Senate Votes: Part 2
We continue highlighting some of the 34 bills and amendments scheduled for a session of the full Senate today.
The proposals include eliminating the state motor vehicle registration surcharge, repealing boating speed limits on Lake Winnipesaukee, and establishing a managed care platform for the state’s Medicaid program.
Kill the Surcharge
Senate Bill 78 – A motor vehicle registration surcharge enacted in 2009 as a two-year temporary funding measure could die sooner.
Sponsored by Sen. Andy Sanborn (R-Henniker), SB 78 would immediately repeal a 2009 provision that raised registration fees and surcharges for certain vehicles — from $35 to $75 depending on the size of vehicle. The resulting revenue is designated for “highway and bridge betterment.” Sanborn’s proposal would reinstall the previous fee structure and eliminate the surcharges, which are due to expire June 30.
The bill’s fiscal note says revenues for the Department of Transportation would decrease by about $6.59 million. That reduction would decrease state highway fund expenditures and local revenue an estimated $791,000 for fiscal year 2012.
Senate Bill 78 passed in the Senate Ways and Means Committee by a 6-0 vote with an “Ought to Pass” recommendation to the full Senate.
Senate Bill 27 – Two years ago, lawmakers enacted a speed limit on Lake Winnipesaukee: 45 mph during the daytime and 30 mph at night. Now, a proposal sponsored by Sen. Lou D’Allensandro (D-Manchester) would replace that with no speed limit at all.
D’Allesandro’s bill would instead require boaters on any body of water to “proceed at a safe speed that is reasonable and prudent under the existing conditions,” with conditions like visibility, weather, and radar use to be considered in determining a safe speed.
The bill’s supporters say common sense boating shouldn’t be replaced by limits of personal freedom, while opponents say safety has been enhanced and the lake is more family-friendly with the current speed limit in place.
The bill was reported out of the Senate Transportation Committee with an “Ought to Pass” recommendation by a slim 3-2 vote.
Senate Bill 147 – Sponsored by Sen. Jeb Bradley (R-Wolfeboro), SB 147 would set up a five-year contract with private vendors to manage the state’s Medicaid program.
Supporters say the long-term savings with a managed care program could amount to tens of millions of dollars not spent in administrative costs. In the bill’s fiscal note, the Department of Health and Human Services said it was difficult to determine what costs could be saved at this time. The Department provided the following information:
- In 2009, a leading health care actuarial firm, Milliman, Inc., reviewed NH Medicaid claims and conducted actuarial analysis to determine the viability of Medicaid managed care in NH. Their report identified factors that impact the ability of the state to achieve savings utilizing managed care. The existing reimbursement rates, size of the Medicaid caseload, administrative costs, and wrap-around responsibility were factors.
- New Hampshire’s reimbursement rates and administrative costs are comparatively low.
- The federal law requiring states to offer choice to recipients would require at least two managed care organizations to serve Medicaid enrollees.
- States must provide wrap around services; all services required by federal law including services which may not be included in the managed care benefit package.
- The Department issued a Request for Information in July, 2010 to solicit ideas from the managed care industry. Twelve entities responded and none of the responses offered savings. Most of the respondents stated they would need 6 to 9 months from the date of contract approval to program start up. Therefore the Department assumed there could be no fiscal impact until FY 2013.
- The New Hampshire Medicaid program currently utilizes most of the tools used in managed care including prior authorization, care management, and pharmacy benefit management.
- Based on the experience of other states, an up front investment is necessary as two claims adjudication systems are needed for the first 6 months after the transition date. The old MMIS system would continue to operate for 6 months since providers have 6-12 months to submit claims for services provided and new the claims would be processed through the new managed care system.
- Federal approvals required at various points in the procurement process may increase the timeline for implementation.
Senate Bill 147 unanimously passed Senate Finance Committee with an “Ought to Pass” recommendation.
>> Wednesday, March 23, full Senate session beginning 10 a.m. at the State House.
This Daily Dispatch was written by Michael McCord.