Medicaid Managed Care
Updated May 2016
Step 2, Phase I is now complete. As of February 1, 2016, the following individuals are also in managed care: Children in Foster Care, Medicare Dual Eligibles (people who have both Medicare and Medicaid), Home Care for Children with Severe Disabilities (aka Katie Beckett Medicaid), Children with special health care needs enrolled in Special Medical Services/Partners in Health, and Children with Supplemental Security Income.
If your child has access to Medicaid services through the Katie Beckett program and the State contributes any amount towards the premiums of your private insurance, you will not have to go into managed care, but can remain on fee-for-service.
No date has yet been set for future phases of Step 2 moving into managed care which includes those receiving Long Term Supports and Services (LTSS) including Choices for Independence (CFI) Services, Nursing Facility Services, Developmental Disability (DD), Acquired Brain Disorder (ABD), and In-Home Support (HIS) services.
June 18, 2014 News from Governor Hassan: letter outlines implementation plans for Step 2 of the NH transition to managed care.
What is Medicaid Managed Care?
In a Medicaid managed care system, Medicaid recipients are provided health care coverage from a company under contract with the state. Managed care companies, or MCOs agree to provide Medicaid benefits to recipients in exchange for a monthly payment from the state. The State of New Hampshire currently contracts with two MCOs to provide health care coverage for most New Hampshire Medicaid recipients. The remaining companies are: NH Healthy Families and Well Sense Health Plan.
Problems with Managed care? Read this:
KNOW YOUR RIGHTS New Hampshire Medicaid Managed Care Health Plans: Your Right To Appeal Or File A Grievance, or call Disability Rights Center - NH at 1-800-834-1721 for more information about the grievance and appeal processes or for advice and/or representation in a Medicaid fair hearing.
You have the right to voice any concerns to New Hampshire Medicaid at any time. You may contact New Hampshire Medicaid Client Services by phone at 800-852-3345, ext 4344 or 603-271-4344.
Link to the NH DHHS website for the NH Medicaid Managed Care program
The managed care health plans are:
- Medicaid Managed Care: Questions and Answers about Enrollment
- The Spring 2012 issue of the RAP Sheet is devoted to managed care and related topics
- Video: In the January 2012 episode of Disabilities Rights Center Presents...,our guests are Deborah Fournier, Esq., Policy Analyst at the New Hampshire Fiscal Policy Institute, and Michelle Winchester, J.D., representing the Institute for Health, Law, and Ethics, UNH School of Law. With host Cindy Robertson, DRC Senior Staff Attorney, our guests explain what managed care is and what it means for New Hampshire.
News & Opinion Columns:
- 4-12-2014, Concord Monitor: Medicaid managed care for developmentally disabled people, substance abuse treatment delayed indefinitely
- 4-3-2014, NHPR: Hassan Delays Portion Of Medicaid Managed Care Plan
- 3-20-2014, NHPR: Transition To Managed Medicaid Hits Some Bumps
- 1-22-2014, NHPR: Commissioner Nicholas Toumpas on The Exchange
- 9-10-2013, NHPR: With Managed Care Launching, Let The Marketing Begin
- 8-16-2013, NHPR: Group Takes State To Court Over Medicaid Managed Care
- 12-11-2012, Concord Monitor Editorial: A mental health program worth preserving
- 5-9-2012, NHPR: Managed Medicaid Gets the Nod
- 5-10-2012, Concord Monitor: Council okays managed care 3 private firms to be paid $2.2 billion
- 5-9-2012 Foster’s: N.H. Executive Council OKs $2.3 billion Medicaid contract
- 5-8-2012 NHPR: State Prepares for Massive Shift to Medicaid Managed Care
- 5-6-2012 Betsy McNamara, Concord Monitor My Turn: State should reject Medicaid contracts
- 5-4-2012 NH Business Review: Questions abound over how, and if, privately managed Medicaid would work
- 3-27-2012 NHPR: Executive Council may slow down managed care
Dan Gorenstein reports on this Monday’s meeting of the Executive Council with Commissioner Toumpas. http://nhpr.org/post/executive-council-may-slow-down-managed-care
- 3-27-2012 Concord Monitor: Council Puts off Managed Care Decision
- 3-27-2012 Becker’s Hospital Review: New Hampshire Proposes 3 Managed Medicaid Contracts; Groups Call for Public Review
- 1-20-2012: Changes Coming to Managed Care, a video by Kevin Landrigan
- Winter 2012: New Hampshire Challenge, Op Ed by Lou Goscinski
- One Sky Services has numerous articles on managed care