NHHA LEGISLATIVE UPDATE
April 15, 2004
Medical Malpractice
The Senate will hear testimony next week
on HB 1413, the mandatory pretrial screening panel bill.
As introduced, HB 1413, was modeled after the successful
pretrial screening panel law in Maine. This type of liability
reform legislation is needed to contain the escalating costs
of malpractice premiums for physicians and hospitals. If these
costs continue to rise exponentially, they will impact access
to care statewide as specialists such as obstetricians either
leave the state or no longer deliver babies.
Although the House worked hard on this bill, they altered HB
1413 thus rendering the panel process ineffective. Senator
John Gallus of Berlin, representing most North Country
hospitals, is proposing changes to fix the bill so that the
panel system will work. These changes include (1) restoring
the admissibility at trial of a panel’s unanimous findings;
(2) increasing the pool of available panel chairs by allowing
the appointment of individuals with judicial experience or
other qualified persons; (3) restructuring legislative
oversight so that the Legislature receives reports from
judicial and executive branches, rather than raw actuarial and
claims data from insurers; (4) eliminating the “loser pays”
option given to a person against whom the panel has made
unanimous findings; and (5) remove extraneous provision
regarding medical records an expert testimony.
The passage of the bill with the Gallus amendment will
encourage early settlement and resolution of medical
malpractice cases. It will reduce per-claim defense costs as
illustrated by the success of Maine’s pre-trial panel law. It
will help to keep OB/GYNs in New Hampshire and keep them
delivering babies in our hospitals. By containing escalating
liability insurance rates, New Hampshire will continue to
attract and retain businesses in our state.
Medical Parole for High Cost Prison Inmates
The House Finance Committee is expected to vote in favor of a new version of SB 382 to grant medical parole to inmates who have a “terminal, debilitating, incapacitating, or incurable medical condition”. This is intended to relieve the state prison from paying for the medical care of very high cost patients estimated at six inmates in the first year, and an additional two to three inmates per year. NHHA is opposed to the amendment – click here to view our letter. Though the state assumes that some of the paroled inmates will be covered by health insurance or Medicare, the majority will qualify for Medicaid. In those cases, Medicaid reimbursement to hospitals for these high-cost patients will frequently fall into the Medicaid “catastrophic claims” payment structure. Unfortunately, not only are the state’s payment rates for catastrophic care exceedingly low, the state has not paid most of these claims for five or more years.
Medicaid Enhancement Tax; Hospital Purchases
The House is expected to vote to amend HB 376 to revise the Medicaid Enhancement Tax (MET)calculation from 6 percent “gross” revenues to 6 percent “net” revenues. This change is being made as a result of the Governor’s talks with HHS Secretary Tommy Thompson and CMS officials. Since the MET is used to match Medicaid Disproportionate Share (DSH) funds, the state expects to draw down $80 million less over the next biennium (July, 2005 – June, 2007). The fallout from this reduction in federal funds will be devastating. The remainder of the bill revises the nursing home bed tax (per CMS’ instructions), and permits non-profit hospitals to participate in the state’s purchasing program for pharmaceuticals and other supplies.
Employee Voluntary Payroll Deductions
SB 316 is being amended to correct an outdated law concerning withholding of wages. The current law does not allow employers to make payroll deductions for any purposes other than a very limited list contained in Department of Labor rules – even when the employee has requested the deduction in writing. However, under present day employment arrangements, employees often pay employers for employer-provided items, such as pharmacy items, meals, parking and child daycare. Current law prohibits employers from offering employees the convenience of having these items automatically deducted from their paychecks.
For years, we have attempted to correct this situation through the regulatory process. The Department of Labor’s lack of resources has prevented such a process. The SB 316 voluntary payroll deduction amendment adds an itemized list to the statute of expenses that employers may deduct at the employee’s written request.
Modifications to Senate Bill 110 – Small Group Health Insurance
The House Commerce Committee heard testimony in opposition to SB 419, the intent of which is to correct problems with last year’s SB 110. SB 419 was passed by the Senate with the following provisions: (1) allows insurers to use the standardized health status form or their own; (2) allows employees the option of having their health status forms forwarded directly to the insurer, bypassing the employer; and (3) upon renewal of small group policies in 2004 and 2005, the current insurer cannot increase total premium by more than 25% per year or a total of 50% over two years. A subcommittee will be working on this bill over the next few weeks.
To view any of these bills, go to
http://www.nhha.org/state_law/bills/bills.php.
