N.H. Admin. Code § Jus 605.04

Current through Register No. 50, December 12, 2024

Section Jus 605.04 - Mental Health Expenses Awards

(a) The commission shall consider and evaluate requests for compensation for mental health expenses if the underlying facts of the claim meet the requirements of Jus 605.01 and none of the circumstances resulting in ineligibility described in Jus 605.02 applies.

(b) A claimant submitting a request for compensation for mental health expenses shall submit the following information and documentation to support the request:

(1) The name and address of each licensed mental health provider who provided crime-related treatment as identified on any bills or invoices received for such treatment;

(2) An up-to-date release, insurance and other collateral source information as described in Jus 604.03;

(3) A completed "Insurance and Other Collateral Financial Source Information for Vehicle Crimes" form as described in Jus 604.04, if the claim involves a vehicle crime;

(4) A mental health treatment plan signed by the licensed provider; and

(5) An authorization for the release of mental health and related billing information that complies with all applicable federal requirements for each provider.

(c) Once the unit has received the information and documentation required pursuant to (b) above, the unit shall:

(1) Contact the licensed mental health care provider to request a copy of the mental health treatment plan submitted by the licensed mental health professional to the victim's insurance carrier, or if the victim does not have insurance, the licensed metal health provider-completed initial assessment and treatment plan;

(2) Contact the licensed health care provider to request a copy of the mental health medication treatment plan created by a health care provider licensed to prescribe medication;

(3) Contact the appropriate licensing body to verify that the treating mental health care provider is in fact licensed in the jurisdiction in which mental health treatment has been, is being, or will be provided; and

(4) Contact the licensed mental health care provider to request a copy of each bill or invoice itemizing all charges for mental health services, including for medications and medication management, the payment for which the victim is responsible.

(d) The following kinds of expenses shall be eligible for compensation under the category of mental health expenses:

(1) The actual cost of treatment, whether individual, group, or both, provided by licensed mental health personnel, after first applying any available insurance or other available collateral financial source, for mental health issues that were directly caused by the crime;

(2) Mileage to and from appointments with licensed mental health care providers, at the fee for service Medicaid rate. Mileage shall be paid for trips over 10 miles round trip and shall be capped at 100 miles round trip; and

(3) All other directly crime-related mental health expenses incurred, including out-of-pocket expenses not already described above.

(e) Awards for compensation of mental health expenses shall be limited pursuant to the following:

(1) The commission shall not award compensation for mental health treatment or services provided by mental health personnel who do not hold appropriate licensure for the kind of treatment provided;

(2) The commission shall award compensation up to $4,000 in total expenses, or 40 visits, whichever comes first;

(3) The mental health treatment shall be crime-related therapy;

(4) The commission shall award compensation that does not exceed the portion of the cost of each individual therapy session for which the victim is responsible, limited to the lesser of:

a.The Medicaid reimbursement rate applicable to the licensed provider; or

b.The amount billed by the licensed provider; and

(5) The commission shall award compensation that does not exceed the portion of the cost of each group therapy session for which the victim is responsible, limited to the lesser of:

a.The Medicaid reimbursement rate applicable to the licensed provider; or

b.The amount billed by the licensed provider.

(f) In circumstances in which a balance remains after applying insurance, other collateral financial sources, and compensation awards under this part, the commission shall contact the licensed mental health care provider to whom the balance is owed and encourage that provider to write off such balance.

N.H. Admin. Code § Jus 605.04

#9553, eff 9-25-09

Amended by Volume XL Number 2, Filed January 9, 2020, Proposed by #12938, Effective 12/9/2019, Expires 12/9/2029.