Revision: July 11, 2024, 10:39 a.m.
SB 455-FN - VERSION ADOPTED BY BOTH BODIES
03/07/2024 0831s
23May2024... 1958h
06/13/2024 2353EBA
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 no less than 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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.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
23May2024... 1958h
06/13/2024 2353EBA 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 no less than 90 percent of the reimbursement rate under Medicare as of January 1, 2024. 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 oversight 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 of $620,000 is appropriated to the department of health and human services for the purpose of establishing a Medicaid reimbursement rate for prosthetic and orthotic devices equal to no less than 90 percent of the Medicare reimbursement rate for prosthetic and orthotic devices under Medicare as of January 1, 2024. The department may accept and expend available federal funds without fiscal committee approval. The governor is authorized to draw a warrant for the general fund share of 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
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
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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 | $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