Definitions: O–Q

(a) “Outpatient” means a patient of an organized medical facility, or distinct part of that facility, who is expected by the facility to receive, and who does receive, professional services for less than a 24-hour period regardless of the hour of admission, and whether or not a bed is used or whether or not the patient remains in the facility past midnight.

(b) “Overpayment” means medical assistance received by an AG that is in excess of what the AG is actually entitled to receive.

(c) “Parent” includes the biological, adoptive, or stepparent, unless otherwise specified.

(d) “Parental support or care” means financial support, guidance, physical care, or supervision of a dependent child.

(e) “Patient” means an individual who is receiving needed professional services that are directed by a licensed practitioner of the healing arts toward maintenance, improvement, or protection of health, or lessening of illness, disability, or pain.

(f) “Payment from a trust” means any disbursal from the corpus of a trust, or from income generated by a trust, which benefits the party receiving it, regardless of whether the benefit is monetary, or nonmonetary, or property disbursements, such as the right to use and occupy real property.

(g) “Penalty period” means the length of time during which payment for services is denied.

(h) “Period of ineligibility” means the length of time an individual is ineligible for assistance due to excess resources or receipt of a lump sum.

( i ) “Permanently and totally disabled” means permanent physical or mental impairment, disease, or combination thereof, which substantially precludes an individual from engaging in useful occupations within their competence, as determined by the department, in accordance with RSA 167:6, VI.

(k) “Personal property” for purposes of reimbursement means “personal property resources" and personal effects such as furnishings, tools, and equipment.

(l) “Personal property resources” means a form of cash or an item which can readily be converted to cash, including such items as bank accounts, stocks, or bonds.

(m) “Plan to achieve self-support (PASS)” means a time limited arrangement or accomplishing financial independence, which is approved by the Social Security Administration and allows a recipient who is visually impaired, disabled, or elderly to set aside income and resources for a work goal.

(n) “Pregnant women (PW)” means medical coverage provided by the department to pregnant women whose income meets eligibility requirements for categorically needy medical assistance, pursuant to RSA 167:68.

(o) “Primary wage earner (PWE)” means the parent or caretaker relative in a 2-parent household who earned the highest income in the 24 months prior to the application for medical assistance, for eligibility of parent and other caretaker relative medical assistance.

(p) “Private institution” means a facility that provides shelter, custody, or care to 2 or more persons and is managed entirely or partially by private funds.

(q) “Protected income level (PIL)” means the amount, based on AG size, against which net income is compared in determining eligibility as medically needy for medical assistance when the AG has applied for medical assistance as medically needy only or is found to be financially ineligible for financial assistance.

(r) “Public institution” means a facility, other than a child care or medical institution, which affords shelter, custody, or care to 2 or more persons and is managed entirely or partially by or through any public instrumentality, official, or employee acting in an official capacity.

(s) “Questionable” means, with regard to verifying factors of eligibility, any verbal or written statement made by an AG member which is inconsistent with:

(1) Other statements made by the same AG member or another AG member;

(2) Information provided on current or past applications for assistance; or

(3) Any information received by the department from any other source.

Source. #13836, eff 12-28-23