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RSA 167:58 · Definitions

167:58 Definitions. – In this subdivision:

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I.

"Abuse" means provider practices that are inconsistent with sound fiscal, business, or medical practices, and result in an unnecessary cost to the medicaid program, or in reimbursement for services that are above those actually rendered, that are not medically necessary, or that fail to meet professionally recognized standards for health care. I-a. "Commissioner" means the commissioner of the department of health and human services.

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II.

"Data" means information of any kind in any form, including computer software as defined in RSA 638:16, VI.

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III.

"Department" means the department of health and human services.

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IV.

"Fraud" means an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or some other person. It includes any act that constitutes fraud under New Hampshire criminal code, RSA title LXII.

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V.

"Provider" means any individual, partnership, corporation or entity furnishing services under a written contract with the department.

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VI.

"Suspension" means the removal of a provider from participation in the medicaid program for not less than 60 days nor more than 6 months.

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VII.

"Termination" means the removal of a provider from participation in the medicaid program for an indefinite period of time. Source. 1981, 189:2. 1983, 291:1. 1990, 260:1. 1995, 310:121, 175, eff. Nov. 1, 1995.

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Source note

Source. 1981, 189:2. 1983, 291:1. 1990, 260:1. 1995, 310:121, 175, eff. Nov. 1, 1995.

Source history

  • 1981, 189:2
  • 1983, 291:1
  • 1990, 260:1
  • 1995, 310:121, 175, eff. Nov. 1, 1995

Related materials

Bill relationships

  • 2026 HB1219 amend

    hort Title. Sections 2 and 3 of this act shall be known as "The Help for Low Income Seniors Act of 2026". 3 New Section; Financial Eligibility for Medicare Savings Program. Amend RSA 167 by inserting after section 4-f the following new section: 167:4-g Medicare Savings Program. I. The department shall administer the Medicare savings program as described in 42 U.S.C. section 1396a(a)(10)(E) in accor

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    Be it Enacted by the Senate and House of Representatives in General Court convened: 1 New Section; Public Safety and Welfare; Single Signature Medicaid Requirement. Amend RSA 167 by inserting after section 34 the following new section: 167:34-a Single Signature Medicaid Requirement. Notwithstanding any other provision of law to the contrary, the department of education and the insurance dep

  • 2026 HB1720 amend

    hips. Be it Enacted by the Senate and House of Representatives in General Court convened: 1 New Section; Child Care Scholarship Program; Notification to Licensees. Amend RSA 167 by inserting after section 83 the following new section: 167:83-a Child Care Scholarship Program; Notification to Licensees. I. When the department receives an application for a child care scholarship which names a

  • 2026 HB1720-FN amend

    hips. Be it Enacted by the Senate and House of Representatives in General Court convened: 1 New Section; Child Care Scholarship Program; Notification to Licensees. Amend RSA 167 by inserting after section 83 the following new section: 167:83-a Child Care Scholarship Program; Notification to Licensees. I. When the department receives an application for a child care scholarship which names a

  • 2026 HB1773 amend

    Senate and House of Representatives in General Court convened: 1 New Section; SNAP; Demonstration Waiver to Prohibit the Purchase of Certain Foods with SNAP Benefits. Amend RSA 167 by inserting after section 17-d the following new section: 167:17-e Demonstration Waiver to Prohibit the Purchase of Certain Foods with SNAP Benefits. I. On or before January 1, 2027, the department of health and

  • 2026 HB1773-FN amend

    Senate and House of Representatives in General Court convened: 1 New Section; SNAP; Demonstration Waiver to Prohibit the Purchase of Certain Foods with SNAP Benefits. Amend RSA 167 by inserting after section 17-d the following new section: 167:17-e Demonstration Waiver to Prohibit the Purchase of Certain Foods with SNAP Benefits. I. On or before January 1, 2027, the department of health and

  • 2026 HB1797 amend · effective 2026-07-01

    . Be it Enacted by the Senate and House of Representatives in General Court convened: 1 New Section; SNAP Benefit Eligibility Criteria and Verification Procedures. Amend RSA 167 by inserting after section 17-d the following new section: 167:17-e SNAP Benefit Eligibility Criteria and Verification Procedures. I. The department of health and human services shall not seek any waiver of work

  • 2026 HB1797-FN amend · effective 2026-07-01

    . Be it Enacted by the Senate and House of Representatives in General Court convened: 1 New Section; SNAP Benefit Eligibility Criteria and Verification Procedures. Amend RSA 167 by inserting after section 17-d the following new section: 167:17-e SNAP Benefit Eligibility Criteria and Verification Procedures. I. The department of health and human services shall not seek any waiver of work

  • 2026 SB123 amend

    Be it Enacted by the Senate and House of Representatives in General Court convened: 1 New Section; State Medicaid Plan; Substance Misuse Treatment; Ear Acupuncture. Amend RSA 167 by inserting after section 3-m the following new section: 167:3-n State Medicaid Plan; Substance Misuse Treatment; Ear Acupuncture Included. Medical assistance under the state Medicaid plan shall include ear acupunct

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  • 2026 SB142 reference · effective 2026-01-01

    thorized by law] administration and enforcement of child support as defined in this section, administration of federal and state family support and assistance programs pursuant to RSA 167, and assistance to developmentally disabled children pursuant to RSA 171-A; provided, however, that nothing in this chapter or RSA 167 shall be construed as authorizing any public official, agent, or representative, in

  • 2026 SB142-FN reference · effective 2026-01-01

    thorized by law] administration and enforcement of child support as defined in this section, administration of federal and state family support and assistance programs pursuant to RSA 167, and assistance to developmentally disabled children pursuant to RSA 171-A; provided, however, that nothing in this chapter or RSA 167 shall be construed as authorizing any public official, agent, or representative, in