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Medicaid managed care for developmentally disabled people, substance abuse treatment delayed indefinitely

The state is delaying implementing the next phase of managed care for Medicaid recipients, with Gov. Maggie Hassan saying there needs to be more public input.

New Hampshire decided to move administration of the state health program for low-income residents to private managed care companies during the 2011-12 budget writing process, but fraught negotiations with hospitals and community mental health centers delayed the first step until last December.

Enrollment for Step 2 focuses largely on about 12,000 developmentally disabled participants who need long-term care and was supposed to begin Dec. 1, but has been postponed to an undetermined date, he said.

The delay also suspends plans to provide a substance use disorder benefit for existing Medicaid recipients.

The state had agreed to provide the benefit to bring current Medicaid enrollees on par with the benefits that people enrolling in Medicaid through the federal expansion of the program will have.

Federal requirements for states that expand Medicaid mean the newly eligible people must have access to a substance abuse treatment benefit. The Department of Health and Human Services is working on the definition and pricing for the benefit for those people this year, before enrollment for expanded Medicaid begins in July.

About 115,000 of the 130,000 eligible Medicaid participants have enrolled in a managed care plan, state Health and Human Services Commissioner Nick Toumpas told the Health Exchange Advisory Board yesterday.

“When we first started on this, no states were contemplating moving long-term care to managed care,” Toumpas said. “Given all the other things going on . . . we want to be much more thoughtful, and handle this respectfully of the people involved,” he said.

Hassan announced the delay at a meeting of the commission monitoring managed care last week.

The program will not move into Step 2 “until there has been a process for public input . . . that all families, providers and stakeholders have confidence in,” her spokesman, Marc Goldberg, said yesterday.

(Sarah Palermo can be reached at 369-3322 or spalermo@cmonitor.com or on Twitter @SPalermoNews.)

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