[{"_1":2,"_88":-5,"_89":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6342229,"mediaKeyId","2255422-41ef03895e54133d03832ed34984d508","parentId",2255422,"title","Supporters urge insurance coverage for Fast Forward wraparound; insurers warn of administrative burden","audioSeconds",3306,"startMs",6606000,"endMs",9912000,"viewUrl","/Search/View?dp=1&key=2255422-41ef03895e54133d03832ed34984d508&start=6606&end=9912","thumbnailUrl","https://assets.pipeline.soar.com/2255422-41ef03895e54133d03832ed34984d508/thumbnail_6606000.jpg","articleUrl","/articles/6342229/New-Hampshire/Supporters-urge-insurance-coverage-for-Fast-Forward-wraparound-insurers-warn-of-administrative-burden","mediaUrl","https://secure.pipeline.soar.com/6342229-463211a33b2c373e5443caa10765faf1/orig.mp4?Expires=1771216521&Signature=RopuqHjAFz4GKeF8lVYIu9S885iFg9dBvkGHpD7y8t7R0K84oyFJPq0hhNQwpgDZpio5mylLF8SScaprX4o9AP7ABeF5wyCftsJhLubVIX54~qxiTKwrUGjrEWeOsnWLcGYmo9pEdDprDjhfdGScy0gkFWOEK1Wu1Bto1y3RIozUZyrJZPtGg5OwE6L~PiQXFTQGNK0W5HFlmd9pm1XguN~Ivy-gtVrKl-OctyEa3ZHeMRQVLIC5HEpzpb8JKMLN2B~RaD5K-~5NaQRW1pMFNSwUFwji3NI7Eade4XvTshPoRVnPDrtg~AdKpcWNJ1a86UVXSL5ngQaYlF-F0fYcwA__&Key-Pair-Id=KUT5TJCACFTXG","author","New Hampshire Senate","date","2025-02-10T00:00:00Z","article","CONCORD, N.H. — At a Jan. 20 hearing, the Senate Health and Human Services Committee considered Senate Bill 128, which would require a public‑private funding structure so children with private insurance could access the state’s Fast Forward youth and family wraparound program without relying on state general funds.

Senator Regina Birdsall, sponsor of SB 128, said the bill responds to a study committee’s recommendation and aims to braid federal, state and private funds so families with commercial coverage receive the same Fast Forward wraparound services now paid for with state dollars when private insurers do not cover them. “Treating children in their communities results in long term savings to the state and to insurers,” Birdsall said.

Fast Forward is a bundled, family‑driven wraparound program operated by two care management entities in New Hampshire. DHHS staff and the care management entities said roughly 20 percent of Fast Forward families currently have private insurance; DHHS estimated the incremental cost to cover commercially insured children who receive Fast Forward services at about $2 million to $3 million annually, once reserves and administrative planning amounts in the draft legislation are included.

Advocates and parents urged passage. Holly Stevens of NAMI New Hampshire said wraparound services are evidence‑based and that family peer support components are “not covered by commercial insurance in any way.” A parent, Katie Lyon Pingree, described repeated emergency department visits and an eventual out‑of‑state residential placement for her son; she urged lawmakers to make Fast Forward available to families regardless of their insurance.

Dennis Calcutt of Connected Families and Luke Renard of NFI North (the two state care management entities) described Fast Forward as a bundled program whose clinical and “functional support” elements — family peer support, care coordination and community‑based supports — are designed to work together. Renard said 602 Fast Forward referrals were handled in his fiscal year, 67 of them commercially insured, and that the program lost money serving commercially insured children because the care management entities do not receive private reimbursement for those bundled services.

Insurance industry witnesses urged caution or opposed the bill as drafted. Andrew Hosmer of Harvard Pilgrim Health Care said carriers already cover many services in the wraparound model and that the bill would impose substantial new administrative requirements — including age‑segmented parity reporting that he said exceeds federal parity (MHPAEA) requirements. Sabrina Dunlap of Anthem urged continued stakeholder work, saying carriers and care managers had not reached contracts and some coding questions remain. AHIP (insurer trade association) representatives asked lawmakers to consider whether coding, contracting and alternative payment models could close gaps short of establishing an assessment mechanism.

Commissioner D.J. Betancourt said the Department of Insurance can work with the sponsors and noted that if the bill becomes an assessment, the department’s preference is to limit scope and add guardrails. He said his staff had prepared a fiscal worksheet and that the $2 million to $3 million range reflected the commercial share of existing program costs plus reserve and operating considerations. The commissioner cautioned that assessments are rare and can set precedents for future requests if not tightly scoped.

Supporters asked the committee to advance the bill so children with private insurance could access the Fast Forward model without relying on state general revenues; insurers and the insurance department urged tighter definitions, clearer coding and a negotiated approach to contracting before an assessment mechanism is adopted.

