The New Hampshire “Medicaid to Schools” Program reimburses New Hampshire school districts for district-associated costs incurred, whether in district or in an out-of-district facility, for the following mental and physical health-related services:
- Occupational Therapy
- Physical Therapy
- Speech Language, Hearing and Vision
- Psychological and Psychiatric
- Mental Health/Guidance
- Rehabilitative Assistance (Non-Instructional/Non-Tutorial Paraprofessional or Aide Services)
- Specialized Transportation Services, but only on days that an additional coverable service is delivered and properly documented
The NH “Medicaid to Schools” Program is a “fee-for-service” program. This means that each related service delivered to a New Hampshire student with an IEP must be documented in order for our school district to recover costs from Medicaid. The following list defines the specific documentation required by the “Medicaid to Schools” Program.
“Transaction Logs” are required to evidence the delivery of services billable to Medicaid. The elements of the transaction log can certainly appear in many formats, but each log must contain the following elements:
- Practitioner name
- Student name
- Type of service
- Group size
- Dates of service
- Length of service (units)
- Original signature of practitioner
- In the case of Rehabilitative Assistance: Original, signed certification by a Licensed Practitioner of the Healing Arts
Enclosed is a sample of transaction logs that meet NH Medicaid requirements and streamline the process for staff. If your facility already uses paperwork with the necessary criteria, no additional documentation is required. We would simply need to obtain copies of the original signed documentation.
Required Credentials for Out-of-State Licensed Practitioners (if applicable)
The Program “Snapshot” provided by MSB delineates the practitioner qualifications under the “Medicaid to Schools” Program in NH. Out-of-state licenses are allowed under the Program’s qualifications if the practitioner is providing the service within his/her licensing state, with the exception of mental health services. Out-of-state practitioners who deliver mental health services require a waiver from DHHS in order for the services to be reimbursable.
It is important that copies of credentials in effect for the year for which services were delivered be retained. Often times the DHHS auditors look at historical documentation several years previous in their audits. In the past, facilities have not retained historical credentialing information, and sending districts have had to pay back money to DHHS as a result. Please retain copies of historical credentials.
There are likely inherent health-related services in your program. Our school district needs more detailed documentation when receiving invoices indicating an all-inclusive “tuition,” in order to bill Medicaid for services. Our school district needs specific itemization of health-related service delivery costs on your invoices as well as the documentation of the specific service delivery (as previously noted above under the “transaction log” discussion).
Medicaid covers rehabilitative assistance services provided by paraprofessionals. The definition of Rehabilitative Assistance includes assistance with disability-related issues such as mobility, communication, behavioral management, nutrition, medications, supported employment (but see specific requirements in He-M 1301.04 (v)(7)), and any other remedial services which are necessary for the maximum reduction of a student’s physical or mental disability, excluding classroom instruction or academic tutoring.
When rehabilitative assistance logs are forwarded for billing, NH requires these forms to be cosigned by a licensed healthcare professional who is knowledgeable of the service provision and is able to verify that the services are health-related in nature, and that weekly consultation took place between the licensed healthcare professional and the rehabilitative assistant.
The billing documentation requirements include verifying a child’s attendance on the days that Medicaid-covered services take place. We request that you provide attendance information for each student for whom we are claiming with indication of specific dates of absence, not a monthly summary.
The method for billing to Medicaid requires setting a rate for each practitioner. Therefore, we will need either the billing rate for each service provided by your facility by practitioner and invoiced to our district or, if that is not available, salary information and benefit amounts for each practitioner providing a covered service.