This bill revises 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 RSA 167:63, IV, redefining "hospitals" to exclude government facilities and special rehabilitation hospitals. The bill establishes an uncompensated care and Medicaid fund in the state treasury, which will be composed of funds collected under RSA 84-A, and ensures these funds are exempt from state budget reductions. The Department of Health and Human Services commissioner is responsible for determining Medicaid payment methods, aiming to minimize year-over-year reimbursement reductions while maximizing federal matching funds. Additionally, the bill sets forth criteria for hospitals to qualify for disproportionate share payments, contingent upon federal funding and approvals from the Centers for Medicare and Medicaid Services (CMS).

Moreover, the bill creates a committee to study the Medicaid enhancement tax and disproportionate share hospital payments in New Hampshire, requiring the commissioner to inform the fiscal committee of any changes to the Medicaid payment methodology prior to implementation. It amends RSA 6:12, I(b)(397) to update the reference from "V" to "XII" regarding the disproportionate share hospital fund. The committee, comprising members from both legislative chambers, is tasked with evaluating the feasibility of transitioning to a directed payment plan and must report its findings by November 1, 2025. Financially, the bill anticipates an increase in state expenditures of approximately $19 million per fiscal year, funded through Medicaid Enhancement Tax revenue and general funds, with the current funding mechanism set to expire on July 1, 2027.

Statutes affected:
Introduced: 6:12
As Amended by the Senate: 6:12
As Amended by the House: 6:12