relative to clinical eligibility criteria for nursing facility and home and community based care.

SB 125 amends New Hampshire's Medicaid eligibility rules for nursing facility and home-based care services. It establishes specific clinical criteria: individuals must require 24-hour care for medical monitoring, rehabilitation, medication administration, or assistance with two or more daily activities (like eating, bathing, or mobility). The bill mandates that skilled medical personnel use an approved assessment tool to determine eligibility, and if unclear, must consult the applicant’s primary care provider. Financial eligibility remains tied to federal Medicaid income standards, requiring income at or below the nursing facility special income limit or deducting allowable medical expenses. This bill directly affects seniors and people with disabilities seeking long-term care services under Medicaid.