SB 519-FN-LOCAL – AS INTRODUCED
2010 SESSION
09/04
SENATE BILL 519-FN-LOCAL
AN ACT relative to spending reductions for the department of health and human services.
SPONSORS: Sen. D'Allesandro, Dist 20; Sen. Hassan, Dist 23; Sen. Janeway, Dist 7; Sen. Larsen, Dist 15; Sen. Sgambati, Dist 4; Sen. Gallus, Dist 1
This bill makes certain spending reductions for the department of health and human services.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
10-2968
09/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Ten
AN ACT relative to spending reductions for the department of health and human services.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Department; Powers and Duties; Distribution of Incentive Funds. Amend RSA 170-G:4, XVI to read as follows:
XVI. Encourage cities, towns, and counties to develop and maintain prevention programs, court diversion programs, and alternative dispositions for juveniles other than placements outside of the home through the use of a formula which shall allow for the transfer of funds to cities, towns, and counties which have, or are developing, prevention programs or alternatives for juvenile care. The amount to be distributed for this program shall be not less than [4.5] 3 percent of the annual amount appropriated to the department of health and human services for placement costs. The method of distribution shall be based upon rules adopted under RSA 541-A by the commissioner. For purposes of this paragraph, prevention programs shall include programs or activities for the prevention of child abuse and neglect.
2 Funding of Services Budget; Limits of Waiting Lists. RSA 171-A:1-a, II is repealed and reenacted to read as follows:
II. The obligations of the department under RSA 171-A:1-a, I are contingent upon the availability and continued appropriation of funds by the legislature.
3 Department of Health and Human Services; Catastrophic Aid Payment. Amend 2009, 144:160 to read as follows:
144:160 Department of Health and Human Services; Catastrophic Aid Program. The department of health and human services shall submit to the federal Centers for Medicare and Medicaid Services a Medicaid state plan amendment for the purpose of defining the criteria by which catastrophic claims payments will be made to reflect only those claims with diagnostic related group (DRG) weights greater than 4.0 and lengths of stay greater than 30 days to support the most medically complex/high acuity cases. Funds are to be used to provide for additional inpatient payments outside of the DRG system where the DRG payment plus any other insurance is below 25 percent of hospital charge. The total funds available for catastrophic claims shall equal 3.3 percent of the projected annual inpatient expenditure. Reimbursement shall be limited to 65 percent of charges, reduced by prior payments, DRG allowed amounts, and third party insurance. The state shall expend half of the catastrophic fund no later than December 31 of each year and the second half no later than June 30 of each year. Claims shall be submitted to the New Hampshire Medicaid program by December 15 and June 15 for the respective 6-month periods in order to be considered for catastrophic payment. Claims shall be paid based upon date of service until catastrophic funds for that 6-month period are exhausted. No claims or portions of claims shall be carried over into the subsequent 6-month period, nor shall excess funds be carried over into the subsequent 6-month period. Notwithstanding the foregoing, the commissioner of the department of health and human services shall submit a Title XIX Medicaid state plan amendment to the federal Centers for Medicare and Medicaid Services to suspend all catastrophic aid payments to hospitals effective April 1, 2010 and continuing through June 30, 2011.
4 Department of Health and Human Services; Rate Setting. Amend 2007, 263:109 to read as follows:
263:109 Department of Health and Human Services; Rate Setting. For the biennium ending June 30, 2009, the commissioner of the department of health and human services shall set rates paid to providers consistent with the operating budget appropriations allotted to pay providers in each program including any rate increases provided in the operating budget. Such rates shall reflect legislative decisions to provide specific rate increases as footnoted in the operating budget. The commissioner shall report quarterly to the fiscal committee of the general court, the governor, the speaker of the house of representatives, and the president of the senate concerning the status of appropriations for payments to providers and the rates established by the department. Notwithstanding this section or any other law to the contrary, rates increased to any providers, except physicians and dentists, shall not exceed the rates in effect as of June 30, 2007.
