SB343 (2010) Detail

Relative to Medicaid managed care.


SB 343-FN – AS AMENDED BY THE SENATE

03/03/10 0789s

2010 SESSION

10-2733

01/09

SENATE BILL 343-FN

AN ACT relative to Medicaid managed care.

SPONSORS: Sen. Bradley, Dist 3; Sen. Downing, Dist 22; Sen. Letourneau, Dist 19; Sen. Gallus, Dist 1; Rep. Packard, Rock 3; Rep. Boutin, Merr 9; Rep. Wendelboe, Belk 1

COMMITTEE: Health and Human Services

AMENDED ANALYSIS

This bill requires the commissioner of the department of health and human services to release a request for information (RFI) soliciting information regarding the feasibility of contracting with a managed care organization for risk-based managed care for all Medicaid recipients.

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

03/03/10 0789s

10-2733

01/09

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Ten

AN ACT relative to Medicaid managed care.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 Request for Information relative to Medicaid Managed Care. The commissioner of the department of health and human services shall release a request for information (RFI) no later than August 1, 2010 soliciting information regarding the feasibility of contracting with a managed care organization for risk-based managed care for all Medicaid recipients, including the elderly, those meeting federal supplemental security income and state standards for disability, and those who are also currently enrolled in Medicare. The RFI shall specifically ask for information relating to reducing the costs of the Medicaid program or slowing the growth in Medicaid spending while maintaining the same quality measures presently achieved. The commissioner shall submit a report to the governor, speaker of the house of representatives, president of the senate, and the health and human services oversight committee no later than 60 days following the completion of the RFI process summarizing the information obtained.

2 Effective Date. This act shall take effect upon its passage.

LBAO

10-2733

01/06/10

SB 343-FN - FISCAL NOTE

AN ACT relative to Medicaid managed care.

FISCAL IMPACT:

      The Department of Health and Human Services states this bill may have an indeterminable fiscal impact on state and county expenditures in FY 2010 and each year thereafter. This bill will have no fiscal impact on state, county, and local revenue and local expenditures.

METHODOLOGY:

    The Department of Health and Human Services states this bill directs the Department to submit a Medicaid waiver for the purposes of making New Hampshire’s Medicaid program subject to operation by a managed care entity with mandatory participation by Medicaid recipients. The Department states Medicaid programs typically explore managed care in an effort to reduce costs. Last year, DHHS requested that Milliman, Inc., a leading health care actuarial firm, review New Hampshire’s Medicaid claims and conduct actuarial analysis to determine the viability of moving to a managed care model. Federal law requires that states that utilize a managed care model must offer choice to recipients. This requires at a minimum, two managed care organizations (MCO) to serve Medicaid enrollees guaranteeing enrollees always have an option to utilize one or the other. This requirement is not waivable. Milliman concluded that several factors impact the ability of a state to achieve savings by utilizing Medicaid managed care. These factors include the state’s existing reimbursement rate structure, size of the Medicaid caseload, administrative costs and the ‘wrap-around’ responsibility. In New Hampshire, caseload, reimbursement and administrative costs have been comparatively low. States opting for managed care must wrap around and pay for all services required by federal law but which the MCO does not include in its benefit package. The Department states they are unable to determine the fiscal impact at this time given the complexities of the variables.