Revision: Oct. 12, 2023, 9:38 a.m.
SB 178-FN-A - AS INTRODUCED
2023 SESSION
23-1054
09/10
SENATE BILL 178-FN-A
AN ACT relative to certain specialty formulas under Medicaid.
SPONSORS: Sen. Rosenwald, Dist 13; Sen. Whitley, Dist 15; Sen. Prentiss, Dist 5; Rep. McMahon, Rock. 17; Rep. Nordgren, Graf. 12; Rep. N. Murphy, Hills. 12; Rep. Nutter-Upham, Hills. 8
COMMITTEE: Health and Human Services
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ANALYSIS
This bill prohibits the department of health and human services from requiring Medicaid beneficiaries to spend their own personal income on specialty formulas, food products, or enteral formulas. The bill makes an appropriation to implement the provision.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
23-1054
09/10
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Three
AN ACT relative to certain specialty formulas under Medicaid.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; Medicaid Services; Enteral Nutrition and Special Medical Formulas. Amend RSA 126-A by inserting after section 4-h the following new section:
126-A:4-i Medicaid Services; Enteral Nutrition and Special Medical Formulas. Subject to approval by the Centers for Medicare and Medicaid Services, the department shall not require medically needy Medicaid beneficiaries to expend personal income for medically necessary specialty formulas, food products or enteral formulas for the purposes of meeting spend down requirements.
2 Appropriation. The sum of $375,000 for the fiscal year ending June 30, 2025 is hereby appropriated to the department of health and human services to implement RSA 126-A:4-i as inserted by this act. The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated.
3 Effective Date. This act shall take effect January 1, 2024.
23-1054
Revised 10/12/23
SB 178-FN-A- FISCAL NOTE
AS INTRODUCED
AN ACT relative to certain specialty formulas under Medicaid.
FISCAL IMPACT: [ X ] State [ ] County [ ] Local [ ] None
| Estimated Increase / (Decrease) | |||
STATE: | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
Appropriation | $0 | $0 | $375,000 | $0 |
Revenue | $0 | $0 | $0 | $0 |
Expenditures | $0 | General Funds: $685,000 Federal Funds: $740,000 Other Funds: $6,000 | General Funds: $1,370,000 Federal Funds: $1,480,000 Other Funds: $12,000 |
General Funds: $1,370,000 Federal Funds: $1,480,000 Other Funds: $12,000
|
Funding Source: | General Fund, federal matching funds, miscellaneous other funds | |||
METHODOLOGY:
This bill states that, subject to approval by the federal Centers for Medicare and Medicaid Services (CMS), the state Department of Health and Human Services shall not require medically needy Medicaid beneficiaries to expend personal income for certain medically necessary products for the purposes of meeting spend-down requirements. The bill contains a general fund appropriation of $375,000 for this purpose in FY 2025. The Department states that based on data from calendar year 2022, 1,430 unique individuals utilized specialty formulas and additives as contemplated by the bill, costing the state Medicaid program $2,862,738 in that year. Of this, 48 percent was paid for with state general funds, with the bulk of the remainder paid for with federal matching funds. Less than one percent was paid for with non-federal other funds for products utilized by beneficiaries of the Granite Advantage Program. The Department anticipates expenditures in future years will be similar to these amounts. Since the bill has an effective date of January 1, 2024, the table above shows an anticipated six months' worth of expenditures in FY24, followed by full years in FY25 and FY26. The Department further notes that per its correspondence with CMS, a specialty food and formula carve out from Medicaid spend-down requirements is currently impermissible. The costs shown above, therefore, would not be incurred unless federal guidance changes.
AGENCIES CONTACTED:
Department of Health and Human Services