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State officials propose changes to Medicaid managed care program

Posted: July 23, 2015

CONCORD — State Health and Human Services officials want to adjust the state’s contract with the two managed care companies administering the state’s Medicaid program.

The contract with the two companies would run through June 30, 2017, and would increase the cost by $314 million to $1.63 billion.

Executive councilors got their first look at the proposed changes during their meeting on Wednesday.

The new contract, which was tabled so councilors could review it before a vote next month, changes the implementation of managed care for nursing home and home-based services for the elderly; includes children in foster care and with severe disabilities and those who qualify for both Medicaid and Medicare under the managed care program, and changes the rates providers are paid.

The community mental health centers are concerned the contract would mean a significant reduction in what they are paid for services, and HHS Commission Nick Toumpas said a meeting is scheduled next week with the centers.

But Toumpas told executive councilors Wednesday the state is not the negotiator between the managed care companies and the community mental health centers.

If there is an impasse, he said, there would be a huge disruption to the 170,000 people served under the Medicaid program.

“We need to have a measure in place,“ Toumpas said.

The council will vote on the proposed contract at one of its two meetings in August.

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