N.H. Code Admin. R. He-E 801.18

Current through Register No. 25, June 20, 2024

Section He-E 801.18 - Financial Management Services

(a) FMS, as defined in He-E 801.02(t) shall be provided in accordance with the budget developed by the participant with the case manager as part of the participant's comprehensive care plan.

(b) The FMS provider shall:

(1) Manage and direct the disbursement of funds in accordance with the PDMS budget and plan;

(2) Facilitate the employment of staff by the family or CFI participant;

(3) Provide orientation and skills training to the participant or the participant's legal representative who is to act as co-employer of direct support staff about responsibilities as co-employers for the direct support workers employed;

(4) Provide fiscal accounting to include:

a. Disbursements for goods and services approved in the comprehensive care plan and the balance of the participant's available funds; and

b. Ensuring separation of each participant's budget and expenses; and

(5) Provide employer functions, including but not limited to:

a. Hiring workers chosen by the participant;

b. Verifying worker citizenship status;

c. Ensuring completion of required background checks and obtaining a waiver if necessary pursuant to He-E 801.37;

d. Processing payroll and issuing payment to employees;

e. Withholding all federal, state, and local taxes and making tax payments to the applicable tax authorities; and

f. Documenting required training.

(c) FMS providers shall enroll with NH medicaid as FMS providers and have the capabilities to perform the required tasks in accordance with 26 USC 3504 and revenue procedure 70-6.

(d) The participant's budget shall include the following, based on the needs identified by the case manager in the comprehensive care plan:

(1) The specific PDMS components:

(2) The frequency and duration of the required services; and

(3) An itemized cost of the PDMS.

(e) The FMS provider shall prepare a budget worksheet that details how the participant intends to spend the funds allocated in the participant's budget and the worksheet shall be reviewed monthly by the participant.

(f) Expenses that exceed the limits allowed under a participant's PDMS budget or that exceed service limits allowed for SME or EAS, or that are not allowed under this program as authorized by CMS, shall not be paid.

(g) All FMS providers shall:

(1) Provide services as described in this part;

(2) Maintain an account for the participant for the purposes of tracking expenditures from the participant's budget;

(3) Inform participants of procedures for payment requests for goods and services;

(4) Review and submit for payment to the department the items or services that the participant purchases based on his or her budget; and

(5) Provide the participant with a monthly statement to track expenditures and to ensure that the FMS provider is handling the participant's budget appropriately and accurately.

N.H. Code Admin. R. He-E 801.18

(See Revision Note at part heading for He-E 801) #9969, eff 8-8-11

Amended by Volume XXXIX Number 32, Filed August 8, 2019, Proposed by #12830, Effective 8/7/2019, Expires 2/3/2020.

Amended by Volume XLII Number 6, Filed February 10, 2022, Proposed by #13340, Effective 1/29/2022, Expires 1/29/2032.