Bill Text - HB692 (2019)

Relative to dental care for Medicaid recipients.


Revision: March 21, 2019, 10:57 a.m.

HB 692-FN - AS AMENDED BY THE HOUSE

 

14Mar2019... 0748h

2019 SESSION

19-0668

01/03

 

HOUSE BILL 692-FN

 

AN ACT relative to dental care for Medicaid recipients.

 

SPONSORS: Rep. Bernet, Hills. 4; Rep. Thompson, Ches. 14; Rep. Schapiro, Ches. 16; Rep. Swinburne, Ches. 10; Rep. Von Plinsky, Ches. 7; Sen. Chandley, Dist 11; Sen. Feltes, Dist 15

 

COMMITTEE: Health, Human Services and Elderly Affairs

 

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ANALYSIS

 

This bill requires the Medicaid managed care program to provide dental benefits to covered persons.

 

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

14Mar2019... 0748h 19-0668

01/03

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Nineteen

 

AN ACT relative to dental care for Medicaid recipients.

 

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

 

1  Medicaid Managed Care Program; Dental Benefits.  Amend RSA 126-A:5, XIX(a) to read as follows:

XIX.(a)  The commissioner shall employ a managed care model for administering the Medicaid program and its enrollees to provide for managed care services for all Medicaid populations throughout New Hampshire consistent with the provisions of 42 U.S.C. section 1396u-2.  Models for managed care may include, but not be limited to, a traditional capitated managed care organization contract, an administrative services organization, an accountable care organization, or a primary care case management model, or a combination thereof, offering the best value, quality assurance, and efficiency, maximizing the potential for savings, and presenting the most innovative approach compared to other externally administered models.  The department shall present the opportunities of the various models or combination of models with a recommendation for the best managed care model for New Hampshire, no later than July 15, 2011, to the fiscal committee of the general court which shall consult with the oversight committee on health and human services.  Services to be managed within the model shall include all mandatory Medicaid covered services and may include, but shall not be limited to, care coordination, utilization management, disease management, pharmacy benefit management, provider network management, quality management, and customer services.  [The model shall not include mandatory dental services.] The commissioner shall issue a 5-year request for proposals to enter into contracts with the vendors that demonstrate the greatest ability to satisfy the state's need for value, quality, efficiency, innovation, and savings.  The request for proposals shall be released no later than October 15, 2011.  The vendors of the managed care model or combination of models demonstrating the greatest ability to satisfy the state's need for value, quality, efficiency, innovation, and savings shall be selected no later than January 15, 2012 with final contracts submitted to the governor and council no later than March 15, 2012 unless this date is extended by the fiscal committee.  After the bidding process, the commissioner shall establish a capitated rate based on the bids by the appropriate model for the contract that is full risk to the vendors.  The capitated rate shall be broken down into rate cells for each population including, but not limited to, the persons eligible for temporary assistance to needy families (TANF), aid for the permanently and totally disabled (APTD), breast and cervical cancer program (BCCP), home care for children with severe disabilities (HC-CSD), and those residing in nursing facilities.  The capitated rate shall be approved by the fiscal committee of the general court.  The managed care model or models' selected vendors providing the Medicaid services shall establish medical homes and all Medicaid recipients shall receive their care through a medical home.  In contracting for a managed care model and the various rate cells, the department shall ensure no reduction in the quality of care of services provided to enrollees in the managed care model and shall exercise all due diligence to maintain or increase the current level of quality of care provided.  The target date for implementation of the contract is July 1, 2012.  The commissioner may, in consultation with the fiscal committee, adopt rules, if necessary, to implement the provisions of this paragraph.  The department shall seek, with the approval of the fiscal committee, all necessary and appropriate waivers to implement the provisions of this paragraph.

2  Effective Date.  This act shall take effect July 1, 2019.

 

LBAO

19-0668

Amended 3/18/19

 

HB 692-FN- FISCAL NOTE

AS AMENDED BY THE HOUSE (AMENDMENT #2019-0748h)

 

AN ACT relative to dental care for Medicaid recipients.

 

FISCAL IMPACT:      [ X ] State              [    ] County               [    ] Local              [    ] None

 

 

 

Estimated Increase / (Decrease)

STATE:

FY 2020

FY 2021

FY 2022

FY 2023

   Appropriation

$0

$0

$0

$0

   Revenue

$0

$0

$0

$0

   Expenditures

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

Funding Source:

  [ X ] General            [    ] Education            [    ] Highway           [    ] Other

 

 

 

 

 

METHODOLOGY:

This bill amends RSA 126-A:5, XIX by removing the prohibition against including dental services under Medicaid managed care and requires the Commissioner of the Department of Health and Services to develop and implement a program to allow the Medicaid managed care organizations to provide dental benefits to its enrollees.

 

The Department states there were 84,724 adults aged 21 and older enrolled in the Medicaid program, of which 47,937 were participating via Medicaid Expansion as of January 1, 2019.  The Department also notes New Hampshire Medicaid currently provides dental services to children enrolled in the Medicaid program and provides limited emergency dental services on a fee for service basis to adult Medicaid enrollees.  However, the Department states it is unable to provide cost estimates without sufficient information about the program or benefit design, which the bill does not include.

 

AGENCIES CONTACTED:

Department of Health and Human Services