KeepHealthCare.ORG – New Hampshire drug and mental health providers to rally for better payments
Without some action, the state’s newly approved Medicaid expansion program could saddle substance abuse and mental health treatment providers with lower payouts that could force cuts to staffing and services around January, when the law takes effect, they say.
“We can’t afford to go backwards,” wrote the Manchester-based Farnum Center in a “call to action” email to supporters ahead of a rally Tuesday morning.
Last month, the passage of a five-year extension of the state’s Medicaid expansion program was hailed as a boost to both health care services and drug treatment services across New Hampshire.
The concerns from substance abuse and mental health treatment providers stem from a change that was intended as an improvement. Under New Hampshire’s present expansion program, first authorized in 2014, recipients receive health care through the “Premium Assistance Program,” a mechanism by which the recipients could use program funds to receive care from private insurers. Under the new arrangement, recipients will receive care through managed care organizations – an insurance alternative designed to reduce health care costs.
The side effect? That adjustment carries a much lower reimbursement rate for mental health and drug treatment providers. That means the present daily rate of $300 to $500 per patient would drop to $162.60 a day, according to Farnum.
At that rate, beds might need to be closed down, advanced inpatient and patient programs reduced, and wait lists increased, Farnum said in its email.
“The treatment provider community, as a whole, cannot sustain these large rate cuts and continue to maintain treatment services for Medicaid patients,” the email read.
That isn’t quite the full story; the new law acknowledges that potential consequence and requires the Department of Health and Human Services to establish “sufficient” rates to ensure access to the programs. Those rates will likely be specified through the department’s requests for proposals (RFPs) in coming months as it seeks to design new contracts with the MCOs to carry out the new Medicaid expansion law.
But that law, Senate Bill 313, doesn’t specify what those adjusted rates should be, nor whether they should match the present rates paid under the Premium Assistance Program.
Providers say Tuesday’s rally is meant to underscore the urgency of the state’s role in ensuring the rates are raised. Beyond the MCO contracting process, organizers are asking legislators to consider appropriating last-minute, emergency funds to carry the facilities over in case the contracts are insufficient.
In a statement Friday, Cheryl Wilkie, chief operations officer of Farnum, called the situation “dire” and “immediate.”
“We all face dramatic reductions in services if we can’t resolve this before 2019,” she said. “We are asking the state’s leaders to step in and help us before it’s too late to help those in need.”
The rally is scheduled for 10 a.m. in the Legislative Office Building.
(Ethan DeWitt can be reached at [email protected], or on Twitter at @edewittNH.)