NH DHHS Provides Update on MCM Program Transition

Concord, NH – The New Hampshire Department of Health and Human Services

(DHHS) is providing an update on its first full week of the newly launched

Medicaid Care Management (MCM) Program. According to daily call statistics

reported to DHHS by the three contracted health plans, Meridian, NH Healthy

Families and Well Sense, call volume has been what was expected, and issues

that have come up have been quickly resolved. The MCM Program launched

Sunday, December 1, 2013.

“We are pleased with the transition thus far,” said DHHS Commissioner

Nicholas Toumpas. “We had a very thorough implementation plan and the

issues that have come up are the types of things we anticipated and planned

for. That said, we continue to closely monitor daily operations of all

three health plans and our internal processes so that we can take care of

clients and providers needs as they arise.”

The area where there has been some difficulty was with pharmacy claims,

where it is imperative that the pharmacy knows which health plan the

customer has selected in order to process the transaction. DHHS and all 3

health plans did extensive outreach to pharmacies over the past week to

resolve the issue. “Though some instances have required work behind the

scenes to assure continuity of care and timely payment,” said Deputy

Medicaid Director Lisabritt Solsky, “in nearly every such instance, the

challenges were resolved rapidly and the member experience was smooth.”

All MCM participants should now have their health plan identification

cards, but should not discard their Medicaid cards. Many of the issues

that surfaced over the first week of operations should be resolved as a

result of members having their new health plan identification cards.

Provider education and outreach will continue over the coming weeks. Each

health plan operates a member call center where members can call to have

their questions answered; providers with questions should call provider

relations with the respective health plans.

Information about MCM and the Health Plans is available on the DHHS

website: www.dhhs.nh.gov