Item 10A

Authorize to amend two existing sole source agreements with the State's managed care health plans, Granite State Health Plan, d/b/a New Hampshire Healthy Families, Bedford, NH, and Boston Medical Center HealthNet Plan, d/b/a Well Sense Health Plan, Boston, MA. The contract for SFY 2019 synchronizes the existing Medicaid Care Management Program re-procurement as legislatively required, adjusts for operational and program changes, including the transition of the NH Health Protection Program to the Granite Advantage Healthcare Program effective January 1, 2019. The adjusted actuarially certified rate structure under the sole source contracts is $803,103,161. This request, if approved, will increase the amount by $147,676,924, due to the transition of the Medicaid expansion group from qualified health plans under the NH Health Protection Program to coverage under the two managed care health plans. The SFY capitation rate for SFY 19 decreases by 1.7% and the pre-existing aggregate average administrative cost allowance of 8% remains in place, as does the operating margin allowance of up to 1.5%. The combined aggregate total is $3,705,598,325 for all Medicaid Care Management program contracts, effective upon G&C approval. Originally approved by G&C on May 9, 2012, Item #54A. Funds are 50% Federal and 50% General Funds for the currently eligible Medicaid population except for the NH Health Protection Program services funds are 94% Federal and 6% Other for Calendar Year 2018; and for the Granite Advantage Health Care Program 93% Federal and 7% Other for Calendar Year 2019.