Access and Availability
We want to hear from you!
Please consider completing this survey to help us better understand your Access and Availability status as outlined by NH DHHS. It only takes 5-10 minutes of your time and you will entered into a drawing to receive breakfast or lunch (your choice) for your office! Thank you!
In order to help our members, your patients, understand the expectations for providing an adequate network, capacity, services, geographic locations across the state, and appointment scheduling, the charts below show the Access and Availability standards to follow from the Department of Health and Human Services:
A Participating Provider Network that adequately meets all covered medical, mental health, Serious Mental Illness, Serious Emotional Disturbance, Substance Use Disorder and psychosocial needs of NH Healthy Families members in a manner that provides for coordination and collaboration among multiple Providers and disciplines and equal access to services.
Assurances of Adequate Capacity and Services for NH Healthy Families’ Participating Provider network shall have Participating Providers in sufficient numbers, and with sufficient capacity and expertise for all covered services to meet the geographic standards.
Time and Distance Standards. At a minimum, NH Healthy Families’ Participating Provider network shall meet the geographic access standards described in the table below for all NH Healthy Families members, in addition to maintaining in its network a sufficient number of Participating Providers to provide all services and equal access.
| Type of Appointment | Scheduling Time Frame |
| Transitional care after inpatient stay (medical or behavioral) – PCP, Specialist or CMHC | Within 2 business days of discharge when part of a member’s discharge plan from inpatient care |
| Transitional care after inpatient stay (medical or behavioral) – Home care | Within 2 calendar days of discharge – must be ordered by PCP, specialty care provider or as part of discharge plan |
| PCP non-symptomatic office visit | Within 45 calendar days of request |
| PCP non-urgent, symptomatic visits | Within 10 calendar days of request |
| PCP or other provider Urgent, symptomatic office visits | Within 48 hours |
| Mental Health Providers | Care within 6 hours, or direct member to crisis center or ER For a non-life threatening emergency Care within 48 hours for urgent care appointment within 10 business days for a routine office visit |
| Post Discharge from New Hampshire Hospital | Contact with community mental health center within 48 hours of psychiatric discharge from a New Hampshire Hospital and follow-up appointment to occur within 7 calendar days |
| Private Hospital Psychiatric Discharge | Follow-up appointment within 7 calendar days |
| Emergency Providers (medical and behavioral) | Immediately (24 hours a day, 7 days a week) and without prior authorization |
| Provider/Service | Requirement |
| PCPs (Adult and Pediatric) | Two (2) within forty (40) driving minutes or fifteen (15) driving miles |
| Adult Specialists | One (1) within sixty (60) driving minutes or forty-five (45) driving miles |
| Pediatric Specialists | One (1) within one hundred twenty (120) driving minutes or eighty driving (80) miles |
| OB/GYN Providers | One (1) within sixty (60) driving minutes or forty-five (45) driving miles |
| Hospitals | One (1) within sixty (60) driving minutes or forty-five (45) driving miles |
| Mental Health Providers (Adult and Pediatric) | One (1) within forty-five (45) driving minutes or twenty-five (25) driving miles |
| Certified Community Behavioral Health Clinics (CCBHC) | All certified CCBHCs in New Hampshire |
| Community Mental Health Programs | One (1) within forty-five (45) driving minutes or twenty-five (25) driving miles |
| Pharmacies | One (1) within forty-five (45) driving minutes or fifteen (15) driving miles |
| Tertiary or Specialized Services (e.g., Trauma, Neonatal) | One (1) within one hundred twenty (120) driving minutes or eighty driving (80) miles |
| Individual/Group MLADCs | One (1) within forty-five (45) minutes or fifteen (15) miles |
| Substance Use Disorder Programs | One (1) within sixty (60) minutes or forty-five (45) miles. |
| Adult Medical Day Care | One (1) within sixty (60) driving minutes or forty-five (45) driving miles |
| Hospice | One (1) within sixty (60) driving minutes or forty-five (45) driving miles |
| Office-based Physical Therapy/Occupation-al Therapy/Speech Therapy | One (1) within sixty (60) driving minutes or forty-five (45) driving miles |
| Provider/Service Type | Requirement |
| MLADCs | The MCO’s Participating Provider network shall include seventy percent (70%) of all such Providers licensed and practicing in NH |
| Opioid Treatment Programs (OTPs) | The MCO’s Participating Provider network shall include seventy-five percent (75%) of all such Providers licensed and practicing in NH |
| Buprenorphine Prescribers | The Participating Provider network shall include seventy-five percent (75%) of all such Providers actively prescribing Buprenorphine in their practice and licensed and practicing in NH |
| Residential Substance Use Disorder Treatment Programs | The MCO’s Participating Provider network shall include fifty percent (50%) of all such Providers licensed and practicing in NH |
| Peer Recovery Programs | The MCO’s Participating Provider network shall include one hundred percent (100%) of all such willing Programs in NH |
| Residential Programs for Serious Mental Illness | The MCO’s Participating Provider network shall include 100% of all such Providers, located in NH, if they are operated by or under contract with Community Mental Health Programs, and 100% of all such Providers if they are otherwise under contract with the Department and are appropriately licensed or certified by the Department under He-P 800 or He-M 1000. |
| Psychiatric Residential Treatment Facilities | The MCO’s Participating Provider network shall include 100% of all such Providers, located in NH, if they are owned or operated by, under contract with, or are otherwise determined or designated by the Department to provide this service, and are appropriately licensed or certified by the Department or a Department approved alternative certification entity. |