Revision: Jan. 8, 2024, 3:54 p.m.
SB 455-FN - AS INTRODUCED
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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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 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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
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 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 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.
24-3071
Revised 1/8/24
SB 455-FN- FISCAL NOTE
AS INTRODUCED
AN ACT relative to Medicaid reimbursement rates for prosthetic and orthotic devices.
FISCAL IMPACT: [ X ] State [ ] County [ ] Local [ ] None
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Estimated State Impact - Increase / (Decrease) | ||||||
| FY 2024 | FY 2025 | FY 2026 | FY 2027 | ||
Revenue | $0 | $0 | $0 | $0 | ||
Revenue Fund(s) | None | |||||
Expenditures | $0 | $1,240,000 general funds; $1,240,000 federal funds | $1,240,000 general funds; $1,240,000 federal funds | $1,240,000 general funds; $1,240,000 federal funds | ||
Funding Source(s) | General Fund Federal matching funds | |||||
Appropriations | $0 | Open | Open | Open | ||
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] N/A | ||||||
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 the Medicare rate for those devices. The Department estimates the cost of the bill at approximately $2,480,000 per year, of which half would be paid for with state general funds and half with federal funds.
With respect to the impact on specific rates, the Department notes that there are some instances in which fee-for-service rates are paid above 100 percent of the Medicare rate. Since the bill does not appear to permit paying above 100% of the Medicare rate, the Department assumes it will need to lower those rates to align with the Medicare rate. Further, to the extent that rates exceeds upper payment limits for services provided to those enrolled in fee-for-service, the Department will be required to refund the federal share. The Department notes that 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.
AGENCIES CONTACTED:
Department of Health and Human Services