NH DHHS Announces Enrollment of Remaining Populations in Medicaid Care Management

The New Hampshire Department of Health and Human Services (DHHS) announced

today that beginning November 1, 2015, Medicaid recipients who could

initially opt out of Medicaid Care Management (MCM) will be required to

enroll in the program and will receive their medical care through a Managed

Care Organization (MCO) health plan, with coverage beginning February 1,


The Medicaid Care Management program is being implemented in incremental

steps. Step 1 of the program began on December 1, 2013 and included the

enrollment of 90 percent of the Medicaid population into the care

management program for their medical care, while others were allowed to

remain in the fee-for-service program. Now, most of the remaining Medicaid

population in the fee-for-service program will be required to enroll,

benefitting from health plan services that afford improved care

coordination and wellness programs.

“The Department recognizes and acknowledges the complex needs of people now

enrolling in an MCO health plan for their medical care,” said DHHS

Commissioner Nick Toumpas. “We are committed to ensuring that appropriate

planning has occurred for this transition and will proactively support

these people during the enrollment process.”

Individuals required to enroll in MCM will receive letters from DHHS

informing them about the enrollment process and selecting the health plan

that is best for the client and their family. The remaining enrollment

population includes: Children in Foster Care, Medicare Dual Eligibles

(people who have both Medicare and Medicaid), Home Care for Children with

Severe Disabilities (aka Katie Beckett Medicaid), Children with special

health care needs enrolled in Special Medical Services/Partners in Health

and Children with Supplemental Security Income.

In preparation for the transition of individuals with complex needs into

MCM, DHHS has conducted frequent and widespread stakeholder engagement

meetings across the State with current MCM enrollees, clients who will be

required to enroll in MCM, and providers who serve these clients. DHHS held

meetings from July-November 2014, to obtain input on best practices for

integration of Step 2 populations and services into the MCM program. DHHS

and the MCOs conducted provider and client informational sessions across

the State from July-August 2015. Focus group meetings with individuals with

complex needs currently in MCM were conducted in June and August 2015 and

information sessions to solicit input from providers on the kinds of

support needed to assist individuals with enrollment in MCM were held in

August and September.

Future phases of Step 2 will include the integration of Long Term Supports

and Services (LTSS) such as Choices for Independence (CFI) Services;

Nursing Facility Services; and Developmental Disability (DD), Acquired

Brain Disorder (ABD) and In-Home Support (IHS) services into the Medicaid

Care Management program.