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Bill would let DHHS provide provisional payments to nursing homes with lengthy Medicaid pendings
Summary
Sen. Daryl Abbas said SB 543 would establish a revolving provisional‑eligibility fund to pay nursing facilities while Medicaid applications are pending (up to 18 months), with facilities ultimately responsible for repayment; DHHS urged contingency language and two funded positions to administer the program.
Sen. Daryl Abbas said SB 543 aims to address a cash‑flow problem for nursing facilities that admit residents with pending Medicaid applications that can take far longer than the statutory 90 days to process.
"For some of the larger facilities ... they are basically advancing $700,000 to $1,000,000 at a time," Abbas said, arguing a state revolving fund or line of credit would help facilities meet payroll and continue to accept Medicaid residents.
DHHS counsel Brian Clark and Robert Berry described the program as a revolving fund that could pay provisional Medicaid‑rate amounts to eligible facilities for up to 18 months while applications are pending; the department would seek reimbursement once eligibility is resolved. They told the committee the bill, as drafted, includes only a $1 placeholder appropriation and that two financial positions—estimated at roughly $250,000 annually total—would be needed to administer the fund. DHHS requested a contingency amendment delaying implementation until funding and positions are secured and suggested moving the effective date to July 1, 2027 to align with the biennial budget process.
Stakeholders including the New Hampshire Healthcare Association supported the policy as a stabilizing measure for long‑term care, while committee members pressed for clarity on county eligibility, liability if an application is denied or a facility declares bankruptcy, and how the 5‑year lookback for asset transfers affects processing time. DHHS and proponents agreed to provide additional fiscal and operational detail as requested by the committee.
