Medicaid

Allegra Boverman / NHPR

As the sunset for New Hampshire's Medicaid expansion approaches, state legislators are debating how best, or whether, to extend the program. And while the prospect of dropping 47,000 Granite Staters who receive this coverage is daunting, some lawmakers are worried about how to fund it when federal support decreases.

Casey McDermott, NHPR

Newly confirmed New Hampshire Health and Human Services Commissioner Jeffrey Meyers spent part of his first official day on the job lending his support to a plan to extend the state’s Medicaid expansion another two years.

Garrett Vonk

More people have health insurance in New Hampshire, but they're also paying more for it.  That's according to the Insurance Department's annual report on costs

Sara Plourde for NHPR

Republican leaders in the New Hampshire House and Senate say they’re willing to consider reauthorizing the state’s Medicaid expansion after its sunset date at the end of 2016 — as long as they can find someone to help foot the costs.

On Monday’s edition of The Exchange, House Speaker Shawn Jasper said it doesn’t seem politically feasible to expect him to pass a plan that requires more public spending.

Primary 2016: Health Care on the Campaign Trail

Jan 6, 2016
Julie Kertesz / Flickr/CC

Health care still a top issue for voters, from the Affordable Care Act to lowering the cost of prescription drugs. And New Hampshire residents have made solving the opioid crisis a national priority. We're looking at where the twenty-sixteen presidential candidates stand.

Sara Plourde for NHPR

New Hampshire's Department of Health and Human Services has proposed a policy that would increase Medicaid and Medicare reimbursement rates for qualified rural clinics that have a shortage of doctors.

The policy also would create the potential for more providers to receive federal and state loan repayment for underserved areas and drive patients to primary care instead of hospitals.

It's called a Governor-Designated and Secretary-Certified shortage area.

Courtesy David Mulder via Flickr Creative Commons

A bipartisan commission says New Hampshire lawmakers should consider adding comprehensive dental benefits to the state's Medicaid program for adults. The commission, which was created last year to analyze barriers to dental care in New Hampshire, released its final report on Monday.

 

New Hampshire got off to a late start compared to many other states that expanded Medicaid under the Affordable Care Act, but it quickly made up for lost time in terms of enrollment.

Allison Quantz for NHPR

More than seven years — and $31 million — past the original deadline, New Hampshire officials are readying the state's Medicaid billing system for federal certification.

The certification visit scheduled for April 20 is the final step in the long-delayed process of developing the system that reimburses doctors and hospitals for providing Medicaid coverage.

The state approved the $60 million contract with a vendor now owned by Xerox in 2005, expecting it to be online by 2007. The system didn't go live until 2013.

The Senate has voted to wait before deciding whether to extend the state’s expanded Medicaid program, also called the New Hampshire Health Protection Program.

Under the law that went into effect last year, the program will expire at the end of 2016. That’s the point when the federal government stops funding the entire expansion, dialing its contribution down to 90 percent.

In a bipartisan vote, the Senate tabled the extension in order to give more time to determine how the program is working.

Jon Ovington

Today a house committee considered a bill that would prohibit Medicaid from funding circumcisions of newborn baby boys.

Bedford Republican Keith Murphy sponsored this bill. He firmly believes circumcision is dangerous – potentially, very dangerous.

"One hundred and seventeen children a year, on average, die from circumcision complications. In fact it’s one of the leading causes of neonatal male deaths," says Murphy.

Susan Simoneta via Flickr CC

Nursing home residents from across the state are pushing for Gov. Maggie Hassan to reinstate a $7 million cut in expected Medicaid reimbursements.

More than a dozen residents and nursing home administrators arrived at the Statehouse Tuesday with Republican Sen. Jeanie Forrester seeking a meeting with Hassan. Nursing homes aren't receiving a $7 million rate increase they had been expecting due to budget shortfalls in the Department of Health and Human Services. The nursing homes have received the increase since 2008 and most created their budgets around them.

Via NH.gov

Nearly 90 percent of those leaving New Hampshire's prison system are eligible for health care coverage under the state's expanded Medicaid program. And while they make up a small fraction of the more than 30,000 who have signed up so far, health and corrections officials say getting them enrolled could have far-reaching effects.

Jon Ovington

A bill proposed in the state legislature would end Medicaid payments for circumcisions.

The bill’s sponsor, state representative Keith Murphy of Bedford, describes the practice as unethical.

"To me there’s something fundamentally wrong about strapping a baby boy to a board and amputating perfectly healthy, normal tissue," says Murphy.

Murphy adds trimming circumcisions from the state budget will save money, although how much will be determined by the legislature next year.

Less than six months after sign-ups began, New Hampshire is already close to meeting its first-year enrollment target for the state's newly expanded Medicaid program.

The state's previous Medicaid program covered low-income children, parents with non-disabled children under 18, pregnant women, older residents and people with disabilities. The expansion adds anyone under 65 who earns up to 138 percent of federal poverty guidelines, which is about $15,900 for a single adult.

NHPR

The Department of Health and Human Services is delaying part of New Hampshire’s Medicaid Managed Care program.

Transferring New Hampshire’s Medicaid program to so called managed care is a huge, sprawling puzzle. The idea is for private insurance companies to take over the state program that provides health insurance for low income residents. And the trickiest part will be transferring the care of the sickest residents – people with developmental disabilities and traumatic brain injuries.

