SB 135-FN - AS INTRODUCED
2025 SESSION
25-1131
05/02
SENATE BILL 135-FN
AN ACT relative to rate setting parity for Medicaid state plan case management services.
SPONSORS: Sen. Avard, Dist 12
COMMITTEE: Health and Human Services
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ANALYSIS
This bill directs the department of health and human services to annually establish rates for Medicaid state plan case management services to create rate parity for such services within the program.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
25-1131
05/02
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Five
AN ACT relative to rate setting parity for Medicaid state plan case management services.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; Rate Setting Parity for Medicaid State Plan Case Management Services. Amend RSA 126-A by inserting after section 18-b the following new section:
126-A:18-c Rate Setting Parity for Medicaid State Plan Case Management Services.
I. Annually, on or before October 1, the department of health and human services shall establish unit rates for all case management services paid under the state Medicaid plan which better reflect the average cost to deliver services.
II. The department shall consider the factors of economy, efficiency, quality of care, and access to care, in accordance with guidelines in federal regulations.
III. The department shall ensure equitable rate parity by giving comprehensive consideration to factors which cause disparity, including but not limited to administrative payments of overhead costs made to certain providers, in the calculations to achieve parity.
2 Effective Date. This act shall take effect 60 days after its passage.
25-1131
Revised 4/30/25
SB 135-FN- FISCAL NOTE
AS INTRODUCED
AN ACT relative to rate setting parity for Medicaid state plan case management services.
FISCAL IMPACT: This bill does not provide funding, nor does it authorize new positions.
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Estimated State Impact | ||||||
| FY 2025 | FY 2026 | FY 2027 | FY 2028 | ||
Revenue | $0 | $0 | $0 | $0 | ||
Revenue Fund(s) | None | |||||
Expenditures* | $0 | $2,300,000 to $6,400,000 | $2,300,0000 to $6,500,000 | $2,300,0000 to $6,500,000 | ||
Funding Source(s) | General Fund | |||||
Appropriations* | $0 | $0 | $0 | $0 | ||
Funding Source(s) | None | |||||
*Expenditure = Cost of bill *Appropriation = Authorized funding to cover cost of bill | ||||||
METHODOLOGY:
This bill directs the Department of Health and Human Services to annually establish rates for Medicaid state plan case management services to create rate parity for such services within the program.
The Department of Health and Human Services states this bill would increase total annual expenditures by $4.6 to $12.8 million of which $2.6 to $6.5 million would be general funds. If it is determined that state plan case management providers were eligible for Medicaid administrative payments, the Case Management/Service Coordination providers, would be required to submit audited cost reports in order to determine if what they are providing is or is not case management and to set an appropriate rate. To audit and set the rates, additional staff would be needed. The Department indicates a financial specialist position and a budget analyst would be needed to audit the additional cost reports and set rates based on those cost reports. The estimated general fund cost for these positions would be $198,000 in FY 2026, $208,000 in FY 2027 and $214,000 in FY 2028.
It is assumed that any fiscal impact would occur after FY 2025.
AGENCIES CONTACTED:
Department of Health and Human Services