Governor Hassan Issues Executive Order Creating
Commission on Medicaid Care Management
Panel to Review and Advise Governor on the
Implementation of Medicaid Managed Care Program
CONCORD – In order to ensure providers and patients are protected as New Hampshire moves to a managed care model for the state’s Medicaid program, Governor Maggie Hassan issued an Executive Order today creating the Governor’s Commission on Medicaid Care Management.
The Governor’s commission will bring together members of the public representing a broad range of experience in health care issues to review and advise on the implementation of an efficient, fair and high-quality Medicaid care management system.
“With new tools and federal funding available, New Hampshire has an opportunity to greatly strengthen our health care system. Moving forward with implementing Medicaid managed care is critical to ensuring that we are able to effectively expand Medicaid coverage and maximize our health care dollars,” Governor Hassan said. “I also recognize the concerns and challenges surrounding managed care implementation. Members of the commission will leverage their significant experience to review implementation and provide insight to ensure we are protecting both patients and health care providers.”
The Governor’s Commission on Medicaid Care Management includes members with expertise in managed care and payment reform models of care, Medicaid public policy, elderly affairs, children’s health, public health, mental health, developmental disabilities and adult health care services.
Mary Vallier-Kaplan, former vice president of the New Hampshire Endowment for Health, will chair the panel and Donald Shumway, former commissioner of the Department of Health and Human Services and president and CEO of Crotched Mountain Rehabilitation Center, will serve as vice-chair. The Commission’s members are Thomas Bunnell, policy consultant for NH Voices for Health; Sue Fox, project director at the UNH Institute on Disability and a parent of a child with developmental disabilities; Wendy Gladstone, MD, a pediatrician at Dartmouth-Hitchcock Medical Center’s Child Advocacy and Protection Program; Yvonne Goldsberry, Ph.D, MPH, vice president of Population Health and Clinical Integration at Cheshire Medical Center/ Dartmouth-Hitchcock- Keene; Catherine McDowell, founder of Coos Family Health and currently running McDowell Project Management; Douglas McNutt, Associate State Director for Advocacy, AARP NH; Gustavo Moral, President of Independent Services Network; Kenneth Norton, executive director of NAMI New Hampshire; and Jo Porter, MPH, deputy director of the NH Institute for Health Policy and Practice.
The Medicaid care management program, as enacted in 2011, is intended to improve the value, quality and efficiency of services provided through Medicaid, stimulate innovation and generate savings for New Hampshire. The program is to be implemented in three phases through contracts entered into between the Department of Health and Human Services and certain Managed Care Organizations who are responsible for providing health care services to members enrolled in the New Hampshire Medicaid Program.
The chair of the commission will call its first meeting within 30 days.
The full text of the Governor’s Executive Order can be found below:
STATE OF NEW HAMPSHIRE
BY HER EXCELLENCY
MARGARET WOOD HASSAN, GOVERNOR
EXECUTIVE ORDER 2013-05
an order establishing the Governor’s commission to review and advise on the implementation of New Hampshire’s Medicaid care management program
WHEREAS, effective June 2, 2011, New Hampshire passed Senate Bill 147 directing the Department of Health and Human Services to employ a statewide managed care model to administer the Medicaid program and to provide for managed care services for all Medicaid populations; and
WHEREAS, Senate Bill 147 authorized multiple options of models of care for all Medicaid recipients and the Department of Health and Human Services requested proposals from managed care companies that would include new payment methods; and
WHEREAS, the managed care program is intended to improve the value, quality and efficiency of services provided through Medicaid, maximize savings, and stimulate innovation for New Hampshire; and
WHEREAS, Senate Bill 147 requires that no reduction occur in the quality of care to all Medicaid enrollees and that all due diligence be exercised to maintain or increase the current level of quality of care provided; and
WHEREAS, the care management program shall be implemented in three phases through contracts entered into between the Department of Health and Human Services and certain Managed Care Organizations who are responsible for the provision of all health care services to the low-income, disabled, and elderly enrollees in the New Hampshire Medicaid Program on a risk basis; and
WHEREAS, the health of New Hampshire’s residents and of the care management program depend upon the accountability of the managed care organizations, transparent and full communication and the care management model’s responsiveness to the need and concerns of beneficiaries and their care givers; and
WHEREAS, in order to ensure that the implementation of each step of the phase-in of Senate Bill 147 meets the purposes of the Medicaid program and the needs of New Hampshire Medicaid beneficiaries, the Governor would benefit from the periodic review and recommendations of a commission comprised of individuals with experience in various areas of care who are qualified to review the program’s implementation, the status and integrity of the planning for each step, and the program’s responsiveness to quality of care concerns including those raised by New Hampshire citizens.
