2023 New Hampshire Revised Statutes › Title X - Public Health › Chapter 126-A - Department of Health and Human Services › Section 126-A:38 - Financial Statements.

126-A:38 Financial Statements. –
I. (a) Within 60 days after admittance, except as provided in paragraph II, and annually thereafter if requested by the commissioner, a financial statement shall be filed under penalty of perjury by a person legally chargeable for expenses pursuant to RSA 126-A:36 on forms provided for this purpose by the office of reimbursements.
(b) The commissioner is hereby authorized to request and receive from any and all former or current employers, including, but not limited to, personal information with respect to dates of employment, number of hours worked, rate of pay, date of birth, available health insurance, current address, payroll deductions, and social security number of any person with respect to whom the department is investigating the ability to pay; provided, however, the commissioner shall limit the request to the minimum information necessary for the review of the individual's ability to pay. The employer shall furnish the information within 15 days of the department's request unless the time period is extended for good cause shown. If the request for the information is burdensome to the employer, it shall give written notice to the commissioner within the 15-day period, and the commissioner shall review the request of the employer and modify the request if reasonably possible to alleviate the burden on the employer.
(c) The department or employer who discloses financial or employment records under this section shall not be subject to civil liability or criminal prosecution which is based upon its disclosure under this section, or for any other action taken in good faith to comply with the requirements of this section.
(d) Any records established or information collected pursuant to the provisions of this section shall be made available only to the commissioner and the attorney general and their authorized designees, attorneys employed by the department of health and human services, and the client or the client's authorized representative. Such records and information shall be available and used only for purposes directly connected with the investigation of a person's ability to pay under this chapter. The records and information made available to the client or the client's authorized representative shall not include information provided to the department that is prohibited from release by federal law, state statute, state case law, or by contract or agreement between the department and another entity if such contract or agreement prohibits release of such information.
II. Persons admitted to the multiple DWI offender intervention program (M.O.P.) prior to January 1, 2013 who do not pay program fees in full at the time of admission shall file a financial statement under penalty of perjury on forms provided for this purpose by the office of reimbursements and shall enter a payment contract for balance of fees due. The office of reimbursements shall be entitled to recover reasonable attorneys' fees and costs of collection for program fees not paid in accordance with a payment contract.
III. Persons admitted to the multiple DWI offender intervention program (M.O.P.) prior to January 1, 2013 shall notify the office of reimbursements of each change of mail address and actual street address until that person has made payment in full of fees due in accordance with an M.O.P. payment contract. Whenever notice to a person subject to a payment contract is required, notice to the last mail address on file with the office of reimbursements shall be deemed notice to and binding on the payer.
Source.
1995, 310:1. 1997, 215:2. 2010, Sp. Sess., 1:28. 2013, 144:40, eff. July 1, 2013.