Section He-M 522.06 - Determination of Eligibility for Medicaid Home- and Community-Based Care Services(a) For those persons found eligible under He-M 522.03(a) , the bureau shall review the referral made pursuant to He-M 522.05(h) (1) and shall, within 15 business days of receipt of the referral, make a decision on eligibility under He-M 522.03(b) . This decision shall be conveyed to the applicant and guardian, if applicable, in writing and include the specific legal and factual basis for the determination, including specific citation of the applicable law or department rule.(b) Within 3 business days of receipt of the bureau's determination regarding an applicant's eligibility under He-M 522.03(b) , an area agency shall issue written notice to the applicant and guardian, if applicable, as follows: (1) For an applicant eligible for services under He-M 522.03(b) , notice shall include the name of the area agency contact person and state that the applicant is eligible under He-M 522.03(a) for service coordination and He-M 522.03(b) for Medicaid home- and community-based care services;(2) For an applicant not eligible under He-M 522.03(b) , notice shall include: a. The specific legal and factual basis for the determination, including specific citation of the applicable law or department rule; andb. Written and verbal notice of the appeal rights under He-M 522.19.(c) Following denial of eligibility, the individual, family, or guardian, as applicable, may reapply for services if new information regarding the diagnosis, level of care, or severity of the disability or functional impairment related to the acquired brain disorder becomes available.(d) The determination of eligibility under He-M 522 by one area agency shall be accepted by every other area agency of the state.N.H. Code Admin. R. He-M 522.06
#7120, eff 10-20-99; ss by #8974, INTERIM, eff 10-6-07, EXPIRED: 4-3-08
New. #9734, eff 6-25-10
The amended version of this section by New Hampshire Register Volume 38, Number 50, eff. 11/30/2018 is not yet available.