Revision: April 9, 2013, midnight
SB 194-FN – AS INTRODUCED
2013 SESSION
01/10
SENATE BILL 194-FN
AN ACT requiring the department of health and human services to implement the Medicaid family planning expansion.
SPONSORS: Sen. Odell, Dist 8; Sen. Stiles, Dist 24; Sen. Gilmour, Dist 12; Rep. Nordgren, Graf 12; Rep. Harding, Graf 13; Rep. Emerson, Ches 11; Rep. Kurk, Hills 2
COMMITTEE: Health, Education and Human Services
This bill requires the department of health and human services to implement the Medicaid family planning expansion as provided under RSA 126-A:4-c.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
13-1008
01/10
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Thirteen
AN ACT requiring the department of health and human services to implement the Medicaid family planning expansion.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Paragraph; Commissioner's Duties; Family Planning Waiver. Amend RSA 126-A:5 by inserting after paragraph XXI the following new paragraph:
XXII. The commissioner shall fully implement expanded coverage of Medicaid family planning services as required by RSA 126-A:4-c no later than July 1, 2013. At the time of implementation, the state’s Medicaid plan shall be amended to enable the state to accept federal matching funds. As provided in RSA 126-A:4-c, the department shall ensure that the state realizes the 90 percent federal Medicaid match available for the family planning services. If the traditional claims payment systems are unavailable for implementation within the time frame indicated in this paragraph, the commissioner shall manually process the payment of claims or contract with a third party administrator to ensure timely provider payment capacity and uninterrupted access to eligible recipients. At least 30 days in advance of program implementation, the commissioner shall conduct an outreach effort to all participating Medicaid family planning providers to distribute guidance and technical assistance regarding patient enrollment procedures, eligibility criteria, and covered medical services and supplies. Within 60 days after program implementation as required under this paragraph and annually thereafter, the commissioner shall make a report relative to the Medicaid family planning services program to the joint legislative fiscal committee.
2 Effective Date. This act shall take effect upon its passage.
LBAO
13-1008
Revised 04/08/13
SB 194 FISCAL NOTE
AN ACT requiring the department of health and human services to implement the Medicaid family planning expansion.
FISCAL IMPACT:
The Department of Health and Human Services states this bill, as introduced, will have an indeterminable impact on state revenue and expenditures in FY 2014 and each year thereafter. There will be no impact on county and local revenue and expenditures.
METHODOLOGY:
The Department of Health and Human Services states this bill requires the Department to implement the family planning coverage group under Medicaid by July 1, 2013, and if traditional claims payment systems are unavailable, the Department shall manually process the payment of claims or contract with a third party administrator for payment of claims. Family planning services would be available to individuals with incomes less than 185% of the federal poverty guidelines who would not otherwise be eligible for Medicaid. The Department indicates the federal Medicaid provides 90% federal matching funds for family planning services in anticipation of avoiding future costs related to unintended pregnancies, births and the associated medical care. The Department has made progress in developing this coverage by framing a Medicaid State Plan Amendment and drafting administrative rules, but the implementation has been delayed because the Medicaid Management Information System was not able to pay claims for these services. The cost of modifying to the legacy Medicaid Management Information System (MMIS) was prohibitive and that system was scheduled to be shut down at the end of March of 2013. The Department states the new Medicaid Management Information System (MMIS), implemented on April 1, 2013, was not designed to include family planning coverage. The Department expects the required modifications to the new system will require adding a new benefit category with a limited benefit package. To date, the Medicaid program has not undertaken this type of design change, and it is expected to take between 6 to 12 months to complete. The Department states it does not yet have an estimate from the vendor on the cost to complete this work.
In addition, the Department indicates modifications to the New HEIGHTS eligibility management system will be necessary at an estimated cost of $300,000, which is not in the Department’s operating budget. The Department states, while the changes are possible, the New HEIGHTS staff are currently being utilized to their maximum potential in programming for the eligibility changes required by the Affordable Care Act (ACA). The ACA changes re-engineer how financial eligibility is determined for pregnant women, caretaker relatives/parents, and children and requires the New HEIGHTS system to have an interface with the health benefit exchange.
The Department states, if New Hampshire proceeds with Medicaid expansion, individuals with incomes up to 138% of the federal poverty guidelines will be eligible for full Medicaid benefits and those with incomes between 138% and 185% of the federal poverty will have access to commercial coverage via the Health Benefit Exchange and receive subsidies to reduce the cost.
The Department indicates it is considering various solutions that would allow for the implementation of a Medicaid family planning benefit by July 1, 2013. The Department has estimated a state general fund cost range for the possible options from $270,400 to $944,000, but cannot determine an accurate cost at this time as the federal participation will vary depending on the option implemented. The Department assumes there will be approximately 1,800 beneficiaries with a per member annual cost of $280. In addition the Department is not able to project the possible costs associated with reallocating resources from the existing federally mandated projects.
This bill does not contain an appropriation.