Legislative Update
April 22, 2003
 

House passes budget with steep Medicaid provider cuts, no tobacco tax increase

The House voted 238-142 for a $2.7 billion budget proposed by Republican leadership that does not increase the cigarette tax nor restore cuts for health care providers, with the exception of nursing homes. The budget provides room for neither health care cost inflation nor rising utilization of health services. NHHA's analysis of the Medicaid budget cuts reveals that, in addition to the 5% across-the-board reduction for all Medicaid providers, hospitals would be burdened with an additional 15-17% cut if payments for catastrophic cases (such as neonatal intensive care unit cases), capital costs and medical education costs are eliminated. The "B" budget, proposed by the House, failed on a 168-212 vote. This budget, which NHHA supported, relied on a 39-cent increase in the tobacco tax and restored a 5 percent cut Gov. Craig Benson proposed in Medicaid reimbursement rates. The budget now goes to the Senate. The public hearing on House Bill 1 is scheduled for Monday, April 28, 2003, 3 p.m. to 5 p.m. and 7 p.m. to 9 p.m. before the Senate Finance Commmittee, Representative's Hall. NHHA will testify.

Certificate of Need
Two bills are in play – HB 788, which abolishes the Certificate of Need Board and SB 163, which  updates the CON statute and features a provision to require CON review of medical equipment acquired through operating leases.  NHHA supports SB 163 as passed by the Senate.  We oppose HB 788 which transfers the review function to the Commissioner of the Department of Health & Human Services and eliminates review of all outpatient services, thereby limiting regulatory oversight to inpatient settings, except for ambulatory surgery centers proposed for rural hospital service areas.

Medical and Hospital Liability Insurance – Loss of Opportunity

Senate Bill 119 was passed by the Senate and now moves on to the House for a hearing before the House Judiciary Committee on May 6^th.   NHHA supports SB 119 which ensures that the Loss of Opportunity doctrine is kept out of New Hampshire statute.  The Loss of Opportunity doctrine, if not specifically removed from the law, allows patients to recover compensation for a new type of "injury" --  the loss of opportunity for a better outcome. Under traditional legal principles, a plaintiff could recover damages only if the plaintiff could prove through expert testimony that the plaintiff's medical provider was negligent and proximately caused a tangible injury, such as premature death, disfigurement, loss of some bodily function or some other identifiable physical injury.  The loss of opportunity doctrine expands the definition of "injury," allowing for recovery of damages if the plaintiff can prove merely that the patient would have "done better" if the patient had received proper care.  Thus, in a loss of opportunity case, the injury is the difference between the chance the patient would have had if there were no negligence, as compared to the reduced chance the patient had because of the negligence.