JULY 22, 2015 


Office of Medicaid Business and Policy 

#A.    Authorize the Department to amend existing individuals agreements with the state’s two managed care health plans, Granite State Health Plan, d/b/a New Hampshire Health Families, and Boston Medical Center Health Net Plan, d/b/a Well Sense Health Plan, in order to: 

  • Extend the agreements for the remainder of the two-year extension period through June 30, 2017 as contemplated by Section 1.3 of the original agreement; 
  • Expand the population covered in Step 1 managed care medical services to include those persons who previously were permitted to “opt out,” the so-called “mandatory population.” 
  • Expand the services covered to include Step 2 Phase 2 waiver services provided to those persons on the Choices for Independence Waiver with a targeted implementation date of January 1, 2016 
  • Adjust rates to reflect the actuarially certified rate structure for the current Medicaid population and for those persons receiving Step II services under the Choices for Independence Waiver though June 30, 2016 as described in Exhibit B. For convenience of reference, the actuarially certified rate structure for the New Hampshire Health Protection Program population through December 31, 2015, previously approved by G&C, is restated in Exhibit B, and 
  • Identify the targeted implementation date for phasing into the Care Management program Step II waiver services for those persons receiving nursing care services.  

Effective September 1, 2015 to replace the extension approved by G&C on June 24, 2015 and authorize managed care services to the two managed care organizations though June 30, 2017. This amendment increases the price SFY 2016 price limitation by $314,265,536 from $412,045,000 to $726,310,536 for a cumulative contract value of $1,629,310,536 for all Medicaid Care Management contracts. 100% Federal Funds for the New Hampshire Health Protection Program, 50% Federal Funds and 50% General Funds for the currently eligible Medicaid population.