Section He-W 513.04 - Provider Participation(a) All SUD treatment and recovery support service providers shall be enrolled as a New Hampshire medicaid provider.(b) SUD treatment and recovery support service practitioners shall meet the provider requirements in He-W 531.05 for the services they are enrolling to provide.(c) Individual practitioners delivering services as part of a medicaid enrolled outpatient SUD program or medicaid enrolled comprehensive SUD program shall be allowed to delegate, in accordance with scope of law and practice, the performance of SUD treatment and recovery support services to individuals under their supervision in such program, and subject to the following restrictions: (1) With the exception of those licensed alcohol and drug counselors (LADCs) who are permitted to engage in independent practice in accordance with Chapter Law 189:2, II, Laws of 2008, and Chapter Law 249:24, V, Laws of 2010, LADCs shall only provide SUD treatment and recovery support services under the supervision of: a. A master licensed alcohol and drug counselor (MLADC) who is on the staff of a medicaid enrolled outpatient SUD program or comprehensive SUD program;b. A LADC who is permitted to engage in independent practice in accordance with Chapter Law 189:2, II, Laws of 2008, and Chapter Law 249:24, V, Laws of 2010, who also is a licensed clinical supervisor (LCS), and who is on the staff of a medicaid enrolled outpatient SUD program or comprehensive SUD program; orc. A licensed mental health provider who is on the staff of a medicaid enrolled outpatient SUD program or comprehensive SUD program;(2) Supervision requirements for SUD recovery support services shall be as follows: a. A certified recovery support worker (CRSW) shall be supervised by one of the following: 1. An MLADC who is on the staff of or under contract with a medicaid enrolled outpatient SUD program, comprehensive SUD program, or peer recovery program; 2 A LADC who is permitted to engage in independent practice in accordance with Chapter Law 189:2, II, Laws of 2008, and Chapter Law 249:24, V, Laws of 2010, who also is an LCS and who is on the staff of or under contract with a medicaid enrolled outpatient SUD program, comprehensive SUD program, or peer recovery program;
3. A LADC who is on the staff of or under contract with a medicaid enrolled outpatient SUD program, comprehensive SUD program, or peer recovery program;4. A CRSW who has been certified for one year and has taken 6 hours of supervisory training and 6 hours of practical training which has been approved by the board pursuant to Alc 409.01; or5. A licensed mental health provider who is on the staff of or under contract with a medicaid enrolled outpatient SUD program, comprehensive SUD program, or peer recovery program;b. A LADC delivering recovery support services shall be supervised by an MLADC who is on the staff of or under contract with a medicaid enrolled outpatient SUD program, comprehensive SUD program, or peer recovery program; and c An MLADC delivering recovery support services shall not require supervision;
(3) Individuals who meet the following criteria shall only provide services under the supervision of an MLADC or licensed mental health provider who is on the staff of a medicaid enrolled outpatient SUD program or comprehensive SUD program: a. The individual shall be enrolled in a formal internship for at least a master's degree in a clinical discipline that meets the requirements for initial licensing as an MLADC pursuant to RSA 330-C:16, I, orb. The individual shall: 1. Have completed at least one year of work in the field of substance use disorders treatment under the supervision of an MLADC or licensed mental health provider;2. Have at least a master's degree in a clinical discipline that meets the requirements for initial licensing as an MLADC pursuant to RSA 330-C:16, I; and3. Be working to accumulate the work experience required for licensure;(4) Individuals who meet the criteria below shall only provide services under the supervision of a psychologist who is on the staff of a medicaid enrolled outpatient SUD program or comprehensive SUD program: a. The individual shall be enrolled in a formal internship for at least a master's program that meets the requirements for initial licensure by the NH board of psychologists pursuant to RSA 329-B; orb. The individual shall: 1. Have completed at least one year of work in the field of substance use disorders treatment under the supervision of a person licensed by the NH board of psychologists;2. Have at least a master's degree that meets the requirements for initial licensure by the NH board of psychologists pursuant to RSA 329-B; and3. Be working to accumulate the work experience required for licensure;(5) Individuals who meet the criteria below shall only provide services under the supervision of a psychotherapist who is on the staff of a medicaid enrolled outpatient SUD program or comprehensive SUD program: a. The individual shall be enrolled in a formal internship for at least a master's program that meets the requirements for initial licensure by the NH board of mental health practice pursuant to RSA 330-A; orb. The individual shall: 1. Have completed at least one year of work in the field of substance use disorders treatment under the supervision of a psychotherapist;2. Have at least a master's degree that meets the requirements for initial licensure by the NH board of mental health practice pursuant to RSA 330-A; and3. Be working to accumulate the work experience required for licensure;(6) Individuals