New Hampshire: Medicaid springs rate cut on providers

Monday, April 26, 2010

CONCORD, N.H. – If only it was an April Fools’ joke. Providers here learned in late March that the state would slash Medicaid rates about 20% on most HME products beginning April 1.

Even worse, providers weren’t notified of the change, and didn’t even have a list of affected codes until April 2, said Tamme Dustin, director and CFO of Herron & Smith in Hooksett.

“I was Googling the state like I periodically do and there was a 2-inch legal notice in a local paper,” she said. “There was no attempt to meet with us to say this is coming, and ask us if this is going to be problematic.”

Problematic indeed. Prior to the change, providers billed Medicaid at cost plus 30%. Now, it’s cost plus 10%.

“We don’t think that’s sustainable,” said Karyn Estrella, executive director of the New England Medical Equipment Dealers Association (NEMED). “We are asking our members for feedback and then we want to meet with Medicaid. They are going to have access problems.”

Besides the rate cut, providers here face the possibility of a competitive bidding program for most product categories—from power wheelchairs to diabetes supplies—according to a request for information (RFI) issued Feb. 17.

“They are trying to get some ideas from providers on some ways the state can move forward,” said Dustin. “We’d like to sit down and look at creating a fee schedule. We are hoping the ideas they gather from the RFI opens the doors to us meeting with them more regularly.”

NEMED had planned a protest on March 30, but despite a large turnout, it was unable to go through with it.

“This is a state where you ‘live free or die,’” said Estrella, referring to the state’s motto. “But you still have to get a permit to hold a demonstration.”