NHHA LEGISLATIVE UPDATE

March 21, 2007

The Legislature is nearing the halfway mark of its 2007 session, and hospitals are seeing progress on our bills. The House will act this week on two important bills that significantly improve the managed care law by (1) creating a standard definition of “medical necessity” to which all health plans must comply, and (2) establishing more stringent credentialing timeframes within which health care practitioners are approved for participation in each health plan. We also convinced legislators to reject a proposal that would have caused more problems than the one intended to be solved regarding hospital-based physicians’ participation in their health plans.

The following are highlights from the State House ….

CERTIFICATE OF NEED

Two CON bills have caused us concern.
A bill was introduced in the Senate that would allow the transfer of up to ten beds from a hospital to an ambulatory surgery center in which it has partial or full ownership. NHHA is opposed to SB 114, which would deregulate the establishment of certain hospitals. It proposes to carve out a certain sector of health care providers in defiance of the Legislature’s repeated affirmation of the state’s “compelling interest” in setting standards relative to the size, type, level, quality and affordability of health services offered. The Senate HHS Committee has recommended the bill be retained for the remainder of the year for the purpose of further study. We’re asking hospital CEOs to contact their Senators to urge them to vote in favor of retaining the bill.

HB 727 proposed to require hospitals applying for a certificate of need to provide information about the provision of health insurance by the construction project’s contractor and subcontractors for their workers. Frisbie Memorial Hospital CEO Al Felgar, testified on behalf of NHHA telling legislators that no CON applicant could provide such information so early on in the project planning process. Furthermore, hospitals are not the only non-profits that undertake building projects. The House Health & Human Services Committee has recommended an overhaul of this bill to remove references to CON, and instead create a commission to study the issue of health coverage offered by building contractors working for all types of non-profit organizations as well as municipalities. The amended bill will go to the full House for a vote next week. Read NHHA’s testimony opposing SB 114.

HEALTH INSURANCE

NHHA’s “Medical Necessity” bill, HB 228, will be voted on this week by the full House. Under current law, each health plan is only required to submit its own definition of medical necessity to the state. Varying definitions therefore have caused confusion for both consumers and providers. HB 228 standardizes the definition of medical necessity so that all health plans will adhere to the same standards. The bill will then move on to the Senate for its consideration. Incorporating a standard definition in New Hampshire statute has been a major priority for hospitals this year.

NHHA’s “Health Plan Credentialing” bill, HB 636, is designed to speed up the process by which health plans approve practitioners to participate in their plans, thereby enhancing access to providers by the plans’ subscribers. The House Commerce Committee has recommended the bill be passed requiring that (1) health plans to pay physicians for on-call coverage while they’re awaiting the plan’s credentialing determination; (2) while awaiting a credentialing decision, a practitioner will be paid by the carrier if s/he had previously been participating with the very same plan in another state before transferring to New Hampshire; and (3) plans would be required to finalize credentialing within 30 days (for primary care) and 45 days (for specialists) . LRGHealthcare’s Andy Patterson testified along with NHHA to explain to legislators the prolonged delays in credentialing by the health plans and the impact on health access.

NHHA convinced legislators to defeat a bill that would have required hospitals to notify patients whether or not a physician working in their hospital participates in the patient’s health plan. Though it would be helpful to patients to know that a particular radiologist, anesthesiologist or pathologist doesn’t participate in the patient’s health plan, it’s impossible for a hospital to know who those physicians are on a day-to-day basis. The House Commerce Committee was satisfied that patients will be informed that not all providers working in the hospital are participating insurance providers.

STATE BUDGET

The House Finance Committee has conducted its hearings on the budget held in Lebanon, Keene, Rochester, Manchester and Whitefield. NHHA, along with a number of hospitals, testified at the hearings, asking that Medicaid funding for medical education be restored, and that more realistic projections be used for determining utilization of hospital services and growth in Medicaid enrollment. The Finance Committee has begun the difficult task of accounting for every proposed expense in every state-funded program. We’re working closely with House budget writers to restore needed funds for hospital services.

The House Finance Committee is currently considering a bill that would place a moratorium on the elimination of Medicaid provider-based billing for physician and outpatient services. HB 43 would propose to create a committee to study how hospitals are paid by Medicaid for hospital-based physicians and other clinic services that are billed using Revenue Code 510. A similar bill will be introduced in the Senate.

HEALTHCARE DECISIONMAKING

Four bills were considered by the House Judiciary Committee that proposed a variety of alternations to the newly enacted healthcare decisions/advance directives legislation that went into effect January 1, 2007. The Committee has recommended that the section pertaining to the withholding or withdrawing life medically administered nutrition or hydration and life sustaining treatment from a mentally incompetent or developmentally disabled person be eliminated. This was suggested last year in negotiations on HB 656 and we support the removal of this language.

In addition, the Committee recommended retaining two other bills for further study – HB 40 prohibiting a photocopy of an advance directive, and HB 57 permitting anyone to create their own advance directive form.

PRICE INFORMATION

The House HHS Committee found HB 490, requiring hospitals to post the price of procedures, to be unnecessary due to the availability of price information at NHHA’s NH PricePoint.org and the Insurance Department’s HealthCost.org.

LEGISLATIVE CALENDAR

Monday, March 19, 2007
House Finance (Division III), LOB, Room 209
9:30 Budget bill. Work session
9:30 HB 597, relative to expenditure caps for institutional health facilities under the certificate of need law. Work session

Health & Human Services Oversight Committee, State House, Room 100.
10:00 Regular Meeting

House Labor Committee, LOB, Room 307
1:00 HB 797, regulating mandatory overtime for nurses and assistants. Public hearing.

Tuesday, March 20, 2007
Senate Ways & Means, State House, Room 100
8:30 Orientation on revenue estimates

House Children & Family Law, LOB, Room 206
10:00 HB 278, relative to notification of a parent or guardian by the medical facility treating a minor injured in an accident. Public hearing

House Transportation, LOB, Room 203
10:00 HB 802, relative to passenger restraints. Public hearing

House Finance (Division III), LOB, Room 209
Following 9:30 executive session. Budget bill. Work session

Wednesday, March 21, 2007
10:00 House in Session

Thursday, March 22, 2007
10:00 Senate in Session

House Finance (Division III), LOB, Room 209
Following 9:30 executive session. Budget bill. Work session


 

Go to http://www.nhha.org/nhha/state_law/bills.php to view the list of bills NHHA is tracking.

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