SB455 (2024) Detail

Relative to Medicaid reimbursement rates for prosthetic and orthotic devices.


SB 455-FN - AS AMENDED BY THE SENATE

 

03/07/2024   0831s

2024 SESSION

24-3071

05/10

 

SENATE BILL 455-FN

 

AN ACT relative to Medicaid reimbursement rates for prosthetic and orthotic devices.

 

SPONSORS: Sen. Prentiss, Dist 5; Sen. Fenton, Dist 10; Sen. Watters, Dist 4; Sen. Altschiller, Dist 24; Sen. Perkins Kwoka, Dist 21; Sen. Whitley, Dist 15; Sen. Innis, Dist 7; Sen. Soucy, Dist 18; Sen. Carson, Dist 14; Sen. D'Allesandro, Dist 20; Sen. Chandley, Dist 11; Rep. Hakken-Phillips, Graf. 12; Rep. Morse, Graf. 9; Rep. J. Murphy, Graf. 12; Rep. Palmer, Sull. 2

 

COMMITTEE: Health and Human Services

 

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AMENDED ANALYSIS

 

This bill directs the department of health and human services to establish a reimbursement rate for prosthetic and orthotic devices under Medicaid that is equal to 90 percent of the rate under Medicare and makes an appropriation to the department for this purpose.  The bill also directs the legislative oversight committee on health and human services to study the issue.

 

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

03/07/2024   0831s 24-3071

05/10

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Twenty Four

 

AN ACT relative to Medicaid reimbursement rates for prosthetic and orthotic devices.

 

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

 

1  Medicaid Reimbursement Rate for Prosthetic and Orthotic Devices.  The commissioner of department of health and human services shall take all available measures to increase the reimbursement rate for prosthetic and orthotic devices under Medicaid so that it is equal to 90 percent of the reimbursement rate under Medicare.  On or before November 1, 2024, the commissioner shall provide a report of such actions to the oversight committee on health and human services, established in RSA 126-A:13.  The report shall include the current reimbursement rates for prosthetic and orthotic devices under each program and address any remaining disparity.

2  Oversight Committee on Health and Human Services; Review of Medicaid Reimbursement Rates.  The committee on health and human services established in RSA 126-A:13 shall undertake an annual review of Medicaid reimbursement rates for prosthetic and orthotic devices, determine the adequacy of such rates given the usual and customary cost of such devices, and identify ways to establish equal reimbursement rates for prosthetic and orthotic devices under Medicare and Medicaid.

3  Appropriation; Department of Health and Human Services; Medicaid Reimbursement Rates for Prosthetic and Orthotic Devices.  For the biennium ending June 30, 2025, the sum necessary to establish a Medicaid reimbursement rate for prosthetic and orthotic devices equal to 90 percent of the Medicare reimbursement rate for prosthetic and orthotic devices is hereby appropriated to the department of health and human services.  The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated.

4  Effective Date.  This act shall take effect July 1, 2024.

 

LBA

24-3071

Amended 3/19/24

 

SB 455-FN- FISCAL NOTE

AS AMENDED BY THE SENATE (AMENDMENT #2024-0831s)

 

AN ACT relative to Medicaid reimbursement rates for prosthetic and orthotic devices.

 

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

 

 

Estimated State Impact - Increase / (Decrease)

 

FY 2024

FY 2025

FY 2026

FY 2027

Revenue

$0

$0

$0

$0

Revenue Fund(s)

None

Expenditures

$0

$620,000 general funds; $620,000 federal funds

$620,000 general funds; $620,000 federal funds

$620,000 general funds; $620,000 federal funds

Funding Source(s)

General Fund

Federal Medicaid Funds

Appropriations

$0

$620,000

$0

$0

Funding Source(s)

General Fund

Does this bill provide sufficient funding to cover estimated expenditures? [X] Yes

Does this bill authorize new positions to implement this bill? [X] No

 

METHODOLOGY:

This bill requires the Department of Health and Human Services to take measures to establish a Medicaid reimbursement rate for prosthetic and orthotic devices that is equal to 90 percent of the Medicare rate for those devices.  The Department estimates the cost of the bill at approximately $1,240,000 per year, of which half would be paid for with state general funds and half with federal funds.

 

In response to the bill as introduced, the Department noted that there are some instances in which fee-for-service rates are higher than those contemplated by the bill.  Since the bill does not appear to permit paying above 90 percent of the Medicare rate, the Department may need to lower those rates accordingly.  Further, to the extent that rates exceed upper payment limits for services provided to those enrolled in fee-for-service, the Department will be required to refund the federal share.  These restrictions do not apply to rates paid as part of the managed care program.

 

For the FY24/25 biennium, the bill contains open warrant language authorizing an appropriation of the amount necessary to fund the bill's provisions.  As the bill does not contain a provision allowing the Department to accept and expend matching federal funds, the Department would need to accept such funds through the Fiscal Committee.

 

AGENCIES CONTACTED:

Department of Health and Human Services

 

Amendments

Date Amendment
Feb. 21, 2024 2024-0831s

Links


Date Body Type
Jan. 10, 2024 Senate Hearing
March 7, 2024 Senate Floor Vote
April 4, 2024 Senate Floor Vote
April 17, 2024 House Hearing
April 17, 2024 House Exec Session
April 17, 2024 House Exec Session

Bill Text Revisions

SB455 Revision: 41142 Date: March 19, 2024, 11:06 a.m.
SB455 Revision: 40975 Date: Feb. 21, 2024, 4:27 p.m.
SB455 Revision: 40243 Date: Jan. 8, 2024, 3:54 p.m.

Docket


April 12, 2024: Executive Session: 04/17/2024 03:00 pm LOB 206-208


April 11, 2024: Executive Session: 04/17/2024 02:30 pm LOB 206-208


April 11, 2024: Public Hearing: 04/17/2024 02:00 pm LOB 206-208


April 10, 2024: Introduced (in recess of) 03/28/2024 and referred to Health, Human Services and Elderly Affairs HJ 11


April 5, 2024: Ought to Pass: MA, VV; OT3rdg; 04/05/2024; SJ 8


March 27, 2024: Committee Report: Ought to Pass, 04/05/2024, Vote 6-0; SC 13


March 7, 2024: Ought to Pass with Amendment 2024-0831s, MA, VV; Refer to Finance Rule 4-5; 03/07/2024; SJ 6


March 7, 2024: Committee Amendment # 2024-0831s, AA, VV; 03/07/2024; SJ 6


Feb. 22, 2024: Committee Report: Ought to Pass with Amendment # 2024-0831s, 03/07/2024; Vote 5-0; CC; SC 9


Jan. 4, 2024: Hearing: 01/10/2024, Room 101, LOB, 09:15 am; SC 2


Dec. 12, 2023: To Be Introduced 01/03/2024 and Referred to Health and Human Services; SJ 1