N.H. Medicaid plan moves forward


CONCORD, N.H. (AP) – The federal government has approved a New Hampshire plan that would send many non-emergency treatments for Medicaid patients to the lowest bidder.

All that’s stopping Health and Human Services Commissioner John Stephen’s “GraniteCare Select” plan are state legislators, who put a provision into the budget preventing the proposal from moving ahead without their clearance.

Health and Human Services spokesman Greg Moore says the plan would save the state nearly $4 million over the next two years. It would put out to bid a variety of non-emergency procedures for pregnant women and children from low-income households who are Medicaid patients. The legislative fiscal committee must approve before the plan can move ahead. Moore said the department probably will seek permission in July.

It might be a tough sell.

Legislators on the HHS oversight committee reviewed the proposal and opposed it, said Sen. Kathy Sgambati, a Democrat from Tilton and former acting HHS commissioner.

“The major problem is that it will create access problems for people,” said Sgambati, who is also on the fiscal committee. “It requires additional travel for people that already have challenges finding transportation.”

Moore said the department has plans to arrange for transportation for people or reimburse them for the cost of gas.

The plan caps the distance patients would travel for four different kinds of procedures – ambulatory surgery, diagnostic imaging, orthodontia and inpatient rehabilitation. For surgery, rural patients would travel a maximum of 65 miles and those who live in urban areas a maximum of 50 miles. For rehabilitation services, rural patients would travel a maximum of 95 miles.

Meanwhile, Stephen’s budget this year had lots of projected savings that legislators questioned, said Rep. Marjorie Smith, a Durham Democrat who chairs the fiscal committee.

“There’s no question that we could save money if we decide not to deliver essential services,” Smith said. “That’s an easy way to save money. That’s just nothing we were willing to do.”

In a news release, Stephen touted the idea of bringing a market approach to Medicaid.

“New Hampshire’s taxpayers are the real winners of this program,” he said.

Smith vowed to hear Stephen out if he comes to the fiscal committee.

Moore said the department is speaking with the attorney general’s office about how to proceed.