N.H. Admin. Code § He-P 2505.02

Current through Register No. 45, November 7, 2024

Section He-P 2505.02 - Recipients with Other Catastrophic Illnesses

(a) Recipients with a diagnosis of cancer, cystic fibrosis, spinal cord injury, hemophilia, or multiple sclerosis shall receive financial assistance for the following:

(1) Outpatient hospital services including diagnostic x-ray, radiotherapy, and diagnostic and therapeutic services;

(2) Physician services, including:

a. Surgical and medical services, including routine pre- and post-operative care, provided in a hospital, in a hospital outpatient department, in a physician's office, or in the individual's home;

b. Services provided by an assisting physician in connection with an operative procedure;

c. Services provided by an anesthesiologist, if anesthesia is administered by an individual other than the surgeon or assisting surgeon; and

d. Consultation services when requested by the attending physician; and

(3) Other services, including:

a. Ambulance services provided to the nearest hospital when medically justified;

b. Durable medical equipment, including, mastectomy prosthesis(es), wigs, ostomy supplies, or catheters, where medically indicated by a physician for the treatment of the catastrophic illness;

c. Drugs and medications when prescribed by a physician, including over-the-counter pharmacy items needed for the recipient's treatment; and

d. Related services including payment of COBRA insurance premiums, and home health care as requested in writing by the recipient and as required to meet the recipient's unique needs, subject to the program budget.

(b) Recipients with a diagnosis of cancer, cystic fibrosis, spinal cord injury, hemophilia, or multiple sclerosis shall not receive financial assistance for the following services:

(1) Services which are experimental or considered alternative therapies by current medical practice;

(2) In-patient hospital and emergency room visits;

(3) Funeral expenses;

(4) Dental care; and

(5) Supplemental payment for medicare part B and D.

N.H. Admin. Code § He-P 2505.02

#2484, eff 9-26-83; ss by #4167, eff 11-6-86; ss by #4638, eff 6-26-89, EXPIRED: 6-26-95

New. #8864, eff 4-13-07