2026-225 IP Rule He-W 880.01

The New Hampshire Department of Health and Human Services issued an initial proposal dated August 28, 2026, to readopt with amendment He-W 880.01, which governs the initiation of Medical Assistance (Medicaid) eligibility. The rule was previously effective January 26, 2023, under Document #13536. The proposal establishes the operative date on which eligibility for categorically needy and medically needy medical assistance begins, keyed to whether all eligibility requirements are met on the date of application. For standard applications, eligibility begins the day of application if all requirements are met on that date; otherwise, eligibility begins the day within the application month on which all requirements are satisfied. For newborns added to an assistance group, eligibility begins on the date of birth. For in-and-out medically needy medical assistance, the monthly spenddown period begins no earlier than the date of application and continues for one calendar month, with eligibility commencing on the day incurred medical costs equal or exceed the spenddown amount. For retroactive coverage, the rule provides that individuals applying for retroactive categorically needy or medically needy medical assistance may receive coverage for up to 23 retroactive months directly preceding the month of application, pursuant to 42 CFR 435.915. However, individuals enrolled in MAGI-based medical assistance in the adult expansion group as defined in 42 CFR 435.119 are limited to one retroactive month. Retroactive in-and-out medically needy eligibility is determined separately for each of the 23 retroactive months. The rule also addresses situations in which Aid to the Needy Blind or Aid to the Permanently and Totally Disabled assistance is initially denied and that denial is subsequently reversed, whether by the department or the Social Security Administration. In those circumstances, medical assistance eligibility is determined beginning on the original application date, provided all general, technical, and categorical eligibility requirements are met and the reversal follows specified reconsideration or appeal procedures under He-C 201 or SSA processes.