Section He-W 589.05 - Non-Covered Services The following shall be non-covered services and shall not be eligible for reimbursement:
(a) Services not listed in a student's care plan;(b) Services that are not coverable under the Social Security Act and for which no FFP is available for said service;(c) Services performed by unqualified individuals pursuant to the Social Security Act, or services delivered by provider types not approvable under the Social Security Act to provide Medicaid services;(d) Consultations, visits, trainings, meetings, or discussions between healthcare providers or individuals in which the student was not physically present for at least 51% of the time;(e) Services which are non-covered pursuant to rules in He-W 500 and are not covered under EPSDT;(f) Supported employment such as vocational goals and job tasks;(g) Services which are solely educational, remedial education, or vocational instruction or tutoring;(h) Services performed by educators or individuals who are not healthcare clinicians such as teachers of the visually impaired or deaf unless:(1) The individual has a valid healthcare license issued by the appropriate licensing board, commission, or council and is acting within the scope of his or her license; (2) The individual is a rehabilitative assistant providing rehabilitative assistance services pursuant to He-W 589.04(af)-(aj); or(3) The individual currently holds a certification as a BCBA;(i) Leisure and social activities that are non-medical;(j) General supervision of a student as required for any student based on the student's development and for non-medical reasons;(k) Services that are solely personal care services delivered by a legally responsible family member pursuant to 42 CFR 440.167;(l) Performance of tasks for the sole purpose of assistance with completion of educational assignments; (m) Services under a CMS NH medicaid waiver;(n) Medicaid state plan services only provided under the 1915(i) provisions of the Social Security Act;(p) Teaching parenting skills;(q) Review of records, documentation development, or report writing;(r) Attending meetings, including individualize education program meetings and IEP team meetings;(s) Parent consultations, contacts, or trainings;(t) School guidance counselor services unless:(1) The individual has a valid healthcare license issued by the appropriate licensing board, commission, or council and is acting within the scope of his or her license; (2) The individual is a rehabilitative assistant providing rehabilitative assistance services pursuant to He-W 589.04(af)-(aj); or(3) The individual currently holds a certification as a BCBA;(u) Services by individuals not having a current license for the practice specialty area for the service area being provided; and(v) Services requiring the technical or professional skill that a state statute or regulation mandates shall be performed by a health care clinician licensed or certified by the state.N.H. Admin. Code § He-W 589.05
Derived from Volume XL Number 11, Filed March 12, 2020, Proposed by #12994, Effective 2/21/2020, Expires 2/21/2030.