Medicaid is a program that pays for medical assistance for certain individuals and families with low incomes and resources. This program became law in 1965 and is jointly funded by the federal and state governments to assist states in providing medical long-term care assistance to people who meet certain eligibility criteria. Medicaid is the largest source of funding for medical and health-related services for people with limited income
Visit the Centers for Medicare and Medicaid Services for more information about Medicaid.
NHHA comments on CMS' Medicaid Equal Access Rule (07/05/2011)
NHHA submitted comments today on CMS’ proposed "Medicaid Equal Access” rule. Although the rule would hold states more accountable for paying providers adequately, we suggest it be strengthened to require states to conduct provider cost studies to determine if payment rates bear a reasonable relationship to provider costs. We also recommend that the rule exclude DSH payments from the Medicaid payment data included in those reviews; require states to conduct access reviews every three years, not five; that CMS apply the access review requirements to all payments between managed care organizations and providers; and that CMS establish a mechanism for stakeholders to raise access and provider payment concerns directly with CMS.
We point out to CMS that New Hampshire pays hospitals the lowest rates in the nation at 55 cents for every dollar spent treating Medicaid patients. And that's why CMS should have stronger oversight to help ensure that payments to providers do not result in access problems for Medicaid beneficiaries. We also recommend that the state's legislative process not obviate the obligation to comply with the federal equal access requirements and that no rate reductions be implemented prior to CMS approval.
Hospitals Oppose State Budget Passed by NH House and Senate (06/23/2011)
The budget that was approved today, June 22, 2011, by both the State House and Senate will wreak havoc on the health care infrastructure and safety net in New Hampshire. It will increase the cost of health insurance for businesses and individuals threaten the availability of essential health care services that our communities depend on, and result in the loss of jobs and economic stability. Please read Steve Ahnen's full statement.
NHHA comments on CMS Medicaid RAC (1/14/11)
In its comment letter to the Centers for Medicare & Medicaid Services (CMS) on the proposed Medicaid Recovery Audit Contractor (RAC) rule, the New Hampshire Hospital Association urges CMS to revise its rule to ensure that states do not repeat the mistakes made during the Medicare RAC demonstration program. The proposed rule leaves significant discretion to the states in developing RAC programs and, among other omissions, does not specify a new audit issue review process nor medical record request limits. NHHA suggests that CMS prescribe specific program requirements – similar to those in the Medicare RAC program – in order to limit overzealous and inappropriate audits by the RACs.
NHHA Comments on Medicaid Outpatient Hospital Rule (12/22/10)
The New Hampshire Medicaid program proposes to reallocate the annual outpatient hospital limit of twelve visits per Medicaid beneficiary to include no more than 4 emergency room visits and 8 non-emergency visits per year per beneficiary. At the December 22nd public hearing on the rule, NHHA testified that, rather than providing incentives to Medicaid beneficiaries to appropriately use primary care settings for non-emergency services, the proposed policy forces hospitals to bear the cost of any ED visits beyond the first four covered visits. NHHA contends that unless and until every Medicaid patient has guaranteed access to a primary care provider, they will continue to use hospital EDs for non-emergency care due to their limited access to medically appropriate alternatives and lack of education on the proper use of health services. Rather, the Medicaid policy should support efforts to ensure that patients receive the right care in the right place at the right time.
New Hampshire Medicaid issues its 2010 Provider Rate Benchmarks Report (10/1/10)
The Department of Health & Human Services recently released a draft of its 2010 report, NH Medicaid Rate Benchmarks for Key Services. This report is the result of DHHS’ review of Medicaid rates based on comparisons to rates paid by Medicare, Medicaid programs of the other New England states, and commercial insurance companies serving New Hampshire residents for similar. The report states that NH Medicaid's payment rates are significantly lower than Medicare and commercial insurance rates as well as lower than the rates of other Medicaid programs in the region. Not surprisingly, compared with DHHS’ 2008 benchmarking report, the differences between NH Medicaid rates and other payers have grown.
The New Hampshire Hospital Association submitted comments on the report which will be incorporated in the Final Report. We are disappointed that comparisons of hospital payment rates were not made between New Hampshire and other New England states’ Medicaid programs and, in the case of critical access hospitals, comparisons with Medicare. Where hospital payment methodologies differ, we would like to have seen an effort to employ an alternative analysis that would, with certain caveats, allow for an approximation of the differences between New Hampshire and the other New England states. For example, this information could have been obtained from Medicare/Medicaid cost reports, at least at an aggregate level. All hospitals complete the same cost reports for CMS.
We urge the Governor, DHHS and Legislature to seriously consider the past two years of Medicaid rate cuts in addition to the findings of the Benchmarks report when, as required by statute, DHHS uses the report to formulate its budget request.