This bill modifies the funding structure for uncompensated care costs within the state Medicaid program, particularly focusing on the distribution of disproportionate share hospital payments. It repeals and reenacts the definition of "hospitals" to clarify that it includes general acute care hospitals while excluding government facilities and special rehabilitation hospitals. The bill establishes an uncompensated care and Medicaid fund in the state treasury, sourced from funds collected under RSA 84-A, which are exempt from state budget reductions. These funds will be utilized by the Department of Health and Human Services (DHHS) for hospital and provider payments, as well as to support Medicaid services.

Additionally, the bill outlines a new process for Medicaid payments to hospitals starting in fiscal year 2026, requiring the DHHS commissioner to determine payment methods that minimize reimbursement reductions and maximize federal matching funds, with all payments needing approval from the Centers for Medicare and Medicaid Services (CMS). It also sets criteria for hospitals to qualify for disproportionate share payments and establishes that the state is not liable for payments exceeding available federal funds. A minimum of 9% of funds collected under RSA 84-A from the previous fiscal year must be allocated to support Medicaid services, prioritizing community mental health centers. The bill also creates a committee to study the Medicaid enhancement tax and disproportionate share hospital payments, with findings due by November 1, 2025. Notably, it amends RSA 6:12 to update the reference for the disproportionate share hospital fund, reflecting the new structure, and is set to take effect on July 1, 2025.

Statutes affected:
Introduced: 6:12
As Amended by the Senate: 6:12
As Amended by the House: 6:12
Version adopted by both bodies: 6:12
CHAPTERED FINAL VERSION: 6:12