Exec. Council needs more time to review $1B Medicaid contracts

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Pictured with Gov. Chris Sununu, retiring Department of Safety Commissioner John Barthelmes listens to Executive Councilors during their meeting Wednesday when they voted to accept his resignation with regret. Barthelmes has been commissioner since 2007. Photo/Garry Rayno

CONCORD, NH —The Executive Council wants a month to review three five-year contracts with managed care companies to administer the state’s Medicaid program.

The three contracts totaling almost $1 billion for fiscal year 2020 were tabled by the council at its meeting on Wednesday. The council scheduled a hearing to question company representatives on March 11 at 1 p.m. in the Executive Council Chambers in the State House.

Currently two managed care organizations administer the program providing health coverage for about 180,000 users, including 50,000 people covered under the Medicaid expansion program of the Affordable Care Act.

Both companies – Boston Medical Center Health Plan Inc. or Well Sense Health Plan, and Granite State Health Plan Inc. or New Hampshire Healthy Families – will continue under the contracts selected by the Department of Health and Human Services along with AmeriHealth Caritas New Hampshire, Inc. of Philadephia, a company that recently withdrew abruptly from Iowa’s managed care Medicaid program after a little more than a year.

AmeriHealth was the top scorer of the four companies bidding to administer the Medicaid managed care program.

AmeriHealth is the Medicaid administrator for more than a dozen states and covered about 75 percent of Iowa’s Medicaid recipients when it withdrew in October 2017 leaving more than 200,000 people without coverage and providers without reimbursement.

The company sought an increase in its contract with Iowa due to what it said were insufficient rates and withdrew when the state refused to negotiate.

District 2 Executive Councilor Andru Volinsky, D-Concord, said AmeriHealth is a for-profit company — unlike the other two — with a track record elsewhere.

He questioned adding a for-profit company to the Medicaid managed care program while there are several federal initiatives to reduce “the profit motive.”

“We wanted to flag it and be better informed,” Volinsky said. “It came to us as a late item with precious little time to examine it.”

He said Health and Human Services Commissioner Jeffrey Meyers would like the council to vote on the contracts at its next meeting March 13, but that is not likely, adding the March 27 meeting is more likely.

“We have a responsibility,” Volinsky said. “Sometimes it takes time. We were supposed to be briefed earlier this month on the contracts.”

After the council meeting, Gov. Chris Sununu said Health and Human Services had investigated the company’s issues in Iowa during the selection process. He noted Medicaid programs are very different from state to state.

Sununu said his office and the councilors saw the stories about the company and the council wants to pause and hold a meeting with the companies so they can answer questions.

New Hampshire’s Medicaid managed care program began Dec. 1, 2013, after years of fits and starts with three companies, but one withdrew like AmeriHealth did in Iowa seven months later.

Meridian Health Plan of Detroit, Mich., withdrew citing its growing business in the Midwest. The company had the fewest Medicaid recipients enrolled in its program when it withdrew.

The three companies initially failed to reach reimbursement rate agreements with providers and had prolonged negotiations with the community mental health system before eventually reaching agreements on those rates.

The Medicaid managed care program covers medical, mental health and substance abuse treatment services for low-income individuals, families and children, and the disabled but does not encompass long-term care services such as nursing homes.

Generally, the federal and state government share program costs along with counties and school districts. Under the Medicaid expansion program, the federal government pays 90 percent of the cost and the state 10 percent.

The new contracts would begin July 1. Under federal regulations, the rates must be reviewed every year so program costs could change from year to year during the five-year contracts.

Conservation Land

The council approved the purchase of three pieces of land to be preserved by the Department of Fish and Game and conservation organizations.

Two parcels of land in Newport, Croydon and Grantham owned by William Ruger Jr. totaling 3,181 acres were purchased for $3.4 million. And a 2,709-acre parcel in Groton was purchased for $1.2 million.

Confirmations and Nominations

The Council approved another five-year term for Department of Employment Security Commissioner George Copadis of Manchester with an annual salary of $118,708.

Sununu nominated Daniel T. Moran of Webster to be the new state Poet Laureate. The five-year term would end in 2024. If confirmed by the council, Moran would replace current Poet Laureate Alice B. Fogel of Acworth.

Garry Rayno may be reached at garry.rayno@yahoo.com