Section He-W 589.08 - Documentation of Expenditure of Non-Federal Funds(a) The enrolled school provider shall provide documentation annually regarding all services rendered pursuant to these rules.(b) Such documentation shall: (1) Demonstrate that: a. The percentage of federal medical assistance reimbursed, as required by section 1905(b) of the Social Security Act, does not exceed 50% of the actual cost of covered services claimed under medicaid; andb. In no case are services that are reimbursable under medicaid, but paid by other federal funding, claimed by the enrolled school provider under NH medicaid;(2) Be reviewed and signed by the enrolled school provider's superintendent;(3) Be submitted to the department no later than October 30 of each year for the preceding fiscal year period; and(4) Be accompanied by a completed form "Documentation of Expenditure of Non-Federal Funds" (2/2020) for a specific July 1 through June 30 time period which includes an attestation signed and dated by the superintendent stating: "I hereby certify that all Medicaid funds paid to the above named districts under He-W 589, Medical Assistance Services Provided by Educational Agencies for the period July 1, xxxx through June 30, xxxx have been supplemented with LEA/SAU and/or non-federal funds to total 100% of the cost of services rendered and that the Medicaid reimbursement does not exceed 50% of the total cost of the services rendered."
N.H. Admin. Code § He-W 589.08
Derived from Volume XL Number 11, Filed March 12, 2020, Proposed by #12994, Effective 2/21/2020, Expires 2/21/2030.