| Advocacy Alert - Managed Care - Winter/Spring 2012 |
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State Switching to Managed Care for Medicaid Services May 9, 2012: New Hampshire's Executive Council voted 3-2 to approve the $2.3 billion contract establishing a Managed Care system for the state's Medicaid recipients. These contracts still need to be approved by the Center for Medicaid Services in Baltimore. May 8, 2012: An advertisement "Open Letter to Executive Council and Governor Lynch from NH Families: Please Do Not Close Our Locally Controlled, Family Run Area Agency Network for Developmental Disability Care" runs in NH Union Leader and Concord Monitor. May 6, 2012: From the Concord Monitor, "State Should Reject Medicaid Contracts" by Betsy McNamara. April 26, 2012: CSNI's Rich Crocker on "Managed Care for NH's Most Vulnerable Citizens?" April 25, 2012: KansasCity Star article on Managed Care situation in Kansas, another state in transition: "Kansas Governor Relents on Managed Health Care for Disabled". April 22, 2012: Keene Sentinel editorial posted: "NH's Executive Councilors are wise to delay a move on Medicaid restructuring." April 19, 2012: Executive Council once again delays decision on Medicaid Managed Care contract until Wed, May 9th. April 16, 2012: Union Leader reports "Managed-Care Vote Likely But Exec Council Delays Cast Cloud". April 12, 2012: CSNI presents a letter and supporting information to the Executive Council outlining the top five considerations for NH's Managed Care for people with developmental disabilities. The Executive Council is scheduled to vote on the contract on Wednesday, April 18th. April 12, 2012: DHHS Commissioner Toumpas provides to the Governor and Executive Council his response to questions from the previous hearing and an example of how Risk Management works. April 10, 2012: Senate Finance Committee public hearing on Wait List funding is Thursday, April 12 at 1:45 in Concord. Families are encouraged to attend and also call or send an email to their Senator. April 3, 2012: Monadnock Ledger Transcript on "State Tackles Medical Funding Option" and "House Spends Money on Waitlisted". April 2, 2012: Concord Monitor Editorial Board asks: "Should Some Services Be Carved out of Managed Care Deal? March 28, 2012: The Medicaid Managed Care contract presented to the Executive Councilors is tabled their vote to approve or disapprove until April 18th. March 21, 2012: From the Monadnock Ledger Transcript, a Rindge family has deep concerns about Medicaid Managed Care. March 2, 2012: The decision as to which companies will serve as Managed Care Organizations (MCOs) for all Medicaid services will be in the hands of the State of NH Executive Council on Wednesday, March 28th. This group will begin consideration on Friday, March 23rd. Families are encouraged to make their concerns known to their Executive Councilors prior to those deliberations. February 17, 2012: Commission Toumpas writes to families in response to their letters about Managed Care. February 19, 2012: From the Keene Sentinel February 17, 2012: From the Nashua Telegraph February 14, 2012: From the Concord Monitor February 13, 2012: From the Keene Sentinel February 5, 2012: From the Concord Monitor February 2012: The National Council on Disability publishes Guiding Principles for successfully enrolling people with disabilities in Managed Care Plans. January 31, 2012: Commissioner Nick Toumpas talks with Laura Knoy on NHPR's The Exchange about Medicaid Managed Care. January 2, 2012: From the Union Leader January 2012: Disabilities Rights Center presents panel discussion of what Managed Care is and what it means for NH. January 2012: National Leadership Consortium on Developmental Disabilities January 2012: CSNI's Timeline of Managed Care in NH January 10, 2012 Update The Care Management Review Committee received a number of bids from managed care organizations by the December 15th deadline. These proposals, currently under review, will be whittled down to a few by January 15th. Meanwhile Connecticut, one of more than thirty states who switched to Managed Care for Medicaid, made the decision in late December 2011 to stop using private insurers for Medicaid. Why? Back to NH, the Review Committee hasn't released any information on this first round of bidders, and it's not yet clear if we'll find out who the finalists are in mid-January. We may have to wait until the contract is awarded to find out who will be the provider. Stay tuned on that... Please note that any changes will not affect the DD system until at least July 2013. The DD community support system is part of the second phase of the program, and the start date for the second stage is somewhat ambiguous at this point. It is supposed to start one year following the actual completion of the first phase. In the meantime, to stay informed, you can find the results of last fall's Stakeholder Feedback Process on the DHHS website. These feedback sessions included public forums, focus groups and an online survey, using input from program users, caregivers and providers. There's a lot of material in the report, but it's worth a look-through if you want to know what people across the state had to say about this issue.
Currently, there are several steps for transition from the current arrangement for Medicaid services. The first phase will enroll all Medicaid recipients in a managed care program for acute care, that is, for their medical services. This will be similar to any of us who use an HMO or provider plan, and is expected to be implemented in July of 2012. The second step will have much more serious impact on services on which individuals with Developmental Disabilities and Acquired Brain Disorder rely. These services include things like day and residential services, consumer-directed services, respite, and service coordination. The Request for Proposal (RFP), released in mid-October, includes DD services in the Managed Care program. The current timeline for this second phase sets its start in July 2013, a year after the first phase is enacted. The next 12 to 18 months will be critical to all of us involved in providing disabilities services. We must use this time to engage in discussion and give serious consideration to implications as options are evaluated. Bob James, Executive Director of One Sky Services in Portsmouth (Region 8), wrote an article describing concerns and exploring what services might be like under a Managed Care scenario. Click here to read Bob James' piece. Additional Background Materials and Resources: NH DHHS Care Management Documents on the DHHS website
CSNI Updates GSIL Medicaid Managed Care Primer (from GSIL website) Choice (clear one-page summary from Bob James, OneSky Services, Region 8) Concord Monitor Editorial Board asks: "Should Some Services Be Carved out of Managed Care Deal? |