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Public Notices: Medicaid State Plan

LEGAL NOTICE

NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES

Web Posting Date: 5/21/2020

The New Hampshire (NH) Department of Health and Human Services (the Department) makes two types of Supplemental Access Payments annually to certain Critical Access Hospitals (CAHs) that provide essential access to critical hospital services or obstetrics care. The eligibility criteria for these payments are established under the NH Medicaid State Plan. Each year the magnitude of these supplemental payments is determined and announced via an amendment to the Supplemental Access Payment provisions of the NH Medicaid State Plan. The NH Medicaid State Plan also describes the methods for determining Disproportionate Share Hospital (DSH) payment adjustments and the total amount, or annual “cap,” for these DSH and Supplemental Access payments for each year as established by NH RSA 167:64. Any CAH that meets the qualifying criteria for the Supplemental Access Payments will receive such a payment amount in lieu of its DSH payment for the same fiscal year, pursuant to relevant state statutory provisions and the hospital-specific federal DSH limit imposed under 42 USC 1396r-4(g), unless that CAH also qualifies for a Deemed DSH payment under the State Plan. The Department proposes to amend its Medicaid State Plan to update the values for the SFY2020 annual funding levels and the payment amounts for all private hospital DSH, Deemed DSH, and Supplemental Access Payments. The Department also proposes to amend its Medicaid State plan to provide an additional Supplemental Payment for all CAHs consistent with NH RSA 167:64.

The Department has determined that the amount of the “Type I - Essential Critical Access Hospital” payment for state and federal fiscal year 2020 is $2,626,222, which is payable to the hospital that meets the “Type I” criteria established by the NH Medicaid State Plan. The Department has determined that the amount of the “Type II - Essential Maternity Access Hospital” payment for state and federal fiscal year 2020 is $5,637,680, which is payable to hospitals that meet the “Type II” criteria established under the NH Medicaid State Plan. The proposed state plan amendment (a) amends the maximum aggregate payment amount available in state and federal fiscal year 2020 for the payment of qualifying uncompensated care costs to all qualifying disproportionate share hospitals to $217,498,464; (b) provides additional supplemental payments of $15,926,544 to all CAHs consistent with NH RSA 167:64, and (c) clarifies how certain hospitals may qualify for Deemed DSH payments even when ineligible for other types of DSH payments; e.g., specialty hospitals for rehabilitation or psychiatry, or hospitals that receive Supplemental Access Payments.

The estimated aggregate fiscal impact of these proposed changes to the NH Medicaid program and its NH Medicaid State Plan in state and federal fiscal year 2020 is a net increase of $15,991,957 Federal Medicaid matching monies fund approximately $8,987,480 of this net increase and New Hampshire state appropriations fund the remainder, $7,004,477. The Department is seeking an effective date of May 28, 2020 for these proposed changes.

Copies of the draft state plan pages describing these proposed updates to hospital Supplemental Access Payments and DSH payment amounts are available. Please contact Diane Peterson at (603) 271-4367, or via e-mail at diane.peterson@dhhs.nh.gov, to request copies. The amendments to the NH Medicaid State Plan pages may undergo further revisions before and after submittal to the Centers for Medicare and Medicaid Services (CMS) based upon public comment or CMS feedback. Comments will be due on June 10, 2020 and should be e-mailed to diane.peterson@dhhs.nh.gov.

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Note:

  • Please see New Hampshire Medicaid State Plan webpage for information on Medicaid’s State Plan.
  • Public notices will remain on this website for 3 years from the website publication date.
  • This webpage is only for Medicaid State Plan required public notices. It is updated only when a new public notice is released, similarly to how public notices are published in a newspaper. Please check this website regularly.

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