NHHA LEGISLATIVE UPDATE
February 27, 2006
Legislative committees were very busy over the past few weeks completing as much work as possible prior to their Winter Break, February 27th – March 3rd.
Infection Reporting
The House HHS Committee’s
version of the infection reporting bill is on its way to the
full House on March 7th. HB 1741 would (1) require hospitals
to report to the NH Department of HHS all occurrences of
central line related bloodstream infections, ventilator
associated pneumonia and surgical wound infections, as well
as to report process measures including rates of flu
vaccinations; and (2) require DHHS to establish criteria,
standards and coding for tracking and reporting of
infections, as well as data collection and analytical
methodologies.
The NH Hospital Association contends that any system
designed to report infections should provide meaningful and
validated data, and therefore recommends that the reporting
of healthcare-associated infection data be carried out in
accordance with the National Quality Forum’s (NQF)
recommendations. The NQF proposes to identify performance
measures to be used in a variety of healthcare settings to
provide meaningful, publicly reported information to
consumers, purchasers, and providers about
healthcare-associated infections. Rather than risk
implementation of incompatible reporting systems around the
country, New Hampshire should participate in the development
of national standards for reporting of healthcare-associated
infection data.
Reporting of ‘Price’ Information
The House voted to refer HB 1723 to “interim study” to be worked on by the House Commerce Committee through the end of the year. NHHA favors transparency, including the collection and reporting of data that contributes to improving quality of care, containing cost increases, and enhancing patients’ ability to make informed choices about their care. However, proposals considered by legislators would have prohibited confidential business arrangements between providers and insurers, even though state and federal antitrust laws prohibit the sharing of such information. Of equal concern was the proposal to collect data that duplicates current data systems operated by public and private organizations engaged in health and insurance data collection in New Hampshire. NHHA urged legislators to take into account the unintended consequences of reporting mandates including costly duplication. The additional time the Committee afforded itself to study HB 1723 should allow for such consideration. NHHA will continue to work with legislators as they examine this bill.
Rates Charged to the Uninsured
The Senate killed a bill that would have required hospitals and other health care providers to charge patients with little or no health care coverage the median rates paid by third party payers. In NHHA’s testimony, we described several innovative programs adopted by New Hampshire’s hospitals to assist patients with their health care costs. These include the New Hampshire Medication Bridge Program in which hospitals and other health care providers have assisted more than 17,000 very low income persons to access over $125 million worth of medications free of charge over the past five years; the New Hampshire Health Access Network (NHHAN), a privately sponsored statewide charity care network serving tens of thousands of low income people; and currently under development is a hospital discount program that will provide discounts of 15% or more for patients without coverage regardless of their financial status. Most of New Hampshire’s hospitals already provide 100% discounts to patients at or below 200% of the federal poverty level, and several provide a 100% discount for people with incomes up to 300% of the poverty threshold. In 2004, community hospitals reported approximately $93 million in hospital charges not collected for care provided as charity care, and $144 million in hospital charges as bad debt.
End of Life Care
After two years of work on New Hampshire’s advance directives laws (Living Will and Durable Power of Attorney for Healthcare), a coalition of legislators and stakeholder organizations were successful in convincing legislators to update the State’s health care decisions statutes. This important legislation – HB 656 – will: make it easier for people to express in writing their preferences for health care; bring NH’s current statute up to date; simplify into plain English the legal language used in the current state law to make it more understandable; and establish procedures for ‘Do Not Resuscitate’ orders. Congratulations to the Healthcare Decisions Coalition led by Shawn LaFrance and many thanks to Representatives Maureen Mooney (R-Merrimack), Cynthia Dokmo (R-Amherst), Hilda Sokul (D-Hanover), Laurie Harding (D-Lebanon), Alida Millham (R-Gilford) and Robert Rowe (R-Amherst) for their efforts to pass HB 656. The Senate will take up HB 656 when it reconvenes after its Winter Break.
Certificate of Need
The Senate killed SB 303 designed to circumvent the Certificate of Need process. If passed, the bill would have prohibited the Health Services Planning & Review Board from approving a specific procedure – elective angioplasty. NHHA reminded senators that the Legislature has rejected initiatives in the past that attempt to circumvent the CON process. Read NHHA’s testimony in opposition to this effort to undermine the integrity of the CON program and process.
Charitable Trusts
The House Commerce Committee has recommended that HB 1399 be killed when the full House reconvenes March 7th. As introduced, the bill would prohibit “pecuniary benefit transactions” between a charitable organization and members of its Board. But the real intent of the bill’s sponsors was to limit the salaries of CEOs of charitable organizations, and hospitals in particular. In fact, Congress dealt with this issue in 1996 with the passage of the “Intermediate Sanctions” or Taxpayer Bill of Rights 2 (Section 4958 of the Internal Revenue Code). IRS regulations govern executive compensation practices, placing responsibility with the not-for-profit organization’s Board of Trustees. In addition, the Director of Charitable Trusts pointed out that New Hampshire’s case law prohibits limiting compensation based on a percentage, as proposed in the bill. Finally, New Hampshire’s community benefit law contains “sunshine” provisions that the Legislature has already established as preferable to increased government regulation.
Purchasing Alliances
The Senate killed a bill
that would have established a law governing purchasing
alliances which could be formed for the purpose of
purchasing health insurance. Carried over from last session,
the House had passed HB 515 before it sent it to the Senate.
Go to
http://www.nhha.org/nhha/state_law/bills.php to view the
list of bills NHHA is tracking.
2006 Legislative Updates: