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NH Health Protection Program - Providers
The New Hampshire Health Protection Program (NHHPP), which started on August 15, 2014, is a health care program for low-income New Hampshire residents ages 19-64. Currently most NHHPP recipients are enrolled in NHHPP's Bridge program and its members are enrolled in one of the two Medicaid Care Management plans: New Hampshire Healthy Families or the Well Sense Health Plan. The New Hampshire Premium Assistance Program (PAP) is the next phase of the New Hampshire Health Protection Program, which will begin in January 2016. The Department of Health and Human Services, using Medicaid funds, will purchase an approved Qualified Health Plan (QHP) for NHHPP's Bridge members. The 5 QHPs, which were certified for sale on New Hampshire's Federally Facilitated Marketplace (FFM), will provide health insurance for those in the PAP. NHHPP recipients will have an opportunity to pick their QHP beginning November 1, 2015, for coverage to begin January 1, 2016. Please visit Premium Assistance Program for more information.

Providers must contract with the 5 Qualified Health Plans, listed below, if they want to continue providing services to NHHPP recipients moving to the Premium Assistance Program.

Qualified Health Plans

Fee Schedule for NHHPP Care Management Members in the Alternative Benefit Plan

Providers will receive the fees on the NHHPP-MCO fee schedule for all NHHPP recipients who are in a health plan under the Alternative Benefit Plan (ABP). While NHHPP recipients are in NH Medicaid Fee-for-Service, providers will be reimbursed at the Standard Medicaid rate. (NHHPP recipients have 60 days to choose a health plan and health plan coverage always begins on the first day of the month following their selection.) Some medically frail NHHPP recipients may not be in the ABP; for those members, the health plans will reimburse providers in the same manner they are presently doing for the population in the current Medicaid Care Management program.

The fee schedule is the last document listed
under Fee Schedules in the below link.

Substance Use Disorder (SUD) Benefits

The NHHPP includes a substance use disorder (SUD) benefit which is covered under the NHHPP Alternative Benefit Plan (ABP). The documents below include the adopted SUD Administrative Rules, a description of the SUD benefit categories, a list of the covered Substance Use Disorder services, and the SUD provider types enrolled with New Hampshire Medicaid. The covered services were phased in over a twelve month period, with all listed services added by September 1, 2015.

It is important that you check/confirm eligibility and plan enrollment in MMIS prior to providing services to New Hampshire Health Protection Plan (NHHPP) recipients. MMIS is the software system that maintains eligibility information for all NH Medicaid and NHHPP recipients.

Provider Training: Checking Member Eligibility and Enrollment in NH Medicaid's Management Information System (MMIS) Online Portal.

Standard Medicaid Services and the Alternative Benefit Plan under the New Hampshire Health Protection Program (NHHPP)

Most adults, ages 19 through 64, who qualify for the NHHPP will receive services under the Alternative Benefit Plan (APB). This document Adobe Acrobat Reader Symbol lists the services covered under Standard Medicaid and the ABP. It also notes which services are covered by the health plans (New Hampshire Healthy Families and Well Sense Health Plan) under Medicaid Care Management.

NHHPP recipients who have special health care needs may indicate on their application that they are medically frail.Medically frail may choose to receive services under the ABP or under Standard Medicaid. It is mandatory for all NHHPP recipients, including the medically frail, to get their services under Medicaid Care Management.

Resource Documents

Important Links

Provider Communications

July, 2014 - Important Notice Regarding Pharmacy Co-pays

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New Hampshire Department of Health and Human Services
129 Pleasant Street | Concord, NH | 03301-3852


copyright 2010. State of New Hampshire