Legislative update
February 4, 2010
NHHA is following dozens of bills this session on a wide variety of issues that
include patient privacy, cost of care and health insurance, Medicaid, medical
liability, quality and property tax exemptions, to name a few. Highlighted below
are several key bills for hospitals.
Health Costs
HB 1438, relative to a patient’s right to know regarding charges for health
care:
This bill requires all health care providers to provide, upon request of the
patient, an estimate of the charge for services to be provided. Included in the
estimate are cost variances due to the patient’s health status, discounts and
procedure codes. The bill also requires health insurers to provide information
on the insured’s coverage, cost-sharing requirements, and pre-certification
requirements based on the estimated charges provided by the health care
provider.
NHHA is committed to providing meaningful price information, and has begun work
on an initiative to have hospitals post their top 50 outpatient diagnostic
services and associated charges. We’ll work with other provider organizations to
educate legislators about this effort and the challenges that limit providers’
ability to estimate pricing information. The hearing on HB 1438 will be held
February 4th.
HB 1426, permitting patients to bring their medications to the hospital or
health care facility: NHHA testified in opposition to a bill that presents
significant patient safety concerns if hospitals are required to allow patients
to bring medications from home that either cannot be identified, may be damaged
due to improper storage, or were obtained from an unknown source on the
internet. While some hospitals currently do allow patients to bring their own
medications to the hospital under very limited and controlled circumstances,
this practice is best left to the discretion of each facility. The House Health
& Human Services Committee is expected to vote on the bill next week.
Health Insurance
HB 1342, relative to the right of election to submit a claim for medical
expenses under a medical payments motor vehicle liability policy or a health
insurance policy: This is one of several bills designed to allow patients with
auto insurance Med Pay policies to submit their health care claims to the auto
insurance carrier with no obligation on their part to reimburse the health
provider for services rendered following an automobile accident. The intent of
these bills is to make it nearly impossible for health care providers to receive
payment directly from the auto insurance carrier, in favor of the insured who
will receive the payment and may use it for any purpose s/he so desires. NHHA is
working with a subgroup of hospital Patient Financial Services Directors to
develop alternative language to ensure that providers can access the Med Pay
payments for reimbursement of health related expenses not covered by health
insurance.
Medicaid
Protecting Medicaid appropriations is a priority of NHHA as the State of New
Hampshire faces unprecedented budget shortfalls in the Medicaid program, with
the latest projected deficit for FY 2010 estimated at $38 million. By week's
end, the HHS Commissioner is expected to announce budget reductions that are
expected to include significant Medicaid hospital payment cuts. No details have
been made available yet.
A hearing was held on a separate budget-cutting proposal,
HB 1664, that calls for budget cuts throughout state government in State
Fiscal Year 2011 beginning July 1, 2010. Included in these cuts are: (1) a $2
million reduction in Medicaid payments to Critical Access Hospital; (2)
elimination of Medicaid Catastrophic hospital payments of $2.8 million; and (3)
elimination of Medicaid Direct and Indirect Medical Education payments to
hospitals of $1,350,000 … a total reduction of $6,150,000 in Medicaid hospital
payments in FY 2011. NHHA testified in opposition to this bill last month.
Deliberation by the House Finance Committee has been postponed, presumably until
the HHS Commissioner's budget reductions are announced.
Medical Liability
The House Judiciary Committee held hearings last week on several bills designed
to weaken the state's pretrial malpractice panel law enacted in 2005. NHHA
opposes all three bills:
HB 1256, restricting medical injury claims subject to pretrial screening
panel review to claims exceeding $250,000.
HB 1257, changing requirements for extensions of time for hearings by
pretrial screening panels for medical injury claims.
HB 1258, relative to the award of costs and attorneys’ fees incurred in the
medical injury screening panel process.
Another bill that was defeated twice in past legislative sessions has been
introduced once again proposing to change apportionment of damages requirements
in liability cases. This bill will upset the current balance in New Hampshire’s
tort system with regard to settlements and payment of judgments. It would
unfairly punish defendants with "deep pockets", regardless of how minimal their
degree of fault in a multi-defendant case thus allowing the courts to impose up
to 100% of damages to a party found to have had minimal responsibility. NHHA
opposes
HB 1255.
Privacy/Health Information
HB 1649, relative to health information and patient rights and establishing
a commission to study adding certain information to a driver’s license:
This bill would establish more restrictive requirements relative to disclosure
of protected health information for treatment, as well as a patient’s right to a
report detailing a named provider’s access to the patient’s electronic medical
record. NHHA, along with other privacy stakeholders, opposes this bill due to
provisions that conflict with federal HIPAA requirements. The hearing on HB 1649
will be held February 9th.
Quality
HB 1169, deleting the repeal of the NH Health Care Quality Assurance
Commission: This bill reauthorizes the Health Care Quality Commission which is
due to sunset July 1, 2010. The Commission has been extremely effective in
bringing hospitals and ASCs together to promote initiatives and share best
practices to enhance patient safety. HB 1169 would allow the Commission to
continue this important work. NHHA supports the reauthorization of the
Commission. The hearing on HB 1169 will be held February 9th.
Taxes
HB 1583, relative to the property tax exemption for organizations with
charitable activities: NHHA opposes HB 1583 which inserts a financial means test
to be applied in the determination of a not-for-profit's tax exemption for
charitable purposes. NHHA testified in opposition to this bill. A subcommittee
of the House Local & Regulated Revenues Committee has recommended the bill be
killed.
NHHA’s complete list of bills is available here.
