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NH hospitals request federal intervention on Medicaid

New Hampshire Union Leader

April 26. 2012 10:48PM

The state violated federal Medicaid law by not analyzing last year's changes to the program, according to the leaders of several New Hampshire hospitals that on Thursday took the unprecedented step of asking for federal intervention in the state-run program.

In a letter dated Thursday, 160 trustees said the $130 million reduction in Medicaid payments to their hospitals was done with no analysis on impacts to the poor and needy.

Such assessments are required under the Medicaid Act, according to the letter, which was distributed by Nixon Peabody, the firm suing the state over Medicaid cuts.

'The state is simply 'flying blind' on how its decisions are affecting access to care,' reads the letter. At another point, it said New Hampshire Medicaid is broken.

Medicaid is the federal program that provides health care to the poor. It is run by the state, and both state and federal governments share its cost.

State Health and Human Services Commissioner Nick Toumpas said his department monitors access to Medicaid, and any Medicaid-eligible person can find health care in the state.

He characterized Medicaid as a vital program in the state; its efficiencies will be improved once a managed-care model starts, he said.

'We do the best we can,' Toumpas said.

In the letter to Medicaid officials, the trustees said federal intervention is necessary to stop further deterioration of the Medicaid delivery system.

Frank McDougall, vice president of government affairs for Dartmouth-Hitchcock, said the letter does not ask for a takeover. Intervention could include a denial of waivers, rejection of Medicaid changes such as the pending managed-care plan, and holding back Medicaid funds to the state.

The letter said some hospitals have laid off medical and support staff, closed programs and reduced funding to community health partners. Some have eliminated or restricted access for Medicaid patients; many have started the process of doing so, the letter reads.

McDougall said that includes Lakes Region General Hospital, which eliminated regular care for Medicaid patients last year, according to previous news accounts. McDougall said Cheshire Medical Center and Southern New Hampshire Medical Center no longer accept new Medicaid patients.

He said Dartmouth-Hitchcock maintains the same level of service that it did in 2010, but the organization wrestles with questions of whether that can continue. It is analyzing the 31 sub-specialties that Children's Hospital at Dartmouth now provides, he said.

McDougall said the Dartmouth-Hitchcock work force has been cut by 5 percent, which includes executives. Executive salaries have been frozen, but not cut, he said.

Not all New Hampshire hospitals are party to the suit. Not included in the letter are trustees from Concord Hospital, smaller hospitals and the two for-profit hospitals in Portsmouth and Derry.

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