NHHA LEGISLATIVE UPDATE


March 14, 2006

Reporting of ‘Price’ Information

HB 1723, relative to health care and health insurance data
The House has referred 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 that were considered included (1) prohibiting confidential business arrangements between providers and insurers, despite antitrust laws that prohibit the sharing of such information; and (2) collecting data that duplicates current data systems managed by public and private organizations engaged in health and insurance data collection in the state. NHHA urged legislators to take into account the unintended consequences of reporting mandates including costly duplication. The additional time the Committee has 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

SB 378, relative to rates charged by health care providers
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, 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.

Infection Reporting

HB 1741, relative to reporting requirements concerning infections in hospitals
The House passed the infection reporting bill, which would (1) require hospitals to report to DHHS 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 next stop for HB 1741 is the House Finance Committee.

NHHA 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 that provide meaningful, publicly reported information to consumers, purchasers, and providers about healthcare-associated infections. Rather than risk implementation of incompatible reporting systems around the nation, NHHA favors having New Hampshire participate in the development of national standards for reporting of healthcare-associated infection data.

End of Life Care/Health Care Decision Making

HB 656, relative to medical decision making for those adults without capacity to make health care decisions for themselves
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 Judiciary Committee will take up HB 656 on March 28th.

Certificate of Need

SB 303, relative to elective angioplasty.
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 consistently 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

HB 1399, relative to the compensation paid to directors or officers of a charitable trust
The House killed a bill that would have prohibited “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. Congress has 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. A coalition of New Hampshire charitable organizations worked with Charitable Trust Director Mike DeLucia to kill this bill by informing legislators 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

HB 515, relative to 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.

Other

HB 1555, establishing a commission to investigate cost drivers in providing health care. The House passed HB 1555 which creates a 20-member commission, including two hospital representatives, to study cost shifting associated with providing services to Medicaid and uninsured patients; hospital construction costs, medical malpractice insurance rates, to name a few. HB 1555 is on its way to the Senate.

HB 1704, establishing a health care fund and requiring certain employers to report certain information to the department of health and human services.
The House killed the “Wal-Mart” bill intended to tax large employers (more than 1500 employees) that do not provide health coverage for their employees. The bill would have determined how much an employer will spend on insurance, or impose a health care tax

HB 1703, requiring certain employers to report on the percentage of payroll which is being spent on health insurance premiums for employees. This companion bill to HB 1704 requiring employers with 500 or more employees to report on how much they spend on health insurance has been tabled by the House. While the Labor Committee voted (7-6) to pass HB 1704 based on the desire to obtain cost shifting information, there were others who feel that requiring such information may be a violation of the State Constitution.

HB 1570, relative to health insurance coverage for part-time college students.
The House passed HB 1570 to extend health insurance coverage to dependent children under age 24 who are not covered under the recently passed “Michelle’s Law” that allows college students who take a medical leave of absence to be covered under their parents’ family plan. While extend coverage to part-time students, HB 1570 also allows coverage for unmarried children under the age of 24 who are financially dependent upon a parent and who either have the same legal residence as the policyholder, or are full-time or part-time students.

 

Go to http://www.nhha.org/nhha/state_law/bills.php to view the list of bills NHHA will be tracking in 2005-2006.  Additional bills will be added as we become aware of them.

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