CurrentNew Hampshire Department of Health and Human ServicesPolicy N/A

Families First Coronavirus Relief Act (FFCRA): COVID-19 Testing Eligibility

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This policy governs a limited Medicaid eligibility category for COVID-19 testing and diagnosis services during the public health emergency. It affects eligible New Hampshire residents who lack other health coverage for COVID-19 testing and are enrolled in fee-for-service coverage.

Policy Summary

PayerNew Hampshire Department of Health and Human Services

PolicyFamilies First Coronavirus Relief Act (FFCRA): COVID-19 Testing Eligibility

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

Key ActionVerify that the member displays the CVDTST coverage category when checking Medicaid eligibility.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

4covered COVID-19 testing service categories

90 daysmaximum retroactive eligibility period from application date

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CurrentNew Hampshire Department of Health and Human ServicesPolicy N/A

Families First Coronavirus Relief Act (FFCRA): COVID-19 Testing Eligibility

Customize your policy alerts

Sign up for all New Hampshire Department of Health and Human Services policy alerts

Know when New Hampshire Department of Health and Human Services releases new policies or updates existing guidance.

Monitor payer policy activity

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Policy Summary

PayerNew Hampshire Department of Health and Human Services

PolicyFamilies First Coronavirus Relief Act (FFCRA): COVID-19 Testing Eligibility

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

Key ActionVerify that the member displays the CVDTST coverage category when checking Medicaid eligibility.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

4covered COVID-19 testing service categories

90 daysmaximum retroactive eligibility period from application date

Eligibility and Covered Services

Eligibility requirements

An individual may qualify for the COVID-19 testing eligibility group only when all applicable eligibility conditions are met.

ALL of the following

ALL of the following
- The individual has no other health coverage that would cover COVID-19 testing.
- The individual is a New Hampshire resident.
- The individual meets applicable U.S. citizenship requirements.
- Eligibility is limited to the public health emergency period.

Covered services and exclusions

Members meeting the eligibility requirements receive only the COVID-19 testing benefit package.

ALL of the following

Covered services include
- Telehealth or in-person screening for a COVID-19 test.
- Chest x-rays for the purpose of diagnosing COVID-19.
- Specimen collection and COVID-19 testing.
- Antibody testing.
Members are enrolled in the CVDTST benefit plan and are fee-for-service only.
COVID-19 treatment and medication are not covered under this eligibility group.

Eligibility Verification

Documentation Required

Verify CVDTST eligibility

When checking Medicaid eligibility, verify that the member is eligible for the COVID-19 testing coverage identified as CVDTST.

Denial Risk

Confirm treatment eligibility separately

Do not rely on the AVR System to identify coverage networks. If the member has tested positive for COVID-19, confirm eligibility for COVID-19 treatment separately.

Key Eligibility Terms

MCVD

CategoryMCVD is the category of eligibility for members receiving COVID-19 testing coverage.

Delivery systemMembers with the MCVD category are enrolled in fee-for-service coverage only.

Managed care statusMembers in the MCVD category are not enrolled in a managed care plan.

CVDTST

Benefit planCVDTST is the COVID Testing Benefit Plan for eligible members.

Covered scopeThe plan covers only specified services: telehealth or in-person COVID-19 screening, chest x-rays for diagnosing COVID-19, specimen collection and testing, and antibody testing.