Section He-W 512.02 - Definitions(a) "Alternative benefit plan (ABP) " means the medicaid benchmark or benchmark equivalent coverage described in section 1937 of the Social Security Act.(b) "Department" means the New Hampshire department of health and human services.(c) "Medicaid" means the Title XIX and Title XXI programs administered by the department, which makes medical assistance available to eligible individuals.(d) "Medically frail" means a newly eligible individual who is exempt from mandatory enrollment in the ABP or PAP in accordance with the conditions set forth in 42 CFR § 440.315(f) .(e) "Newly eligible adult" means adults who are eligible for medicaid under the New Hampshire health protection program and the provision of section 1902(a) (10) (A) (i) (VIII) of the Social Security Act of 1935 as amended, 42 USC § 1396a(a) (10) (A) (i) (VIII) .(f) "Premium Assistance Program (PAP) " means the Marketplace Premium Assistance Program, established by RSA 126-A:5 which requires that adults eligible for medical assistance under 42 USC § 1396a(a) (10) (A) (i) (VIII) enroll in a cost-effective Qualified Health Plan offered on New Hampshire's federally facilitated Marketplace, authorized through the Section 1115(a) research and demonstration waiver, # 11-W-00298/1 by the Centers for Medicare and Medicaid Services on March 4, 2015.(g) "Premium Assistance Program participants (PAP participants) " means those newly eligible adults who are mandatorily required to enroll in a qualified health plan, and those who voluntarily enroll in a qualified health plan.(h) "Qualified Health Plan (QHP) " means an individual health insurance policy certified by the Centers for Medicare and Medicaid Services (CMS) for sale through New Hampshire's individual health insurance Marketplace.(i) "Subluxation" means an incomplete dislocation, off centering, misalignment, fixation, or abnormal spacing of the vertebrae.(j) "Title XIX" means the joint federal-state program described in Title XIX of the Social Security Act and administered in New Hampshire by the department.(k) "Title XXI" means the joint federal-state program described in Title XXI of the Social Security Act and administered in New Hampshire by the department.(l) "Wrap benefits" means: (1) Non-emergency medical transportation;(2) Early Periodic Screening Diagnosis and Treatment (EPSDT) services as described in He-W 546, for individuals who are under the age of 21; and(3) Family planning services and supplies from a medicaid enrolled provider, and adult dental in accordance with He-W 566.04(e) and adult vision services in accordance with He-W 530.03(g) .N.H. Admin. Code § He-W 512.02
Amended by Volume XXXVI Number 01, Filed January 7, 2016, Proposed by #11012, Effective 1/1/2016, Expires 6/29/2016.Amended by Volume XXXVI Number 28, Filed July 14, 2016, Proposed by #11119, Effective 6/29/2016, Expires 6/29/2026.