1. (a) All disproportionate share non-public hospitals, as defined in He-C 5001.01(c), shall complete and submit the “Annual Medicaid Uncompensated Care Cost Data Request Form” (January 2023 edition) as follows:

   1. (1) To the office of the commissioner, NH department of health and human services;
   2. (2) Annually, no later than the second to last Friday in February of each year; and
   3. (3) Signed by the chief financial officer (CFO) of each hospital.
2. (b) Copies of the “Annual Medicaid Uncompensated Care Cost Data Request Form” (January 2023 edition) may be obtained from the office of the commissioner, department of health and human services, Concord, NH 03301-6505.
3. (c) Hospitals shall maintain all data on claims related to Medicaid and uninsured patients, including Medicare and third-party liability revenue until such time as directed otherwise by the Department.

Source. #6888, eff 11-21-98, EXPIRED: 11-21-06 New. #9814, INTERIM, eff 11-19-10, EXPIRES: 5-18-11; amd by #9916-A, eff 4-23-11, (para (b)); amd by 9916-B, eff 4-23-11, (para (a)); ss by #10029, INTERIM, eff 11-19-11, EXPIRES: 5-17-12; ss by #10109, eff 5-17-12; ss by #10789, eff 2-21-15; ss by #12468, eff 1-26-18; ss by #12719, eff 1-29-19; (see also Revision Note at part heading for He-C 5002); ss by #13545, eff 1-28-23