New Hampshire must send Medicaid work-rule documents to federal officials

The state health department must send required work-rule documents to federal Medicaid officials. The filing concerns work rules for Granite Advantage, New Hampshire's expanded Medicaid program. Before filing, the department must give its proposed plan to a legislative budget committee for review. The department must file by December 1, 2026, or within 30 calendar days after the federal application form is published, whichever comes first.

The state health department must require documents proving work-rule compliance before enrolling a covered applicant. This applies to Granite Advantage applicants who are subject to federal Medicaid work rules. Applicants must provide documents; their own statements alone do not count. The documents must show compliance for the one month immediately before the month of application.

The state health department must check compliance and end coverage when a covered member fails to prove compliance or an exemption after notice. This applies to enrolled Granite Advantage members who are subject to federal Medicaid work rules. The department must use documents, not a member's statement alone. A member must receive notice and 30 additional days to show compliance or an exemption. Checks must occur at least quarterly between eligibility reviews. Coverage ends after the 30-day notice period if the member has shown neither compliance nor an exemption.

The state health department must verify exemptions and get committee approval before adding optional exemptions or other program waivers. These rules apply to Granite Advantage applicants and members seeking exemptions from federal work rules. The department may use its own records or a person's documents, but cannot accept that person's statement alone. An approved professional must certify a listed disabling condition or treatment for a long-term substance use disorder for a medical frailty or special needs exemption. A legislative health oversight committee must approve extra optional exemptions or other program waivers.

New Hampshire pauses its separate Granite Advantage work-rule provisions while federal work rules apply. The pause covers only parts of the existing Granite Advantage law directly related to work and community activity requirements. If federal work rules are eliminated, the state health commissioner must promptly certify in writing that the pause has ended. The pause lasts for the duration of the federal work rules.