who qualify to provide services pursuant to He-W 513.04(c) (3) - (5) above and who hold at least a master's degree shall have ongoing supervision of at least 2 hours per month as follows: a. There shall be direct, individual, or group supervision of at least one hour per month by the supervising practitioner noted in (3) -(5) above; andb. The second hour of supervision may be peer review or case review, such as client-centered conferences;(7) Individuals who qualify to provide services pursuant to He-W 513.04(c) (3) - (5) above and who are enrolled in a formal internship shall receive direct supervision as follows: a. There shall be direct supervision of at least one hour per week;b. The supervisor shall write and sign a weekly note in the intern's supervisory record stating his or her observations and recommendations relative to the intern's performance; andc. The supervisor shall write and sign a monthly note in the intern's supervisory record summarizing his or her evaluation;(8) The medicaid program shall reimburse the outpatient or comprehensive SUD program only if the supervision required in accordance with He-W 513.04(c) (3) - (7) occurs and is documented;(9) The delegated services shall be billed by the outpatient or comprehensive SUD program; and(10) A LADC who is permitted to engage in independent practice in accordance with Chapter Law 189:2, II, Laws of 2008, and Chapter Law 249:24, V, Laws of 2010, shall not provide supervision to an MLADC for the purposes of providing services under He-W 513.(d) SUD treatment and recovery support service providers shall ensure that the recipient has undergone a clinical evaluation, as required by He-W 513.03(b) above, prior to the provider's delivery of other SUD treatment and recovery support services.(e) SUD treatment and recovery support service providers shall ensure that all SUD treatment and recovery support services are provided and documented in accordance with the Health Insurance Portability and Accountability Act (HIPAA) of 1996, 45 CFR 160, 45 CFR 164, Subparts A and E, and 42 CFR, Part II.(f) SUD treatment and recovery support service providers shall ensure that any SUD group treatment and recovery support services described in He-W 513.05 below are delivered in accordance with the following: (1) Services shall only be covered when 2 or more individuals are present for a group service;(2) SUD treatment groups shall include no more than 12 individuals with one licensed practitioner present or no more than 16 individuals when that licensed practitioner is joined by a CRSW or a second licensed practitioner;(3) Recovery support groups shall include no more than 8 individuals with one CRSW present or no more than 12 individuals when that CRSW is joined by a second CRSW; and(4) Peer recovery support groups shall include no more than 8 individuals with one peer recovery coach present or no more than 12 individuals when that peer recovery coach is joined by a second peer recovery coach.(g) SUD treatment service providers shall ensure that all covered services are provided in accordance with criteria as set forth in ASAM Criteria (2013), available as noted in Appendix A, except for SBIRT services provided in accordance with He-W 513.05(c) , substance use screening provided in accordance with He-W 513.05(d) , crisis intervention provided in accordance with He-W 513.05(q) , and evaluations provided in accordance with He-W 513.05(u) .(h) All SUD treatment and recovery support service providers shall treat co-occurring disorders in accordance with scope of law and practice.(i) Except as in (j) below, LADCs, and MLADCs who are delivering or supervising SUD treatment and recovery support services shall be licensed by the NH board of licensing for alcohol and other drug use professionals.(j) Providers who hold a reciprocal international certification and reciprocity consortium/alcohol and other drug abuse (IC&RC) license shall be considered to have met the requirement in (i) above for the purpose of He-W 513.(k) New Hampshire enrolled out of state providers whose license or certification allows them to provide SUD services in the state in which they practice shall be considered to have met the requirements in (i) above.(l) Hospitals enrolled in medicaid as a hospital in accordance with He-W 543 shall also be enrolled in medicaid as an outpatient or comprehensive SUD program in order to provide outpatient or comprehensive SUD services in accordance with He-W 513.05.(m) Providers who are enrolled in other states and who meet the definition of outpatient or comprehensive SUD programs in accordance with He-W 513.02(b) or (q) shall also be enrolled in NH medicaid in order to provide outpatient or comprehensive SUD services in accordance with He-W 513.05.(n) Providers who are employed by, or under contract with, a comprehensive or outpatient SUD program shall be considered to be on the staff of that program.N.H. Admin. Code § He-W 513.04
#10655, INTERIM, eff 8-15-14, EXPIRES: 2-11-15
Amended byVolume XXXV Number 06, Filed February 12, 2015, Proposed by #10774, Effective 1/27/2015, Expires7/27/2015.Amended by Volume XXXV Number 36, Filed September 10, 2015, Proposed by #10922, Effective 9/1/2015, Expires9/1/2025.Amended by Volume XXXVI Number 23, Filed June 9, 2016, Proposed by #11107, Effective 7/1/2016, Expires 7/1/2026.Amended by Volume XXXVII Number 15, Filed April 13, 2017, Proposed by #12157, Effective 3/10/2017, Expires 3/10/2027.Amended by Volume XXXVIII Number 50, Filed December 13, 2018, Proposed by #12681, Effective 11/27/2018, Expires 11/27/2028.