Monday, September 23, 2013

NH Medicaid clients getting managed care notices

 — Thousands of New Hampshire Medicaid clients are receiving letters notifying them to pick one of three managed care plans as the state rolls out its managed care system.
If Medicaid clients don't pick a plan, one will automatically be assigned to them beginning Nov. 12. If they aren't happy with their plan, they have 90 days to pick a different one. The plans take effect Dec. 1.
Meridian Health Plan, New Hampshire Healthy Families and Well Sense Health Plan are offering plans. The state is urging Medicaid clients to check to see which of their current medical providers are in a plan if they want to keep using them.
Letters will be sent to reach 120,000 Medicaid clients, Associate Commissioner Mary Ann Cooney said Monday.
New Hampshire is switching from a fee-for-service health care system to managed care to save money and try to provide Medicaid clients with better access to health care, especially those with chronic illnesses such as diabetes.
The three companies offering plans are offering extra benefits as incentives to sign up. Well Sense is offering clients a free dental kit including an electric toothbrush, free car safety seats and booster seats for infants and children and free bike helmets for kids. New Hampshire Health Families and Meridian Health Plan are offering SafeLink cellphones to some. All three offer programs to address obesity.
"Each one of the health plans has certain features that distinguishes it from the others, but overall, clients are going to get the services they've been provided," said Cooney.
A law was passed two years ago to move the state from fee-for-service to a managed care system for Medicaid clients, but efforts to implement the system stalled when health care providers refused to participate due to low state reimbursement levels for treating those patients, among other issues. The budget written by Republicans that same year cut state hospital aid for all but a handful of critical access hospitals. And the 10 largest hospitals sued over Medicaid rates, which complicated efforts to negotiate over managed care.
Lawmakers restored some aid in the budget adopted in June and required hospitals to participate in the managed care system to receive it. Since then, hospitals and other providers have agreed to participate, making it possible for the state to move ahead with its managed care system. The system will be implemented in phases. Switching to managed care is mandatory for most clients during the first phase, which covers medical care, such as doctors.
The developmentally disabled, clients in nursing homes and clients receiving long-term care services will be required to enroll in a plan in about a year during implementation of phase two of the system. Cooney said clients in nursing homes are required to select a plan for the doctors they see outside the nursing home during this enrollment period.

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