1 Department of Health and Human Services; Medicaid Methodology Working Group Established.

I. The department of health and human services shall convene a working group for the study of nursing home rate Medicaid methodology consisting of the following:

(a) A member of the house of representatives, appointed by the speaker of the house of representatives;

(b) A member of the senate, appointed by the president of the senate;

(c) The commissioner of the department of health and human services, or designee;

(d) A member of the New Hampshire Association of Counties, appointed by that organization;

(e) A member of the New Hampshire Health Care Association, appointed by that organization;

(f) A member of the New Hampshire Hospital Association, appointed by that organization; and

(g) A certified public accountant specializing in nursing home cost reporting, appointed by the governor.

II. The working group shall be convened by the commissioner of department of health and human services, or their designee, and shall be subject to RSA 91-A. The working group shall make recommendations concerning the nursing home reimbursement methodology, with a focus on the following considerations:

(a) Access to nursing home care and the existence of waiting lists;

(b) Barriers to hospital discharge to nursing homes;

(c) Whether the acuity or direct care needs of nursing home residents are properly captured by reimbursement;

(d) Capital reimbursement in light of aging nursing home infrastructure;

(e) The relationship between workforce needs of nursing homes and reimbursement;

(f) The overall solvency of the nursing home sector; and

(g) The fairest means of addressing changes of ownership within reimbursement in a manner that protects Medicaid program integrity.

III. No later than December 31, 2026, the commissioner of the department of health and human services, or their designee, shall submit to the speaker of the house of representatives, the president of the senate, the house clerk, the senate clerk, the governor, the state library, and the county-state finance commission any proposed changes to state law or regulations the department, in consultation with the working group, believes is necessary if the department intends to modify the nursing home Medicaid rate methodology.

2 Department of Health and Human Services; Appropriation. The sum of $5,000,000 for the fiscal year ending June 30, 2026 is hereby appropriated to the department of health and human services for the purpose of awarding a one-time general fund payment to licensed nursing facilities serving individuals covered by Medicaid that received, on January 1, 2026, a new daily reimbursement rate below 95 percent of what they had received on July 1, 2025, as calculated by the department of health and human services. The department of health and human services shall have sole discretion over distribution of the funds. 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 upon its passage.

1 Department of Health and Human Services; Medicaid Methodology Working Group Established.

I. The department of health and human services shall convene a working group for the study of nursing home rate Medicaid methodology consisting of the following:

(a) A member of the house of representatives, appointed by the speaker of the house of representatives;

(b) A member of the senate, appointed by the president of the senate;

(c) The commissioner of the department of health and human services, or designee;

(d) A member of the New Hampshire Association of Counties, appointed by that organization;

(e) A member of the New Hampshire Health Care Association, appointed by that organization;

(f) A member of the New Hampshire Hospital Association, appointed by that organization; and

(g) A certified public accountant specializing in nursing home cost reporting, appointed by the governor.

II. The working group shall be convened by the commissioner of department of health and human services, or their designee, and shall be subject to RSA 91-A. The working group shall make recommendations concerning the nursing home reimbursement methodology, with a focus on the following considerations:

(a) Access to nursing home care and the existence of waiting lists;

(b) Barriers to hospital discharge to nursing homes;

(c) Whether the acuity or direct care needs of nursing home residents are properly captured by reimbursement;

(d) Capital reimbursement in light of aging nursing home infrastructure;

(e) The relationship between workforce needs of nursing homes and reimbursement;

(f) The overall solvency of the nursing home sector; and

(g) The fairest means of addressing changes of ownership within reimbursement in a manner that protects Medicaid program integrity.

III. No later than December 31, 2026, the commissioner of the department of health and human services, or their designee, shall submit to the speaker of the house of representatives, the president of the senate, the house clerk, the senate clerk, the governor, the state library, and the county-state finance commission any proposed changes to state law or regulations the department, in consultation with the working group, believes is necessary if the department intends to modify the nursing home Medicaid rate methodology.

2 Department of Health and Human Services; Appropriation. The sum of $5,000,000 for the fiscal year ending June 30, 2026 is hereby appropriated to the department of health and human services for the purpose of awarding a one-time general fund payment to licensed nursing facilities serving individuals covered by Medicaid that received, on January 1, 2026, a new daily reimbursement rate below 95 percent of what they had received on July 1, 2025, as calculated by the department of health and human services. The department of health and human services shall have sole discretion over distribution of the funds. 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 upon its passage.