NHHA LEGISLATIVE UPDATE
March 8, 2004
STATE BUDGET
Last week the House Finance Committee
heard firsthand the Legislative Budget Assistant’s forecast of
a $35 million deficit in the state budget instead of a
$70 million surplus for the biennium.
A number of Governor Benson's proposals in the compromise
budget are not materializing including changes to DHHS
programs including the Access program, the preferred drug
list, means testing, and provider payment flexibility – though
predicted to save $35 million – will actually net $0. $11
million in projected savings for information technology will
net less than $2 million; and the $7.5 million for a new
Nashua liquor store will net $0.
Though most tax revenues are meeting or exceeding projections,
budget cuts are expected.
MALPRACTICE REFORM
HB 1413, relative to the
creation of mandatory screening panels for medical injury
cases:
Hospitals support HB 1413,
modeled after Maine's successful pre-trial screening panel law
which encourages quicker settlements. HB 1413 would require
medical malpractice cases to go before a three-person panel,
with unanimous decisions admissible if the parties go to
trial. Presently, New Hampshire hospitals' malpractice
premiums are 40% higher than Maine's. New Hampshire
physicians' premiums are double.
The House Judiciary Committee
is working on changes to the bill and is expected to vote on
the bill by Wednesday, March 10th.
Meanwhile, the Senate is
working on other tort reform proposals, including:
SB 452, relative to
qualifications of expert witnesses in medical injury cases:
The Senate Judiciary Committee
voted to amend SB 452 thus adopting federal standards for
expert testimony and would apply to all malpractice cases, not
just medical malpractice. SB 452 will be voted on by the
full Senate March 11, after which the bill will move on to the
House of Representatives. The four remaining Senate tort
reform bills will be acted on by the Judiciary Committee this
week. These include proposals to limit non-economic damages;
limit attorney contingency fees, allow periodic payments on
future damages; and changing the statute of limitations.
PROVIDER/HEALTH INSURER CONTRACTING
SB 389, relative to health carrier and provider contract disputes:
Hospitals supported SB 389, as introduced, which allowed patients
to have continued access to their physicians in the event of a dispute
concerning the negotiation of a contract between a hospital and a health
plan. The Senate Insurance Committee amended the bill to
increase the extension of the prior contract by another 60
days from the date of the termination of the contract. This
would result in continuing the inadequate terms of the
previous contract for a total of four months – an unreasonably
lengthy period which could undermine the financial viability
of a smaller, more vulnerable hospital.
DENTAL CLINICS OPERATED BY HEALTH CARE CHARITABLE TRUSTS
SB 441, relative to the operation of dental clinics by health care
charitable trusts:
NHHA is opposed to SB 441, requiring not-for profit hospitals to apply to the
Board of Dental Examiners to operate a dental clinic. Licensure
boards, however, do not have jurisdiction over charitable
trust service offerings beyond the licensure of its
practitioners. To address concerns that the dental practice
statute should include a provision to permit non-profit health
care organizations to operate dental clinics, NHHA has
suggested an amendment that adds healthcare charitable trusts
to the list of statute‘s exemptions. The Senate HHS committee
votes on SB 441 on Wednesday.
COMMUNITY BENEFITS
HB 1408, relative to reporting requirements for certain nonprofit
organizations, including health care charitable trusts: HB 1408 expands
the timeframe from 3 to 5 years for healthcare charitable trusts to update
their community needs assessments. The bill also requires
hospitals and other charitable trusts with annual revenues in
excess of $500,000 to submit their audited financial
statements to the Attorney General's Office. The annual
revenue amount of $500,000 was increased from $100,000 in the
original bill to ease the burden on smaller charitable
trusts. NHHA supports HB 1408 as amended.
PHYSICIAN OWNERSHIP IN PHOs
HB 1319, relative to the percentage of ownership in physician hospital organizations:
The Commerce Committee has recommended HB 1319 be sent to interim study before any further action is taken on this bill. The original intent of HB 1319 was to limit ownership by physicians to not more than 15% of physician hospital organizations. The underlying issue, however, was the potential conflict of interest by providers who refer patients to physical therapy, radiology, or laboratory facilities in which they have an ownership interest. Although current law requires physicians to disclose to patients any ownership interests in organizations to which they refer patients, and to report such referrals to the Department of Health and Human Services, it appears that these requirements have not been monitored or enforced. The committee will further explore how to ensure compliance with the disclosure requirements and which agency should be responsible for such oversight.
To view any of these bills, go to http://www.nhha.org/state_law/bills/bills.php.
