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" in RSA 167:63, IV, clarifying that it pertains to general acute care hospitals licensed under RSA 151, 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 allocated for hospital and provider payments and to support Medicaid services. The Department of Health and Human Services commissioner is responsible for determining payment methods, aiming to minimize year-over-year reimbursement reductions and maximize federal matching funds. Additionally, the bill sets forth criteria for disproportionate share hospital payments, which will only be available to hospitals meeting federal definitions. It emphasizes collaboration between the commissioner and hospitals to adapt payment methods in response to federal law changes. Payments are contingent upon receiving federal funds and necessary approvals from the Centers for Medicare and Medicaid Services (CMS), with the state not liable for payments exceeding available federal appropriated funds in case of federal funding reductions. The bill also mandates that at least 9% of funds from the Medicaid enhancement tax support Medicaid services, prioritizing community mental health centers. A committee will study the Medicaid enhancement tax and disproportionate share hospital payments, reporting findings by November 1, 2025. Notably, it amends the reference for the disproportionate share hospital fund from RSA 6:12, I(b)(397) from V to XII, with the act taking 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