NHHA LEGISLATIVE UPDATE
February 29, 2008
Legislators return next week from a mid-session break. The
House, in particular, has a very full agenda for final
action on bills scheduled to “cross over” to the Senate by
March 20th.
State Budget Cuts
Last week, Governor Lynch dealt a major blow to hospitals by
announcing a $14,000,000 cut in Medicaid hospital care
payments to achieve a savings of $7 million in State General
Fund in the remaining four months of the fiscal year. State
spending cuts of this magnitude are unprecedented.
Unexpectedly low revenues are the reason for the Governor’s
plan to reduce state spending by $50 million. The Department
of HHS alone must come up with $22.5 million, and Medicaid
hospital care payment cuts account for 31% of DHHS cuts.
HHS Commissioner Nick Toumpas asked hospitals to come up
with a solution in less than a week to deal with Medicaid
Hospital Care reductions of $14,000,000 To save $14,000,000
over the next four months could require cutting payment
rates by 33%. What’s worse, New Hampshire hospitals are
already the lowest paid in the nation at 56 cents
on-the-dollar of cost for delivering Medicaid Hospital Care,
while the average for the nation is 85 cents on-the-dollar.
NHHA met with Commissioner Toumpas yesterday and proposed a
three-tiered alternative to payment rate cuts to achieve the
targeted savings. This could be achieved by: (1) finalizing
pending outpatient cost settlements yielding approximately
$5 million; (2) attributing to hospitals the additional $ .5
million paid to the State in federal Medicaid DSH payments
over and above what the State budgeted for this revenue
source; and (3) applying unspent Medicaid pediatric
specialty funding for SFY 2008 of $1.2 million.
We’re awaiting the Governor’s response to this alternative
to Medicaid Hospital Care payment rate cuts that avoids
draconian cuts, does not require the State to forego
millions in Federal match funds, and would not exacerbate
cost-shifting.
Privacy
Providers of all types are gearing up to defeat HB 1587,
relative to patient health care information next week to be
voted on by the full House next Wednesday. HB 1587 upsets
the careful balance under HIPAA that protects patient
privacy while allowing the flow of information necessary to
care for the patient. Passing stricter standards at the
state level will only confuse providers and add untold costs
to an already strained healthcare system.
Furthermore, HB 1587 will hamper, not help, the Governor’s
efforts to improve healthcare quality, safety and efficiency
through the expansion of the use of Electronic Medical
Records (EMR) and e-prescribing. In fact, a provision in the
bill would prohibit new providers from joining existing EMR
systems as of January 1, 2008.
If passed, New Hampshire will allow patients to refuse to
share critical clinical information, thereby placing
healthcare providers in the position of either treating
patients with insufficient information thus putting patients
at risk, or denying treatment altogether. This is a disaster
in the making, and HB 1587 should not be allowed to pass.
Uninsured
The House Commerce committee has recommended the House kill
HB 1195, relative to health care provider reimbursement for
services provided to uninsured patients. Although designed
to address disparities between rates charged to different
patient groups – insured versus uninsured – legislators
agreed with hospitals that HB 1195 would likely create
significant unintended consequences, such as people opting
to drop their insurance to avoid premiums in favor of paying
a fixed amount for services. Legislators are also concerned
about restraint of trade implications. Finally, the Task
Force on Affordable Health Insurance, created by the
Legislature, should be allowed to complete its work and make
recommendations to deal with access to affordable insurance
products.
Health Insurance Expansions
The House will vote next week on two bills that proposed to
repeal last year’s legislation that expanded health coverage
to adult dependents up to age 26 and to divorced families.
The House Commerce Committee recommends against repealing
these new laws, as they’ve been well received by the public.
A complete list of bills NHHA is following is available at
www.nhha.org/nhha/state_law/bills.php.
Go to
http://www.nhha.org/nhha/state_law/bills.php to view the
list of bills NHHA is tracking.
