Section He-W 541.01 - Definitions(a) "Clean claim(s) " means a claim that can be processed without obtaining additional information from the provider or from a third party, including a claim with errors originating in the state's claims system, but not including a claim from a dispensing provider who is under investigation for fraud or abuse or a claim under review for medical necessity.(b) "Department" means the New Hampshire department of health and human services.(c) "Family planning services" means medical services, medical procedures, and pharmaceutical supplies and devices provided by or under the supervision of a physician or other health professional that allow a recipient to prevent or delay pregnancy or to otherwise control family size, and which receive an enhanced match rate of 90% federal match.(d) "Hysterectomy" means a surgical procedure for the purpose of removing the uterus.(e) "Institutionalized individual" means an individual who: (1) Is involuntarily confined or detained under a civil or criminal statute, in a correctional or rehabilitative facility, including a mental hospital or other facility for the care and treatment of mental illness; or(2) Is confined under a voluntary commitment in a mental hospital or other facility for the care and treatment of mental illness.(f) "Medicaid" means the Title XIX and Title XXI programs administered by the department which makes medical assistance available to eligible individuals.(g) "Mentally incompetent individual" means a mentally incompetent individual as defined in 42 CFR 441.251.(h) "Recipient" means any individual who is eligible for and receiving medical assistance under the medicaid program.(i) "Sterilization" means any medical procedure, treatment or surgical procedure which is intended to render an individual permanently incapable of reproducing.(j) "Title XIX program" means the joint federal-state program described in Title XIX of the Social Security Act and administered in New Hampshire by the department under the medicaid program.(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 under the medicaid program.N.H. Admin. Code § He-W 541.01
(See Revision Note at chapter heading He-W 500); ss by #5874, eff 8-1-94; ss by #7329, eff 8-1-00, EXPIRED: 8-1-08
New. #9272, eff 9-19-08; amd by #10139, eff 7-1-12
Amended by Volume XXXVI Number 49, Filed December 8, 2016, Proposed by #12053, Effective 11/19/2016, Expires 11/19/2027.