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New Hampshire Rulemaking Register · October 24, 2026 · Primary source

2026-223 IP Rule He-W 837

Score 79PRIMARYregulatoryState register42 CFR Pt 2NH

Summary

New Hampshire DHHS has filed an initial proposal to readopt with amendment He-W 837, the administrative rules governing the Granite Advantage Health Care Program, to implement the federally mandated Medicaid community engagement and work requirements under Section 71119 of Public Law 119-21, effective January 1, 2027. The proposed rules reduce the monthly community engagement hour requirement from 100 to 80 hours, add new exemption categories including family caregivers and individuals in SUD treatment at ASAM Level 2.1 or above, restructure non-compliance and disenrollment procedures, and repeal prior rule sections that no longer apply. The rule affects adults ages 19 to 64 with income at or below 133 percent of the federal poverty level who are not receiving Medicare. A public hearing is set for November 13, 2026, with written comments due November 20, 2026.

What this may mean

Granite Advantage Medicaid enrollees who are not excluded or exempt must demonstrate 80 hours per month of qualifying community engagement activities beginning January 1, 2027, or face suspension and eventual disenrollment. SUD treatment facilities and behavioral health providers are directly implicated because enrollment in ASAM Level 2.1 or above SUD treatment serves as an exemption from the requirement, making provider documentation of treatment level and intensity a condition of patient Medicaid continuity. Entities serving this population, including BH and SUD treatment facilities, may see changes in enrollment verification workflows tied to the new exemption certification requirements.

Informational only. Not legal, medical, financial, or other professional advice. Always consult a qualified professional familiar with your specific facts before relying on any item.

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