter Law 189:2, II, Laws of 2008,
and Chapter Law 249:24, V, Laws of 2010, shall not provide supervision to an
MLADC for the purposes of providing services under He-W 513.
(d) SUD treatment and recovery
support service providers shall ensure that the recipient has undergone a
clinical evaluation, as required by
He-W 513.03(b)
above, prior to the provider's delivery of
other SUD treatment and recovery support services.
(e) SUD treatment and recovery support
service providers shall ensure that all SUD treatment and recovery support
services are provided and documented in accordance with the Health Insurance
Portability and Accountability Act (HIPAA) of 1996, 45 CFR 160, 45 CFR 164,
Subparts A and E, and 42 CFR, Part II.
(f) SUD treatment and recovery support
service providers shall ensure that any SUD group treatment and recovery
support services described in
He-W 513.05
below are delivered in accordance with the following:
(1) Services shall only be covered when 2 or
more individuals are present for a group service;
(2) SUD treatment groups shall include no
more than 12 individuals with one licensed practitioner present or no more than
16 individuals when that licensed practitioner is joined by a CRSW or a second
licensed practitioner;
(3) Recovery
support groups shall include no more than 8 individuals with one CRSW present
or no more than 12 individuals when that CRSW is joined by a second CRSW;
and
(4) Peer recovery support
groups shall include no more than 8 individuals with one peer recovery coach
present or no more than 12 individuals when that peer recovery coach is joined
by a second peer recovery coach.
(g) SUD treatment service providers shall
ensure that all covered services are provided in accordance with criteria as
set forth in ASAM Criteria (2013), available as noted in Appendix A, except for
SBIRT services provided in accordance with
He-W 513.05(c)
, substance use screening provided in
accordance with
He-W 513.05(d)
, crisis intervention provided in accordance
with
He-W 513.05(q)
, and evaluations provided in accordance with
He-W 513.05(u)
.
(h) All SUD treatment and recovery support
service providers shall treat co-occurring disorders in accordance with scope
of law and practice.
(i) Except as
in (j) below, LADCs, and MLADCs who are delivering or supervising SUD treatment
and recovery support services shall be licensed by the NH board of licensing
for alcohol and other drug use professionals.
(j) Providers who hold a reciprocal
international certification and reciprocity consortium/alcohol and other drug
abuse (IC&RC) license shall be considered to have met the requirement in
(i) above for the purpose of He-W 513.
(k) New Hampshire enrolled out of state
providers whose license or certification allows them to provide SUD services in
the state in which they practice shall be considered to have met the
requirements in (i) above.
(l)
Hospitals enrolled in medicaid as a hospital in accordance with He-W 543 shall
also be enrolled in medicaid as an outpatient or comprehensive SUD program in
order to provide outpatient or comprehensive SUD services in accordance with
He-W
513.05.
(m) Providers who are enrolled in other
states and who meet the definition of outpatient or comprehensive SUD programs
in accordance with
He-W 513.02(b) or (q)
shall also be enrolled in NH medicaid in
order to provide outpatient or comprehensive SUD services in accordance with
He-W
513.05.
(n) Providers who are employed by, or under
contract with, a comprehensive or outpatient SUD program shall be considered to
be on the staff of that program.
