NH Medicaid Care Management Program | New Hampshire Department of Health and Human Services

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NH Medicaid Care Management (MCM) Program

Important Notices

Manatt Memo: Maintaining Funding Levels and Financing Structure for Nursing Facilities in Managed Care
Request for Comments on the NH Medicaid Care Management Quality Strategy

What's New ...

SFY 2018 Medicaid Care Management Capitation Rate Reports
- Capitation Rate Report (May 22, 2017)
- Updated Capitation Rate Report (November 10, 2017)
House Bill 517: Uniform Prior Authorization Implementation
The passage of House Bill 517 (HB517), the budget trailer bill, places new responsibilities on the Department to oversee the Medicaid managed care organizations’ (MCOs) prior authorization (PA) requirements for behavioral health drugs.

Most NH Medicaid Program recipients receive health care services through the Medicaid Care Management (MCM) program. New Hampshire Medicaid's Care Management program uses two Health Plans to manage health care for recipients. These Health Plans cover the same services that NH Medicaid does. The Health Plans also offer additional optional services, programs, and other extras to promote healthy behavior. Medicaid recipients enrolled in the MCM program work with the Health Plan they either selected or were assigned.

If you have questions about plan benefits, services, or rules, contact:

NH Healthy Families Health Plan:
1-866-769-3085
www.Nhhealthyfamilies.com
Well Sense Health Plan:
1-877-957-1300
www.WellSense.org

What You Will Find Here and How You Can Use It

This webpage will have information about MCM for Medicaid recipients, providers, and for the public.

MCM Enrollment

Initial enrollment in a Medicaid Health Plan may occur throughout the year for individuals first eligible for the MCM program. Health Plan members may switch plans during Annual Open Enrollment which occurs during November and December each year. This year’s Annual Open Enrollment is November 1 through December 29 with a new plan effective date of January 1, 2018 for members choosing to switch Health Plans.

You can pick from these two Health Plans: