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New Hampshire - Personal Emergency Response System — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

In New Hampshire, Personal Emergency Response System (PERS) services are funded primarily through the Choices for Independence (CFI) Waiver, administered by the Department of Health and Human Services (DHHS). Providers must enroll through the New Hampshire MMIS Health Enterprise Portal and meet the specific requirements outlined in the CFI Waiver service definitions.

To become an approved PERS provider, applicants must first enroll as a New Hampshire Medicaid provider and then contract with the Managed Care Organizations (MCOs) that administer the CFI Waiver. There is no distinct state license required for PERS providers, but they must meet Medicaid enrollment criteria and pass required background checks.

1. Service Definition and Scope

Under the Choices for Independence (CFI) Waiver, a Personal Emergency Response System (PERS) is defined as an electronic device that enables individuals at high risk of institutionalization to secure help in an emergency. The system is connected to the person's telephone and programmed to signal a response center once a "help" button is activated.

The service includes the installation, upkeep, and maintenance of the device, as well as the monthly monitoring fee. The response center must be staffed 24 hours a day, 7 days a week by trained professionals.

2. Regulatory and Oversight Agencies

The New Hampshire Department of Health and Human Services (DHHS) oversees the Medicaid program and the CFI Waiver. The Division of Medicaid Services manages provider enrollment and policy.

Because most CFI Waiver services are delivered through managed care, providers must also work with the state's contracted Managed Care Organizations (MCOs) for credentialing and contracting.

3. Gatekeeping Prerequisites: Who Can Even Apply

New Hampshire does not require a Certificate of Need or a specific state license to operate as a PERS provider. However, providers must be able to meet the Medicaid enrollment requirements and the specific service standards outlined in the CFI Waiver.

The primary structural requirement is that providers must enroll with NH Medicaid (Fee-for-Service) first to obtain a NH Medicaid ID number before they can complete credentialing and contracting with the MCOs that manage the CFI Waiver.

4. Licensure and Certification Requirements

New Hampshire does not have a distinct licensure category for PERS providers. Instead, approval is based on meeting the provider qualifications specified in the CFI Waiver and successfully enrolling in the NH Medicaid program.

Providers must demonstrate the capacity to provide 24/7 monitoring, install and maintain the equipment, and comply with all general Medicaid provider rules under N.H. Admin. Code He-W 520.

5. Medicaid Provider Enrollment

Providers must submit an enrollment application through the New Hampshire MMIS Health Enterprise Portal. The application type is typically a Billing Provider.

After submitting the application and required documentation, the state will review the application. Once approved, the provider receives a NH Medicaid ID number, which is necessary to proceed with MCO contracting.

6. Staffing, Training and Background Checks

Under N.H. Admin. Code He-W 520.06, certain Medicaid providers are subject to risk-based screening. High-risk providers must undergo state and federal criminal background checks, including fingerprinting.

PERS providers must ensure their response center staff are trained to handle emergencies and communicate effectively with first responders and the participant's designated contacts.

7. Documentation, Policies and Records

Providers must maintain comprehensive records of service delivery, including installation dates, maintenance logs, and records of all emergency signals received and the actions taken.

Policies must cover emergency response protocols, equipment testing and maintenance schedules, and participant confidentiality in accordance with HIPAA.

8. Billing, Rates and Claims

PERS services are typically billed using specific HCPCS codes for installation and monthly monitoring. Rates are established by DHHS and the contracted MCOs.

Providers must submit claims to the appropriate MCO for participants enrolled in managed care, or to the state's MMIS for Fee-for-Service participants.

9. Approval Sequence and Timeline

The approval process begins with submitting the Medicaid enrollment application via the MMIS portal. The state reviews the application and conducts any required background checks.

Once the NH Medicaid ID is issued, the provider must apply for credentialing and contracting with the MCOs. The entire process can take several months depending on application completeness and MCO processing times.

10. Common Denials and Survey Findings

Applications may be denied or delayed if the provider fails to submit required documentation, such as the DSSP 417 form for background checks, within the specified timeframes.

Providers may also face issues if they cannot demonstrate the capability to provide 24/7 monitoring or if they fail to complete the MCO credentialing process.

11. Key Contacts and Resources

Providers should utilize the NH MMIS portal for enrollment and contact the Medicaid Provider Service Center for assistance with the state enrollment process.

For MCO contracting, providers must contact the provider relations departments of AmeriHealth Caritas New Hampshire, NH Healthy Families, and WellSense Health Plan.

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