New Hampshire: Medicaid looks to drop cost-plus

Thursday, August 26, 2010

CONCORD, N.H. - New Hampshire may be the "granite state," but fortunately for providers here, recent Medicaid cuts weren't set in stone.

In mid-June, the state rescinded cuts that went into effect April 1 on most HME products. Those cuts, which were made without notifying providers, slashed Medicaid reimbursement by about 20% across the board.

The New England Medical Equipment Dealers Association (NEMED) responded to the cuts by hiring a public relations firm to get stories in local newspapers, on the radio and on local cable news.

"There were some really good stories that portrayed the impact these cuts were having on families," said Karyn Estrella, executive director of NEMED.

In addition, providers reached out to legislators and the governor's office, alerting them to the problem. In early June, they got a meeting with state Medicaid officials, which was attended by a representative from the governor's office.

"About a week later, they rescinded everything," said Estrella.

That included a proposed request for information that would have explored a single source provider system, she said.

Now, Medicaid is working with providers to establish a fee schedule to replace its cost-plus system.

"We've been asking them to develop a fee schedule for five years," said Tamme Dustin, director and CFO of Herron & Smith in Hooksett. "It will help the state administratively and it will be a smoother system for everyone."