ADULT HEALTH SERVICES PROVIDER IN NEW HAMPSHIRE

Fatumata Kaba
Jul 27
4 min read

PROMOTING WELL-BEING AND INDEPENDENCE THROUGH COMPREHENSIVE HEALTH SUPPORT

Adult Health Services in New Hampshire provide essential healthcare and wellness support to adults with disabilities, chronic conditions, or age-related challenges. These services focus on improving physical, mental, and social well-being through a range of health and therapeutic interventions. Adult Health Services are authorized under New Hampshire Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: New Hampshire Department of Health and Human Services (DHHS)

Role: Administers Medicaid waiver funding for Adult Health Services and manages provider enrollment, service authorization, and reimbursement.

Agency: Bureau of Elderly and Adult Services (BEAS)

Role: Ensures quality standards, service delivery, and compliance for Adult Health Services under HCBS waiver programs.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Medicaid-funded Adult Health Services meet HCBS quality, person-centered planning, and participant protection standards.

2. ADULT HEALTH SERVICES OVERVIEW

Adult Health Services aim to support adults with healthcare needs by offering personalized medical care, health monitoring, and wellness programs.

Approved providers may deliver:

Health Monitoring and Assessment: Regular checks of vital signs, chronic condition management, and wellness evaluations.
Medication Management: Assistance with medication schedules, reminders, and administration.
Nutritional Support: Meal planning, dietary counseling, and health education.
Physical Health Maintenance: Exercises, mobility support, and physical therapy.
Mental Health Support: Counseling, stress management, and wellness coaching.
Chronic Disease Management: Diabetes, hypertension, and respiratory condition care.
Health Education and Self-Care Training: Teaching participants and caregivers how to manage health conditions effectively.
Care Coordination: Liaising with healthcare providers to ensure continuity of care.

All services are provided according to the Individualized Service Plan (ISP) to meet the participant’s healthcare needs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register the business entity with the New Hampshire Secretary of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Adult Health provider via the New Hampshire Medicaid Provider Enrollment Portal.
Obtain licensure from DHHS as a healthcare service provider if applicable.
Maintain general liability and professional liability insurance.
Develop comprehensive policies for health monitoring, medication management, and wellness support.
Ensure staff meet background checks, health screenings, and healthcare training requirements.

4. NEW HAMPSHIRE PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Complete the Provider Enrollment Application through the New Hampshire Medicaid Provider Enrollment Portal for Adult Health Services under HCBS waivers.

Application and Documentation Submission:

Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, healthcare licenses, and policy manuals.

Program Readiness Review:

DHHS and BEAS evaluate provider readiness, including health care protocols, safety measures, and staff qualifications.

Approval & Medicaid Enrollment:

Upon approval, providers are authorized to bill Medicaid for Adult Health Services using designated billing codes.

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License (New Hampshire Secretary of State)
IRS EIN confirmation
NPI confirmation
Healthcare Service Provider License (if applicable)
Proof of general and professional liability insurance
Adult Health Services Policy & Procedure Manual, including:
- Health assessment, care planning, and medication management protocols
- Staff credentialing, background checks, and ongoing training records
- Documentation standards for health tracking and Medicaid billing
- HIPAA compliance, patient rights, and grievance handling
- Safety protocols, infection control, and emergency preparedness
- Quality assurance and health outcome monitoring
- Client education and family support guidelines