He-W 508.03 - Recipient Eligibility

He-W 508.03. Recipient Eligibility

(a) In accordance with RSA 167:3-e, III, and RSA 167:3-f, III (a)-(f), recipients shall be eligible for medical assistance for home care of children with severe disabilities (HC-CSD), if the recipient:

(1) Resides in a place maintained as the recipient's home community;

(2) Is able to receive services in the home as defined in 45 CFR 233.90(c)(1)(v)(B);

(3) Meets the program criteria described in Section 1902(e)(3) of the Social Security Act;

(4) Meets the criteria described in He-W 641.04, except that, pursuant to the prohibition in Section 1614(f)(2)(B) of the Social Security Act, the criteria described in He-W 641.04(b)-(e) on the deeming of parental income shall not apply;

(5) Has an impairment, or combination of impairments, that meets, medically equals, or functionally equals the criteria for an impairment as described in 20 CFR, Part 404, Subpart P, App. 1;

(6) Meets the medical criteria pursuant to RSA 167:3-f, III(e); and

(7) Requires the same degree of care that is typically provided in a hospital, psychiatric hospital, nursing facility, or intermediate care facility for the mentally retarded (ICF-MR), in accordance with He-W 508.04.

(b) In addition to (a) above, recipients shall be eligible only if the services proposed for the recipient are:

(1) Medically appropriate in accordance with He-W 508.05; and

(2) Cost effective in accordance with He-W 508.06.

(See Revision Note at chapter heading He-W 500); ss by #5941, eff 12-22-94, EXPIRED: 12-22-02

New. #8196, INTERIM, eff 10-29-04, EXIRED 7-1-05

New. #9291, eff 7-1-09 (from He-W 508.02)

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