Specifications include, but are not limited to: Disability determinations are conducted in order to determine the medical eligibility component for applicants seeking Medicaid disability benefits. Pursuant to 42CFR435.912(a)(1)-(2), requires Medicaid eligibility determinations be completed within 90 days of receiving applications for benefits. At this time, the Department does not have sufficient clinical staff to meet the federal timeframes that are mandated for disability determinations. The contract resulting from this RFA will require a Medical Review Team consisting of physicians, nurses, and psychiatrists or psychologists to review cases referred by the Department and provide the Department with a clinical determination within fifteen (15) business days from receipt of referral. The team of professionals on the Medical Review Team will determine the medical eligibility of each individual applying for assistance through Aid to the Permanently and Totally Disabled, Medicaid for Employed Adults with Disabilities, Medicaid for Employed Older Adults with Disabilities, Home Care for Children with Severe Disabilities and, Aid to the Needy Blind on the basis of medical, diagnostic, and mental health, utilizing the “NH DDU Disability MERS” (see Appendix E – New Hampshire Disability Determination Unit Medical Eligibility Review Summary).
