Medicaid State Plan Amendments

This amendment update the current policy and practice of the Physician Services section in the Medicaid State Plan in the following areas:

This SPA make updates to add and clarify services for Adult, Youth and Family Peer Support.

This plan amendment titled, "Nursing Facility MQIP for Dates of Service April through June 2025" updates the quarterly pool amount and total Medicaid day count for New Hampshire’s nursing facility supplemental payment, also known as MQIP, for both private and non-state government owned and operated facilities.

This amendment make requirements for Indian Health Services and Tribal clinics consistent with the requirements set forth in 42 Code of Federal Regulations §440.90. The SPA requires a mandatory exception to the four-wall requirement for the Medicaid clinic services benefit to authorize reimbursement for clinic services provided outside of the four walls of Indian Health Services and Tribal clinics.

This plan amendment titled, "Disproportionate Share Hospital (DSH) Payment Adjustments” updates the payment amounts to be made for State Fiscal Year 2025 to non-public hospitals that qualify for DSH payment adjustments under the New Hampshire State Plan provisions governing inpatient hospital services payments.

This plan amendment updates the Disproportionate Share Hospital payment time period to the current fiscal year, the fiscal year amount, and the payment frequency.

This plan amendment will increase rates for an acuity add-on for each service date for individuals that meet the medical necessity of various levels.

This plan amendment updates the rates for two primary care codes (99213 and 99214) to 2.154%.

This plan amendment updates the Supplemental Teaching Physician (STP) Payment Program.

This plan amendment updates the rate for Select Dental codes to 2.5%.