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March 1, 2013

Posted: March 1, 2013

BDS Gov’s Budget 2013

Legislative Updates from CSNI

Governor Hassan and Medicaid Managed Care Activity

This week, the Governor indicated that she wants to sign an 1115 waiver with CMS.  This would bring in more federal Medicaid funds for nontraditional medical care such as care coordination, obesity management, smoking cessation and so on to the Medicaid population. In addition, there is growing evidence that the Governor believes (as Commissioner Toumpas) that Medicaid expansion cannot move forward without the DHHS contracted commercial insurance companies non as MCO’s. The Governor recognizes NH’s hospitals have been financially strained by budget decisions but has stated that she is working to help with funding but needs to have hospitals sign contracts with the MCO’s.  The Governor has said that if the hospitals sign on, Medicaid managed care will become a reality. She is encouraging all hospitals to sign on and  expects many will. In addition, it is expected that the Governor will soon announce more details about the “Medicaid managed care Commission.”

BDS Presents to House Finance Division III

On Thursday, morning Matthew Eras and Nancy Rollins of the Department of Health and Human Services presented to the House Finance Committee, Division III.

The presentation and the attached documents confirm the following information from Governor Hassan’s budget:


Are We Still Doing the Minimum?

The questions from the Committee (mostly from Rep. Kruk) focused on how BDS could limit or reduce services. I.e. What is the minimum required of the State for this population? Could we continue a waitlist for the ABD/DD populations? Can we create a waitlist for early intervention? BDS pushed back on an EI waitlist, citing the long term cost savings the programs yields to the State.

Are We Maximizing Federal Funds?

Other questions included: Are we maximizing federal funds? Generally the answer is “Yes.” After much prodding from the committee, the department is apparently going to “re-attempt” to get matching Medicaid dollars for the DRF in Laconia.

Medicaid Managed Care?

Rep. Cindy Rosenwald asked if Medicaid managed care was assumed in the budget numbers. Interestingly, Nancy Rollins said “Yes” but they are reflected in the Office of Medicaid and Business Policy (yes, even Waiver and other BDS Medicaid funding). This is completely contrary to what Stephen Moser, Chief Financial Officer for the department has said to MCAC and other groups. Mr. Mosher has publically said that all so called “Step 2” services are budged as fee for service in the FY 14 and FY 15 budget. This is an area that needs clarification.

$900,000 Savings?

There was also discussion about the $900,000 “administrative reduction” from the current Fiscal year. The department reported to the committee that Area Agencies have “returned” this money to the department. It was also reported that this reduction is now “built into the base” of future funding to the Area Agencies.

First Long Term Care Meeting

Also on Thursday, Representatives: Laurie Harding, Mariellen MacKay, Lisa DiMartino and Susan Emerson conducted a “brain storming” meeting on Long Term Care in NH (this included Mental Health). Those represented included: CSNI, Community Mental Health Centers, Case Management Companies, Nursing Homes (Private and County) AARP, Centene Corporation and others. Other than each group explaining why they were there and who they represent, the discussion of course turned to Medicaid managed care. Rep. Harding wants to invite Lorene Reagan (formerly of HHS, now with an MCO) to a future meeting to talk about what Boston Medical Center HealthNet Plan is doing in MA around innovation. The group will not meet again until early April.

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