","mediaType","Video","parentTitle","Senate Health and Human Services (02/10/2025)","oneSentenceSummary","CONCORD, N.H. — At a Jan. 20 hearing, the Senate Health and Human Services Committee considered Senate Bill 128, which would require a public‑private funding structure so children with private insurance could access the state’s Fast Forward wraparound program.","taxTitle","Health and Human Services, Senate , Committees\t, Legislative, New Hampshire","taxId",29510,"location","New Hampshire","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6342234,"Senate committee hears bill to create uncompensated mental‑health assessment for community providers",5547,963000,6510000,"/Search/View?dp=1&key=2255422-41ef03895e54133d03832ed34984d508&start=963&end=6510","https://assets.pipeline.soar.com/2255422-41ef03895e54133d03832ed34984d508/thumbnail_963000.jpg","/articles/6342234/New-Hampshire/Senate-committee-hears-bill-to-create-uncompensated-mentalhealth-assessment-for-community-providers","https://secure.pipeline.soar.com/6342234-17b3a9b5744d7d8b7e3c205e02802e53/orig.mp4?Expires=1771216521&Signature=RZ2mDLlUi0PdDa4Wn5X9qtHUtBBG0Y-0weZCzCxKgin2C832fKzBDWCBXVoaxomSqaAUaR8t3zPPicnFktrYqMxr30GxJha79I4aCRZbWbNZX9wjgaB3H-LG9~L0D1HfqEMOunFMlvjrVXmRaL65UVKTnbwHrgFNF-pLczzUpGGVyFv7T2s4cqpzoAM4ikMSQuN3lY-4EFfibX51tusmqDy6DKrCAGg8sA2-t1Ff1K-VPbdEJIFRwCscuyQrhQ6YyQzCPWHhLCQ9I5I2O1RKrfWaajMupgQl7kJ5ELscerCv2nLoxHF6ga58f6mUke21EnMNZXP1GeVZSdkPUvnLdA__&Key-Pair-Id=KUT5TJCACFTXG","CONCORD, N.H. — Lawmakers heard testimony Jan. 20 on Senate Bill 136, a proposal to establish an uncompensated mental‑health care assessment fund and a committee within the New Hampshire Department of Insurance to allocate money to community mental health centers.

Senator Deborah Altschiller, sponsor of SB 136, told the Senate Health and Human Services Committee the bill would create an assessment targeted only at uncompensated mental‑health care and administered by the insurance department. “This bill is only about mental health care,” she said, asking the committee to amend wording and to consider adding the words “mental health” where missing in the draft.

Supporters — including leaders of the state’s 10 community mental health centers and the New Hampshire Community Behavioral Health Association — said uncompensated costs have climbed sharply in recent years and threaten the centers’ ability to deliver outpatient services, prevention and the state’s Mission 0 objective to eliminate psychiatric boarding in emergency departments.

Dr. Cynthia Whitaker, president and CEO of Greater Nashua Mental Health, said her center’s uncompensated care rose to $2.5 million in the last year after remaining about $1 million annually for years. “Our philanthropy can’t take that,” Whitaker said. She described centers as statutorily required safety‑net providers that must serve patients regardless of ability to pay and said uncompensated costs are forcing delays or cancellations of planned capital projects and may impair staffing.

Roland Lamy, executive director of the New Hampshire Community Behavioral Health Association, outlined provider data showing aggregate uncompensated care across the 10 centers and a decline in Medicaid revenue that, together, produced operating losses of roughly $20 million system‑wide in fiscal 2024. Lamy said his spreadsheet shows uncompensated care drivers include Medicaid “spend down” patients who move in and out of eligibility, unpaid cost‑sharing and services private insurers do not cover.

Under the draft bill, the assessment would be levied against commercial covered lives to create a pooled fund to offset uncompensated mental‑health costs at designated centers. Lamy and other witnesses said the model is similar in structure to prior state assessments used for the state reinsurance pool and other programs.

Insurers and trade representatives warned that an assessment is effectively a tax on carriers and could raise premiums or otherwise destabilize insurance markets. Andrew Hosmer of Harvard Pilgrim Health Care said the department of insurance’s fiscal note language left the definition of “uncompensated care” ambiguous and that an assessment “is ultimately a tax” that could lead to higher deductibles or premiums for members. He cited an original fiscal worksheet that calculated a high per‑member figure before the sponsors clarified the bill’s mental‑health‑only scope.

Insurance Commissioner D.J. Betancourt testified that the department writes fiscal notes strictly on how a bill is drafted and said the department is willing to work with sponsors to refine definitions and guardrails. “I am not a huge fan of assessments,” Betancourt said, explaining assessments often create upward pressure on premiums and can have retaliatory revenue effects from out‑of‑state market actions. Michelle Heaton, director of the department’s life and health division, added that payment mechanics are complex for self‑funded groups and noted the bill’s current language that would bar carriers from passing the assessment to employers or individuals may be difficult to enforce.

Several federally qualified health centers (FQHCs) and other safety‑net providers testified that uncompensated care is already large and growing. Christine Stoddard of the Bi‑State Primary Care Association said the 10 community health centers reported about $14.5 million of uncompensated care in 2023 and urged a definition of “safety‑net providers” that would include both community mental health centers and FQHCs because of integrated, overlapping services.

Department of Health and Human Services staff told the committee the department awarded $5 million in stabilization funding to CMHCs in August 2024 and placed a $5 million prioritized need request in the budget, but centers’ uncompensated costs exceed that amount. Jennie O’Higgins, DHHS legislative liaison for behavioral health, told senators the department’s worksheet estimated the incremental commercial share of uncompensated FastForward‑type costs differently (note: FastForward discussion was part of the subsequent bill), and offered to provide more detailed fiscal figures on request.

Supporters asked the committee to recommend SB 136 ought to pass to preserve community mental health capacity; opponents asked for narrower definitions, stronger guardrails and more time to negotiate payment and contracting solutions with carriers. The hearing closed with requests that the Department of Insurance and sponsors refine the fiscal estimates and definitions before further action.

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Supporters urge insurance coverage for Fast Forward wraparound; insurers warn of administrative burden

Senate committee hears bill to create uncompensated mental‑health assessment for community providers