NHHA LEGISLATIVE UPDATE
February 19, 2007
Recent Developments from the State House …
MEDICAID BUDGET
Governor Lynch’s Budget Message: Governor John Lynch
submitted a $10.2 billion budget proposal for 2008/2009 to
the Legislature on February 15th. The Governor’s two-year
budget would increase state spending by 9%. He wants to
raise the cigarette tax by 28 cents and cover an additional
10,000 children to the Healthy Kids program.
The Medicaid budget figures for hospitals appear
unrealistically low with a 2% reduction for outpatient
hospital services in FY 2008 down from 2007 projected
expenditures. Specific numbers are not available for
inpatient hospital service, though we’ve learned that
payments to hospitals for medical education has been
eliminated for 2008/2009. This affects services provided to
Medicaid patients by Dartmouth Hitchcock residents who
practice throughout the State.
Public hearings on the State budget are scheduled around the
state to hear testimony from concerned citizens.
Monday, March 5, 2007, 4:00 pm – Lebanon: DHMC Auditorium
E&F
Tuesday, March 6, 2007, 5:00 pm – Keene: KSC Hall, Alumni
Recital Hall, Redfern Arts Center
Thursday, March 8, 2007, 4:00 pm – Rochester: Rochester
Community Center
Monday, March 12, 2007, 4:00 pm – Manchester, PSNH
Auditorium.
HHS Commissioner Withdraws Plans to Reduce Medicaid Payments
to Hospitals for Physician Services: With pressure from
hospitals and legislators, Commissioner John Stephen
scrapped his plans to eliminate “Code 510” billing by
hospitals for physician services. The change in this
longstanding billing practice had been set for March 1,
2007.
NHHA Weighs in on DHHS Proposed Budget Cuts: On February
8th, NHHA, along with other Medicaid stakeholders, presented
our concerns about HHS Commissioner John Stephen’s proposed
2008/2009 budget to the House Finance Committee subcommittee
on health and human services. Over the last four years, DHHS
has cut Medicaid payments to hospitals by $25 million, an
extreme and disproportionate reduction. New Hampshire
hospitals are currently paid about 60 cents for each dollar
of the cost to provide care, down from 92 cents on the
dollar in 1991. NHHA will fight any proposals to further cut
payments to hospitals.
Health & Human Services Oversight Committee Probes Medicaid
Director for Anwers: The Health & Human Services Oversight
Committee asked tough questions of Medicaid Director, Norm
Cordell, at last week’s meeting of the joint House and
Senate committee. Of particular concern to the Committee is
DHHS’ plan to put out to bid through “selective contracting,
” services such as outpatient surgery, acute rehabilitation,
and cardiac surgery. The Committee also questioned the
proposal to eliminate Medicaid payments for the medical
education component of hospital services that support
services provided by physicians-in-training to Medicaid
patients.
HEALTH INSURANCE
NHHA’s “Medical Necessity” bill, HB 228, is moving along in
the legislative process toward passage in the House. If
passed, New Hampshire’s managed care statute will, for the
first time, provide a standard definition of medical
necessity with which all health plans must comply.
NHHA supports the Healthy Kids bill, HB 298, requiring the
state’s Children’s Health Insurance Program to be
administered by the New Hampshire Healthy Kids Corporation,
which is the current administrator of the program.
MEDICAL LIABILITY
This week, the New Hampshire House will consider legislation
that, if passed, will have a dramatic and negative impact on
New Hampshire health care providers. HB 143 changes a
careful balance regarding liability in civil cases. If
passed, this bill could result in lawsuits in which a health
care provider could be held fully liable even if only
partially at fault. A coalition of New Hampshire businesses
and health care providers are working to kill this bill.
The House Judiciary Committee will hear testimony this week
on a bill to repeal the pretrial screening panel bill. NHHA
opposes this bill.
CERTIFICATE OF NEED
Two CON bills went before the House HHS Committee this past
week. HB 597 would raise the CON threshold for nursing
homes, specialty hospitals and ambulatory surgery centers to
the same level as the threshold for hospitals, currently at
$2.3 million. Capital projects below this level would not be
subject to review by the Health Services Planning & Review
Board. Nursing homes anticipate by raising the expenditure
bar, physical plant upgrades can be accomplished without CON
review.
HB 723 would extend the CON moratorium on nursing home and
rehabilitation beds, which expired December 31, 2006. A
similar bill was proposed last year, but was defeated as a
consequence of being rolled into a more controversial bill
that was killed during the last days of the 2006 session.
According to supporters, sufficient state dollars are not
available to support more beds.
HIV TESTING
The House will consider voting to update the HIV education,
prevention and control statute to add explicit patient
consent in conformance with current CDC guidelines for
HIV/AIDS testing. It further reduces burdensome paperwork
for providers by bringing the patient consent process in
line with other medical test consent procedures.
REPORTING OF BURN INJURIES
NHHA has participated in discussions to remedy a bill – HB
139 – that would require health care providers to report all
burn injuries to the State Fire Marshal. It would be
impossible for Emergency Physicians to report each and every
burn that presents to the ED. Rather, a limited definition
of the types of burns that should be reported would be more
helpful identifying potential crime victims.
Go to http://www.nhha.org/nhha/state_law/bills.php to view the list of bills NHHA is tracking.
