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County officials warn managed‑care move and low reimbursement could hit budgets and EMS operations
Summary
The county administrator told commissioners that a DHHS move to place nursing‑home services under managed care and current ambulance reimbursement practices could cost Cheshire County millions and strain EMS finances; the county is pursuing meetings with DHHS and legislative remedies.
County officials told the Cheshire County Commission on March 26 that proposed state changes and current payer practices threaten county revenues and emergency‑service finances.
The county administrator said a DHHS proposal to move nursing‑home oversight into managed care would raise questions about state and federal oversight and could eliminate ProShare funding. “It would be a death blow to the counties” if proshare and bed‑tax revenue were lost, the administrator said, estimating roughly $5.2 million in lost ProShare plus about $800,000 in bed‑tax revenue — a potential $6 million hit to county revenues if no waiver or compensation is provided.
Officials also reviewed two pending reimbursement bills: House Bill 316 (a 200% private‑pay cap described by the administrator) and a Senate proposal that would increase allowable private‑pay rates to roughly 325%–350% of Medicaid. The administrator said the bills differ and crossover negotiations may change final rates; he urged public education and advocacy to protect county hospital and EMS finances.
On ambulance billing, county staff described routine underpayment from commercial payers. The administrator gave an example in which a billed ground-ambulance service of about $1,900 produced a partial payment from Anthem and a lower-than-billed secondary payment, leaving the county to absorb significant unpaid charges. Commissioners said that raising allowable rates would help EMS sustainability; the administrator said the county is coordinating with lawmakers and will press DHHS on formula changes.
Commissioners did not vote on these matters at the meeting but scheduled follow-up: the administrator plans a meeting with DHHS deputy commissioner Henry Litman to discuss ProShare formula changes and will report results back to the commission.
