Section He-C 5001.01 - Definitions(a) "Audit" means the independent disproportionate share hospital audit required by federal Medicaid regulations at 42 C.F.R. Part 455, Subpart D.(b) "Department" means the New Hampshire department of health and human services.(c) "Disproportionate share non-public hospitals" means, for purposes of this part, in-state hospitals, licensed under RSA 151, which participate in the provider network of the State Medicaid managed care program, and which meet the minimum criteria for disproportionate share hospital payments pursuant to 42 U.S.C. section 1396r-4(d) , and in-state hospitals as identified by RSA 167:63, IV, which meet the requirements for a deemed disproportionate share hospital under 42 U.S.C. section 1396r-4(b) , but do not include government facilities.(d) "Disproportionate share payment," in conformity with relevant provisions of RSA 167:64, the New Hampshire Title XIX Medicaid State Plan, federal law at 42 U.S.C. section 1396r-4, and federal regulations promulgated thereunder, means the amount determined by the department and paid to eligible hospitals to compensate the hospitals for services provided to Medicaid recipients and uninsured individuals.(e) "Uncompensated care" means losses arising from the difference between the cost of providing inpatient or outpatient hospital services to Medicaid recipients and to uninsured patients during the year, and the reimbursement received for those recipients and patients consistent with 42 U.S.C. section 1396r-4(g) and related federal regulations promulgated by the Centers for Medicare and Medicaid Services.(f) "Uncompensated care and Medicaid fund" means the fund established by RSA 167:63 through RSA 167:65, from which payments are made to eligible hospitals to support their services to Medicaid recipients and uninsured individuals.(g) "Uninsured patient care" means inpatient and outpatient hospital services provided to any individual with no health insurance or source of third party coverage for services provided to the individual patient during the year. Uninsured patient care does not include care provided to patients with health insurance for the services provided in their third party coverage benefit package but who have unpaid co-pays or deductibles or any other unreimbursed costs associated with a patient's out of pocket payment responsibilities for covered inpatient or outpatient hospital services provided to them.N.H. Admin. Code § He-C 5001.01
#5167, EMERGENCY, eff 6-21-91, exp. 10-19-91; ss by #5249, eff 10-18-91; ss by #6599, eff 10-8-97, EXPIRED: 10-8-05
New. #9814, INTERIM, eff 11-19-10, EXPIRES: 5-18-11; ss by #9916-A, eff 4-23-11; amd by #10029, INTERIM, eff 11-19-11, EXPIRES: 5-17-12; ss by #10109, eff 5-17-12
Amended byVolume XXXV Number 10, Filed March 12, 2015, Proposed by #10789, Effective 2/21/2015, Expires2/21/2025.Amended by Volume XXXVIII Number 06, Filed February 8, 2018, Proposed by #12468, Effective 1/26/2018, Expires 1/26/2028.Amended by Volume XXXIX Number 06, Filed February 7, 2019, Proposed by #12719, Effective 1/29/2019, Expires 1/29/2029.