NOW, THEREFORE; I, MARGARET WOOD HASSAN, GOVERNOR of the State of New Hampshire, by the authority vested in me pursuant to Part II, Article 41 of the New Hampshire Constitution, do hereby establish the Governor’s Commission on Medicaid Care Management, effective April 10, 2013, which shall be comprised of eleven (11) members of the public appointed by the Governor representing a broad diversity of interests in an effective, efficient, and high-quality Medicaid care management system for the State of New Hampshire, including members with expertise in managed care and payment reform models of care, Medicaid public policy, elderly affairs, children’s health, public health, mental health, developmental disabilities and adult health care services.
FURTHER, the Governor’s Commission on Medicaid Care Management shall include the Commissioner of the Department of Health and Human Services, or designee, as an ex officio member; and
FURTHER, if any one of the appointed members is unable to serve, the Governor shall replace such member; and
FURTHER, the Governor’s Commission on Medicaid Care Management shall be charged with the following responsibilities:
a. The Commission shall advise the Governor regarding the Medicaid care management program’s implementation to ensure that the program:
i. is implemented consistent with Senate Bill 147 and with contract terms entered into between the Department of Health and Human Services and managed care organizations;
ii. in accordance with the best practices of managed care models and payment methods; and
iii. is operated to achieve goals of improving access to eligible populations, quality and appropriateness of care and cost effectiveness of the Medicaid program.
b. The Commission shall seek input and expertise from the public, including enrollees, providers, managed care organizations, advocates and public policy specialists, as needed to assess the progress and performance of the Medicaid care management program; and
c. The Commission shall have the opportunity to review the Medicaid care management program’s performance data in the form of reports and/or summaries provided to or by the Department of Health and Human Services to assess the needs for future changes to the program and recommend such changes to the Governor; and
d. The Commission shall have the opportunity to review in advance proposed changes, work plans and designs for all phases of the Medicaid care management program and provide written input to the Governor regarding the same.
FURTHER, the Governor shall designate a chairperson and vice-chairperson from among the members; and
FURTHER, members shall serve at the pleasure of the Governor or until resignation in writing is submitted to the Governor by a member; and
FURTHER, the commission shall:
a. Meet at least monthly at the call of the chair. Such meetings shall be open to the public.
b. Provide periodic updates, reports, and recommendations to the Governor on the implementation and integrity of the Medicaid care management program.
c. Schedule the first organizational meeting within 30 days of this Executive Order.
FURTHER, the Department of Health and Human Services shall provide administrative support to the commission as necessary; and
FURTHER, the Commissioners of the departments of Health and Human Services and Insurance shall serve as technical advisors to the Commission members.
NOW, THEREFORE; I, MARGARET WOOD HASSAN, GOVERNOR of the State of New Hampshire, by the authority vested in me pursuant to Part II, Article 41 of the New Hampshire Constitution, do hereby establish, effective April 10, 2013 the Governor’s Commission on Medicaid Care Management.
Given at the Executive Chambers in Concord, this 10th day of April, in the year of Our Lord, two thousand and thirteen and of the independence of the United States of America, two hundred and thirty-seven
Margaret Wood Hassan
GOVERNOR OF NEW HAMPSHIRE