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NH 2007 Insurance Legislation

It passed!

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What does it cover?Some Early Intervention Services:

Physical Therapist

Occupational Therapist

Speech Pathologist

Licensed Social Worker

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So, how does this benefit the early intervention system?

Pays for services not previously paid for in the past by private insurance.

Cap of $3,200.00 per child per year

Cap of $9,600.00 per child birth to third birthday

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What about costs to the family?

Co-pays

Deductibles

Life Time Cap

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Why was it successful?The largest insurer in the state (Anthem) was already covering early intervention services in both Massachusetts and New Hampshire.

The caps matched Anthem’s caps.

A strong argument regarding the cost savings in the long term was made by multiple sources.

SB93 includes co pays and deductibles.

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Tips for other states?Get the cost analysis done as soon as possible.

Be prepared to explain how funds flow – having multiple funding streams supporting the program can be hard to explain.

Be clear about any gaps in funding.

Show that private insurance not paying results in cost shifting to the State.

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Identify your Champions ahead of time…..

Identify your ‘people’ resources:

Private non-profit organizations

Advocacy groups

Your ‘natural’ advocates and born leaders.

Parents – keep them informed and help them to learn how to help you.

State government champions for early childhood issues– keep them informed and help them to learn how to help you.

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NH Champions

Senator Hassan, sponsor of both bills

Patti Rawding-Anderson, Advocate for Early Intervention

Peggy Small-Porter, Program Director

Community Services Network, Inc. (CSNI)

Parents who chose to be involved!

NH Insurance Commission

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How did NH move from no insurance mandate to having a mandate?

Carolyn H. Stiles cstiles@dhhs.state.nh.us NHDHHS/BDS/FCESS

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What’s next?

Lead Agency continues to monitor program and regional billing practices.

Insurance Commission will monitor insurance carrier refusals to pay.

At some point in the future, seek an increase in the annual cap.