MEDICAID MANAGED CARE
We need your support on SB 155-medicaid managed care “shall not be implemented before July 1, 2019.”
This is an important opportunity to PUSH A PAUSE BUTTON on the implementation of Medicaid managed care scheduled for a NH Senate Health & Human Services hearing on Tuesday, March 7, 1:30pm in the LOB, room 101.
The NH Legislature needs to know that individuals and their families do not want adult services to be managed by out-of-state MCO’s. More importantly, the NH Legislature, NH families and all stakeholders deserve more time to evaluate what is the best model of care for our citizens receiving long term supports and services. The MCO model is unproven in its ability to provide LTSS (Long Term Supports and Services) but our Area Agency system does work! It’s a longstanding NH tradition. Locally based supports and services are state law under RSA 171 A. Can the MCO’s provide the same high quality, locally-based services following Center for Medicaid Services regulations and save money? No way!
Your stories matter! families and individuals:
1.) testify on March 7th
2.) call/write letters to your state senators today.
NH Senate Health & Human Services Committee: http://www.gencourt.state.nh.us/Senate/committees/committee_details.aspx?cc=S26
NH Senate Roster: http://www.gencourt.state.nh.us/Senate/members/senate_roster.aspx
SB 155 simply reads “Notwithstanding any other provision of law to the contrary, step 2 of the Medicaid managed care program, established in RSA 126-A:5, XIX, shall not be implemented before July 1, 2019”
You know all the usual talking points but here are a few more:
NH has a long, proud tradition of community based supports and services for individuals with disabilities guaranteed under RSA 171 A wherein users of the system make person-centered care decisions as well as oversee the service delivery system through volunteer boards at Area Agencies. This “bottom-up” approach will be replaced by “top-down” out-of-state MCO companies who have little or no experience with providing long-term adult services.
NH’s existing area agency system provides high quality care at a low cost. Nationally, we are rank 3rd by United Cerebral Palsy in quality care and 34th in our fiscal effort which means we are cost effective!
NH needs time to evaluate what is best for our most vulnerable populations. With potential changes in federal funding in Medicaid to block grants, why is NH rushing to spend time and resources tooling up for an unproven MCO-model of care for adult services when that framework may be incompatible with changes to the federal funding stream?
SB 553 (June 2016) mandated a strong stakeholder group and a robust planning process, however there still is NO plan addressing key issues like: network adequacy; quality metrics and outcome measures; rate setting and fiscal transparency/accountability.
The Governor declared in February 2017 “managed care shall go forward in January 2018” despite that during the December 2016 SB 553 Working Group meeting it was anticipated that CFI and Nursing could not start until around July 1, 2018. Where is fidelity to the SB 553 process striving to ensure our most vulnerable citizens will remain well-cared for? How can we “move forward” before its been determined that the MCO model is appropriate in the context of NH?
Why has the NH Legislature given up “local control” to out-of-state MCO’s? Why is there no fiscal accountability on how well the MCO’s are doing on Step 1 so that the legislature can evaluate their performance thus far? Where are the analytic facts? Area Agencies are fiscally accountable to both the Department of Health & Human Services and the NH Legislature. Where is oversight on the MCO’s?
FY 2016, the MCO’s had $50 million shortfall in administrative costs on Step 1 and $14 million shortfall on service delivery fees that NH had to pay! Nearly every month there were MCO service rate increases. The NH Legislature and families need time to evaluate if moving forward is really the smart choice.
Please contact email@example.com if you plan to testify or need support with testimony. Please let ABLE NH know if you send a letter or call.
Together, our voices will be heard!
The Parent Information Center has outline below what would it mean if NH followed only the Federal minimum requirements.
◦ MANY MORE IMPORTANT RIGHTS AND PROTECTIONS WOULD BE LOST!
Please contact Linda Quintanilha, Organizing Director, ABLE NH at 603.494.1183 with questions. Email: Quintanilha.firstname.lastname@example.org