Medicaid gets makeover

Wednesday, October 31, 2007

CONCORD, N.H. - New Hampshire's DME community has worked diligently to bring the state's Medicaid program in line with other states, getting several bills passed.
In June, a bill passed that requires The Department of Health and Human Services to set fee schedules for all provider groups for billing rates, medical equipment and services, and review them every two years.
"New Hampshire Medicaid has always had a different type of fee schedule than other states, and we're trying to update them to using the Medicare model," said Tamme Dustin, director and CFO for Hooksett-based HME Herron & Smith. "This will start the ball rolling to where they are going to be forced into reviewing rates, and we'll be able to develop a reasonable fee schedule that encompasses not just the cost of the product but encompasses services, as well."
On Sept. 1, another bill passed that makes it easier for beneficiaries to get coverage for items denied as not medically necessary by creating an independent review process that includes consideration of extenuating circumstances. The new law also provides coverage for adult incontinence supplies.
Finally, the state's fiscal committee approved a more comprehensive list of non-covered items in July. Earlier this year, advocates for the disabled staged protests when the state clarified its list of non-covered items, leading some to believe that many items had recently been excluded (See HME News, August 2007).
"There weren't any major changes, it just (made it clearer) to beneficiaries what was covered and what was not," said Dustin.