Revision: May 9, 2013, midnight
SB 194-FN – VERSION ADOPTED BY BOTH BODIES
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.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.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 04/22/13
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 increase state expenditures by $373,100 in FY 2014 and FY 2015, and may have an indeterminable impact on state expenditures in FY 2016 and each year thereafter. There will be no impact on state revenue, or 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 program 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 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 expanded family planning coverage.
In April, the Department met with family planning providers to develop a plan to implement the program. Under this plan, the Department would implement the expansion using a manual eligibility and claims process with administrative support from the family planning providers. The Department states this will minimize additional administrative costs to the state. The Department assumes it will be able to implement the program utilizing 3 existing full time employees. Based on fiscal year 2012 data, the Department calculated an average annual cost of $287 per client for family planning services. The department assumes an additional 1,300 individuals will be eligible for services under the expansion. Based on these assumptions, the Department estimates the following costs:
FY 2014 |
FY 2015 | |
Additional Clients: |
1,300 |
1,300 |
Average Cost per Client: |
$287 |
$287 |
Total Cost: |
$373,100 |
$373,100 |
Federal Funds: |
$335,790 |
$335,790 |
General Fund: |
$37,310 |
$37,310 |
The fiscal impact beyond FY 2015 cannot be determined due to a number of unknowns including the impacts of the Affordable Care Act and Medicaid Expansion. Implementation of Medicaid Expansion will reduce the number of individuals eligible for family planning services.
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 coverage and those with incomes between 138% and 185% of the federal poverty will also have access to commercial coverage via the Health Benefit Exchange.
This bill does not contain an appropriation.