New Hampshire: Providers size up new MCOs

Monday, September 24, 2012

CONCORD, N.H. – HME providers here learned just before Labor Day that CMS had approved the state’s plan to move Medicaid beneficiaries into managed care organizations on Jan. 1.

“We thought we had a little more time,” said Tamme Dustin, director and CFO of Herron & Smith in Hookset and past president of the New England Medical Equipment Dealers Association (NEMED). “There are still a lot of unknowns as far as we’re concerned.”

In May, New Hampshire awarded contracts to three MCOs: Centene Corp., Meredian and Boston Medical Center.

That last organization is of particular concern, says Dustin. While the other two MCOs plan to adopt the state’s existing Medicaid fee schedule, Boston Medical Center does not. It may, in fact, offer lower reimbursement on certain product categories, she said. 

“We are trying to get meetings (with them),” said Dustin. “We have a lot of hesitation doing anything with Boston Medical Center right now.”

Dustin has also been trying to organize a conference call where providers could meet with all three MCOs to get information and ask questions. Additionally, a small group of providers has chipped in to contract with a lobbyist for one year to help with the transition, said Karyn Estrella, executive director of NEMED.

“The lobbyist will go to committee meetings and keep us up to date as this program moves forward,” she said. “It will also help us get a closer relationship with the Department of Health and Human Services.”

That includes getting a seat on DHHS’s advisory board.