Section He-W 575.11 - Payment for AAC Aids Payment for AAC aids shall be made as follows:
(a) The DME provider of AAC aids shall submit claims for payment to the department's fiscal agent;(b) Claims shall not be submitted prior to the date the AAC aid is delivered to the recipient;(c) The payment amount for rental shall be based on the manufacturer's customary rental charge to the public;(d) Payment for the purchase of AAC aids shall be made at the lesser of the following amounts: (1) Usual and customary charge to the public, as established by the provider; or(2) Provider acquisition cost, plus a mark-up, which shall be determined as follows: a. For purchases from providers who have a program in place for ongoing education and technical support for the use of the AAC aid(s) after purchase, the mark-up shall be no greater than 35%; andb. For purchases from providers who do not have a program in place for ongoing education and technical support for the use of the AAC aid(s) after purchase, the mark-up shall be as follows: 1.For AAC aids with a total cost of less than $301, the mark up shall be no greater than 35%;
2.For AAC aids with a total cost from $301 to $750, the mark-up shall be no greater than 30%;
3.For AAC aids with a total cost from $751 to $1,200, the mark-up shall be no greater than 25%; and
4.For AAC aids with a total cost of $1,201 and above, the mark-up shall be no greater than 20%;
(e) Payment as calculated in (d) above shall not include shipping costs, except for cases in which the AAC aids are purchased from multiple vendors, or the provider would receive less than $35 per vendor over their cost when shipping is included;(f) When the AAC provider receives less than $35 over the acquisition cost when shipping is included, then an amount shall be included in the total payment to account for the cost of shipping;(g) In the case of an AAC aid that has been rented before purchase, the cost of one month's rental shall be deducted from the purchase amount computed in (d) above;(h) For rental of AAC aids: (1) No prepayment shall be made; and(2) The provider shall submit claims at the end of the rental period;(i) Payment for repairs of purchased AAC aids shall be the all-inclusive usual and customary charge to the public, except that: (1) The allowable labor costs shall not exceed $50.00/hour; and(2) Payment shall not include the cost of shipping and handling;(j) Recipients shall not be liable for shipping and handling costs associated with repairs, rentals, and purchases; and(k) Payment shall be denied if the recipient is not eligible for NH Medicaid on the date the authorized AAC aid is ordered.N.H. Admin. Code § He-W 575.11