Amendment vs bill Amendment #2024-2152s vs latest version

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HB 1593-FN - AS AMENDED BY THE SENATE 22Feb2024...
Sen.
0709h 11Apr2024...
Bradley, Dist 3 May 22, 2024 2024-2152s 05/08 Floor Amendment to HB 1593-FN Amend the title of the bill by replacing it with the following:
1161h 05/23/2024 2117s 05/23/2024 2152s SESSION 24-2282 05/10 HOUSE BILL 1593-FN AN ACT making an appropriation to the department of health and human services to support recreational activities for individuals with developmental disabilities and relative to the uncompensated care and Medicaid fund.
3 AN ACT making an appropriation to the department of health and human services to support recreational activities for individuals with developmental disabilities and relative to the uncompensated care and Medicaid fund.
SPONSORS:
7 Amend the bill by replacing all after section 1 with the following:
Rep.
9 2 Uncompensated Care and Medicaid Fund;
Stringham, Graf.
3;
Rep.
Edwards, Rock.
31 COMMITTEE:
Health, Human Services and Elderly Affairs ───────────────────────────────────────────────────────────────── AMENDED ANALYSIS This bill:
I.
Makes an appropriation to the department of health and human services to fund recreational activities for individuals with developmental disabilities.
II.
Temporarily restructures the uncompensated care and Medicaid fund under RSA 167:64 as the Medicaid payment fund and disproportionate share hospital fund, administered by the department of health and human services.
The bill sunsets changes to the funding distribution mechanism June 30, 2028.
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Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.] Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
HB 1593-FN - AS AMENDED BY THE SENATE 22Feb2024...
0709h 11Apr2024...
1161h 05/23/2024 2117s 05/23/2024 2152s 24-2282 05/10 STATE OF NEW HAMPSHIRE In the Year of Our Lord Two Thousand Twenty Four AN ACT making an appropriation to the department of health and human services to support recreational activities for individuals with developmental disabilities and relative to the uncompensated care and Medicaid fund.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Department of Health and Human Services;
Individuals with Developmental Disabilities;
Funding for Recreational Services.
I.
Recreational activities typically provide an opportunity for individuals with developmental disabilities to participate in their community in preferred settings, where individuals are able to work on skill development to aid health, wellness, socialization, and safety goals.
However, the department of health and human services has received clarification from the Centers for Medicare and Medicaid Services that supports and services that are recreational in nature are not reimbursable services under the Medicaid program.
II.
In order to ensure that costs to access recreational services are covered, and that individuals with developmental disabilities are able to participate in recreational activities within their communities, the sum of $500,000 is appropriated to the department of health and human services for the biennium ending June 30, 2025.
This appropriation is in addition to any other funds appropriated to the department of health and human services.
The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
Any unexpended funds shall lapse to the general fund on June 30, 2025.
III.
In order to be eligible to receive funds for recreational services under this section, an individual shall have graduated or exited the school system and be receiving services under the 1915(c) developmental disabilities or acquired brain disorder waiver and shall be requesting payment for an activity or service that cannot be covered by the New Hampshire Medicaid State Plan or a 1915(c) Home and Community Based Waiver.
IV.
The department of health and human services shall contract with one or more organizations, such as an area agency as defined in RSA 171-A, to assist in administering these funds.
With the approval of the governor, the department may utilize a sole source procurement method to implement recreational services as quickly as possible.
V.
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Payment for recreational services shall be limited to $600 per individual.
VI.
The department of health and human services shall include language in the contracts designated in subparagraph IV to prioritize services previously included in individualized budgets.
HB 1593-FN - AS AMENDED BY THE SENATE - Page 2 - VII.
The department shall issue an interim report to the fiscal committee on or before April 1, 2025.
The report shall include data on utilization, including the number of individuals seeking services in accordance with paragraphs I, II and III, the number of individuals provided services, the types of specific services provided, the total cost of the services provided, and other relevant information necessary to enable the legislature to assess the program.
VIII.
The department shall issue a final report to the fiscal committee on or before September 30, 2025.
The final report shall include all the information listed in paragraph VII.
2 Uncompensated Care and Medicaid Fund;
The commissioner of the department of health and human services shall determine which payment method or methods are used to make the Medicaid payments subject to this section through Medicaid reimbursement for inpatient or outpatient hospital services, Medicaid supplemental payments, managed care directed payments, disproportionate share hospital payment adjustments, or any other Medicaid payment method allowed by the Centers for Medicare and Medicaid Services (CMS).