5 Department of Health and Human Services; Indirect Graduate Medical Education Suspension. Amend 2009, 144:24 to read as follows:
144:24 Department of Health and Human Services; Direct Graduate Medical Education. The commissioner of the department of health and human services shall submit a Title XIX Medicaid state plan amendment to the federal Centers for Medicare and Medicaid Services to suspend the provision of direct graduate medical education payments to hospitals as contemplated at 42 U.S.C. section 1396a(a)(30)(A) to be effective July 1, 2009. Upon approval of the state plan amendment, and as of the effective date of the state plan amendment, any obligations for payment of direct graduate medical education are suspended until [June 30, 2011] July 1, 2011. The commissioner of the department of health and human services shall submit a Title XIX Medicaid state plan amendment to the federal Centers for Medicare and Medicaid Services to suspend the provision of indirect graduate medical education payments to hospitals effective April 1, 2010. Upon approval of the state plan amendment, and as of the effective date of the state plan amendment, any obligations for payment of indirect graduate medical education are suspended until July 1, 2010.
6 Repeal. RSA 137-G, relative to the catastrophic illness program, is repealed.
7 Effective Date.
I. Section 6 of this act shall take effect July 1, 2010.
II. The remainder of this act shall take effect upon its passage.
LBAO
10-2968
Revised 03/26/10
SB 519 FISCAL NOTE
AN ACT relative to spending reductions for the department of health and human services.
FISCAL IMPACT:
The Department of Health and Human Services states this bill will decrease state expenditures by $1,789,000 in FY 2010, $13,923,506 in FY 2011, and by an indeterminable amount in FY 2012 and each year thereafter. This bill will have no fiscal impact on state, county, and local revenue, or county and local expenditures.
METHODOLOGY:
Section 1 – The Department of Health and Human Services states section 1 of this bill would reduce diversion incentive funds from 4.5% of estimated placement costs to 3% in FY 2011. This would reduce state general expenditures by $781,506 in FY 2011. The Department is unable to determine the fiscal impact in FY 2012 and beyond since it is dependent on the amount appropriated for placement costs in those fiscal years.
Section 2 – DHHS states section 2 of this bill provides that the Department’s obligations to persons with developmental disabilities and brain injuries are contingent upon the availability and continued appropriation of funds by the Legislature. The Department states total expenditures for the developmental disabilities (DD) waitlist would be reduced by $6,200,000, and expenditures for the acquired brain disorder (ABD) waitlist would be reduced by $1,396,000 in FY 2011. The general fund share of the reduction would total $3,100,000 for the DD waitlist, and $698,000 for the ABD waitlist in FY 2011.
Section 3 – DHHS states section 3 of this bill suspends catastrophic aid payments to hospitals effective April 1, 2010 for the remainder of the biennium ending June 30, 2011. The Department states this will reduce total state expenditures by $1,000,000 in FY 2010, and $2,800,000 in FY 2011. The general fund share of the reduction would total $398,000 in FY 2010, and $1,313,000 in FY 2011.
Section 4 – DHHS states section 4 of this bill rolls back certain reimbursement rate increases passed in Chapter 263:109, Laws of 2007 (HB 2). The Department states this section would affect a limited group of professional services, and would exclude physician and dental services. DHHS estimates this section will decrease total state expenditures by $27,000 in FY 2010, and $55,000 in FY 2011. The general fund share of the reduction would total $11,000 in FY 2010, and $26,000 in FY 2011.
Section 5 – DHHS states section 5 of this bill suspends indirect medical education (IME) payments to teaching hospitals for the remainder of the biennium ending June 30, 2011. The Department states this section will reduce total state expenditures by $550,000 in FY 2010, and $2,199,000 in FY 2011. The general fund share of the reduction would total $219,000 in FY 2010, and $1,031,000 in FY 2011.
Section 6 – DHHS states section 6 of this bill would eliminate the catastrophic illness program (CIP) which pays for services for certain individuals with either cancer, hemophilia, end-state renal disease, spinal cord injury (non-ambulatory), cystic fibrosis, or multiple sclerosis who meet financial eligibility criteria. The projected cost savings would be up to $2,500 per fiscal year, per individual receiving CIP benefits. CIP provides financial support for outpatient hospital services, physician services, durable medical equipment, ambulance services, prescriptions, and COBRA insurance premiums. The Department states this section will decrease state general fund expenditures by $212,000 in FY 2010, and $492,000 in FY 2011.
In summary, the proposed bill would decrease total state expenditures by $1,789,000 in FY 2010, and $13,923,506 in FY 2011. The general fund share of the reduction would total $840,000 in FY 2010, and $7,441,506 in FY 2011.