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August 30. 2012 3:00PM

Feds approve NH's managed care plan for Medicaid

CONCORD – Federal officials have given the state the go-ahead to implement a managed-care system for the Medicaid health insurance program for the poor and disabled.

The change to the managed-care system from the current fee-for-service plan was projected to save the state about $16 million this fiscal year. However, the program is not expected to be in place until the end of the year.

The Executive Council in May hired three managed-care companies to implement the program, and the companies have begun preliminary work enrolling providers and Medicaid recipients.

The Legislature voted to implement managed care for Medicaid and included potential savings in the current state budget. The Department of Health and Human Services submitted the Medicaid state plan amendment to the federal government in March 2012.

“The Medicaid Care Management Program is an approach to delivering and financing health care that is aimed at both improving the quality of care and reducing costs,” said DHHS Commissioner Nicholas Toumpas. “We have been very thoughtful in our approach and have engaged our stakeholders throughout this process.”

The decision by the federal government allows the state to use a model that provides future sustainability for a program that so many citizens rely on, he said.

“In our health care system, our goal should be to move away from the fee-for-service model and instead focus on better coordinated care and preventative care. This will help to control costs and improve the quality of services,” Gov. Lynch said.

DHHS will continue to work with the Centers for Medicaid and Medicare to complete program implementation in the coming months.

Under the agreement with the federal government, the state must submit a monthly report to the Center for Medicaid and Medicare beginning Oct. 1 until the system is fully implemented.


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