NHPR Staff

A new data set gives a bird’s eye view of New Hampshire’s uninsured residents – and how they stand to gain health coverage under the Affordable Care Act.

The data itself is not shocking. State health officials and insurers alike know New Hampshire’s most rural communities have the highest rates of uninsured. But this is the first time that information has been aggregated into a map that viewers can navigate on a county-by-county basis.

Jack Rodolico

Yusuf Valera resents that he has to buy health insurance. He’s never had it, and he says he doesn’t want it now.

"I don’t have much of a choice. If I don’t do it, then they’re going to take money out of my taxes anyway," Valera says.

The irony is Valera stands to gain - in a big way - from the Affordable Care Act. Yet like most New Hampshire residents, he simply doesn't like the law.

St. Joseph Hosptial, Nashua

One in five Medicare patients treated for a list of common conditions - like pneumonia and heart failure -  are readmitted to the hospitals that treated them within a month.

One way the federal government is trying to improve that is by penalizing hospitals based on their readmission rates. It’s a provision of the Affordable Care Act that will hit 2,610 hospitals across the country next year, including nine in New Hampshire.

NHPR

CORRECTION: An earlier version of this story said the state will wait until April before it puts Medicaid patients with chronic conditions under the oversight of two managed care companies. In fact the state has not announced when that transition will happen.

New Hampshire is postponing a crucial phase of Medicaid managed care. The delay follows concerns raised by advocates of patients with complicated health conditions.

New Hampshire has increased the amount of Medicaid funding it devotes to home-based care for the disabled since a 1999 U.S. Supreme Court ruling gave people a choice to live outside institutions.

By 2012, according to data provided by the Centers for Medicare and Medicaid Services, the state was providing 50.3 percent of Medicaid long-term care money for disabled people living in home- or community-based settings. That compares to 40.3 percent in 2002.

Via Meridien's NH website

One of three private companies brought in to manage administration and benefits within the state’s Medicaid program is ending its agreement. The Department of Health and Human Services announced Tuesday Meridian Health Plan will withdraw at the end of July.

“This has not been an easy decision,” says Dr. David Cotton, CEO of Detroit-based Meridian, “but  our  recent growth in the Midwest demands that we refocus our resources to continue to provide top-quality managed care products in our core  markets.” 

Nearly 90% of the people who signed up for health care through the Affordable Care Act in New Hampshire have paid their first month’s bill.

Anthem, the only insurance company in the exchange this year, says roughly 35,000 out of the 40,000 who enrolled through healthcare.gov are paid up.

That's a higher percent than estimates put out by Republican members of the U.S. House Energy and Commerce Committee. Their report released April 30th stated that just 67% of enrollees nationally had paid their first month’s premium.

Lawmakers Look For Medicaid Tax Solution

May 6, 2014
Todd Bookman / NHPR

A recent ruling declaring a state tax on hospitals unconstitutional is leaving lawmakers scrambling for a fix. On Tuesday, three amendments were put forward, each offering a different path.

Representatives Cindy Rosenwald (D-Nashua) and Neal Kurk (R-Weare) are co-sponsoring a plan that changes technical language within the Medicaid Enhancement Tax and designates that none of the revenue be allocated to the state's general fund.

“We need to rethink the nature of the MET, the purpose and the partnership,” said Rosenwald.

The Senate's tax committee is meeting to discuss a recent court ruling that found New Hampshire's tax on hospitals unconstitutional.  Senate President Chuck Morse told the Ways and Means Committee last week he hopes negotiations among legislative leaders, the governor and the hospitals produce a short-term fix to avoid a major impact on the budget. The committee is hoping to have a proposal to attach to a House bill when the panel meets Tuesday.  The Superior Court ruling applies to the 2014 tax year and future tax years.

State of New Hampshire

 

Senate President Chuck Morse says lawmakers need to agree on a short-term fix to address a court ruling that found New Hampshire's tax on hospitals unconstitutional.

Gavel
SalFalko, Mentus Media / Flickr Creative Commons

 A judge has ruled that New Hampshire cannot collect a Medicaid Enhancement Tax from hospitals.   In a ruling released Friday, Hillsborough County Superior Court Philip Mangones says the state should have stopped collecting the tax in 2011 when a loophole in the Medicaid reimbursement system closed. He says the tax is unconstitutional.   Catholic Medical Center, St. Joseph Hospital and Exeter Hospital sued in 2011, challenging the $31 million they paid in the tax that year.

Transition To Managed Medicaid Hits Some Bumps

Mar 20, 2014

It’s been a little more than 100 days since the state of New Hampshire dramatically re-shaped its biggest program. On December 1st, traditional Medicaid became Medicaid Managed Care, shifting administration of the health program into the hands of private companies in the hopes of saving $15 million a year.

Perhaps the biggest change to the program for recipients revolves around something called prior authorizations.

Gov. Maggie Hassan says she expects those eligible for insurance under a Medicaid expansion plan backed by a bipartisan group of State Senators will be covered in July.

The plan to insure as many as 50,000 low income residents by using federal money to pay for private coverage cleared a key committee last week.

The plan is expected to win full approval by lawmakers, but those votes have yet to be scheduled.  

Governor Hassan says she’s optimistic that will happen with enough time for the plan’s two-month enrollment period to begin May 1.

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