The commissioner of the department of health and human services shall determine which payment method or methods are used to make the Medicaid payments subject to this section Amendment to HB 1593-FN - Page 2 - through Medicaid reimbursement for inpatient or outpatient hospital services, Medicaid supplemental payments, managed care directed payments, disproportionate share hospital payment adjustments, or any other Medicaid payment method allowed by the Centers for Medicare and Medicaid Services (CMS).
In determining which Medicaid method or methods to utilize and at what percentage for each method, the commissioner shall seek to prevent to the greatest extent possible HB 1593-FN - AS AMENDED BY THE SENATE - Page 3 - year over year hospital reimbursement reductions in the aggregate while at the same time achieving the highest available federal match.
In determining which Medicaid method or methods to utilize and at what percentage for each method, the commissioner shall seek to prevent to the greatest extent possible year over year hospital reimbursement reductions in the aggregate while at the same time achieving the highest available federal match.
or (2) Meets the minimum criteria for disproportionate share eligibility under relevant federal statutory changes at 42 U.S.C.
or Amendment to HB 1593-FN - Page 3 - (2) Meets the minimum criteria for disproportionate share eligibility under relevant federal statutory changes at 42 U.S.C.
section 1396r-4(g) governing HB 1593-FN - AS AMENDED BY THE SENATE - Page 4 - hospital-specific limits on disproportionate share hospital payments under Title XIX of the Social Security Act and the provisions of all federal regulations promulgated thereunder.
section 1396r-4(g) governing hospital-specific limits on disproportionate share hospital payments under Title XIX of the Social Security Act and the provisions of all federal regulations promulgated thereunder.
For the purpose of making disproportionate share hospital payments only, there is hereby established in the state treasury the disproportionate share hospital fund, which shall be kept separate and distinct from all other funds.
For the purpose of making disproportionate share hospital payments only, there is hereby established in the state treasury the disproportionate share hospital fund, which shall be Amendment to HB 1593-FN - Page 4 - kept separate and distinct from all other funds.
HB 1593-FN - AS AMENDED BY THE SENATE - Page 5 - XIII.
XIII.
Funds available under this section shall also be used to make provider payments and to support Medicaid services and Medicaid programs administered by the department in amounts directed by the budget in each year of the biennium.
Funds available under this section shall also be used to make provider payments and to support Medicaid services and Medicaid Amendment to HB 1593-FN - Page 5 - programs administered by the department in amounts directed by the budget in each year of the biennium.
HB 1593-FN - AS AMENDED BY THE SENATE - Page 6 - (1) A "deemed disproportionate share hospital” as defined by criteria set forth under 42 U.S.C.
(1) A "deemed disproportionate share hospital” as defined by criteria set forth under 42 U.S.C.
I.
Amendment to HB 1593-FN - Page 6 - I.
HB 1593-FN - AS AMENDED BY THE SENATE - Page 7 - I.
I.
LBA 24-2282 Amended 4/30/24 HB 1593-FN- FISCAL NOTE AS AMENDED BY THE HOUSE (AMENDMENT #2024-1161h) AN ACT making an appropriation to the department of health and human services to support recreational activities for individuals with developmental disabilities.
Amendment to HB 1593-FN - Page 7 - 2024-2152s AMENDED ANALYSIS This bill:
FISCAL IMPACT:
I.
[ X ] State [ ] County [ ] Local [ ] None Estimated State Impact - Increase / (Decrease) FY 2024 FY 2025 FY 2026 FY 2027 Revenue $0 $0 $0 $0 Revenue Fund(s) None Expenditures $500,000 $0 $0 Funding Source(s) General Fund Appropriations $500,000 $0 $0 Funding Source(s) General Fund • Does this bill provide sufficient funding to cover estimated expend[X] Yes • Does this bill authorize new positions to implement this bill? [X] No METHODOLOGY:
Makes an appropriation to the department of health and human services to fund recreational activities for individuals with developmental disabilities.
This bill makes an appropriation to the Department of Health and Human Services for the purpose of funding recreational activities for adults with developmental disabilities.
II.
Previously funded as part of the state's Medicaid program, the federal Centers for Medicare and Medicaid Services (CMS) has clarified that recreational activities are not eligible for federal reimbursement.
Temporarily restructures the uncompensated care and Medicaid fund under RSA 167:64 as the Medicaid payment fund and disproportionate share hospital fund, administered by the department of health and human services.
This bill contains a $500,000 general fund appropriation in FY24 for the purpose of providing such services, which shall not lapse until July 1, 20The bill requires the Department to contract with one or more organizations, such as an area agency, to administer the funds.
The bill sunsets changes to the funding distribution mechanism June 30, 2028.
AGENCIES CONTACTED:
Department of Health and Human Services