NHHA LEGISLATIVE UPDATE

April 26, 2006


Infection Reporting

HB 1741, relative to reporting requirements concerning infections in hospitals
Both the House and Senate 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.

NHHA recommended and the Senate amended the bill to delay its implementation until July 2007 when reporting of healthcare-associated infection data can be carried out in accordance with the National Quality Forum’s recommendations on performance measures that will provide meaningful information to consumers, purchasers, and providers. This change eliminates the possibility that New Hampshire will develop a reporting system that is incompatible with the rest of the nation. It also eases the pressure on the Legislature to fund the program this coming fiscal year.


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. The Senate passed this bill April 20th.


Reporting of ‘Price’ Information

HB 1723, relative to health care and health insurance data
The House referred this bill for further study by the House Commerce Committee.
While NHHA favors transparency, we urged legislators to take into account the unintended consequences of reporting mandates that create costly duplication. NHHA opposes the bill’s provisions that would (1) prohibit confidential business arrangements between providers and insurers and (2) duplicate current data systems managed by public and private organizations engaged in health and insurance data collection in the state.


Health Costs

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. The Senate will vote on a recommendation to pass the bill on May 5th.


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 the innovative programs adopted by New Hampshire’s hospitals to help 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 low income persons to access over $125 million worth of medications free of charge; 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.


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. The real intent of the bill’s sponsors was to limit CEO salaries of charitable organizations, and hospitals in particular. Congress resolved 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’s Board of Trustees. New Hampshire charitable organizations worked with the state’s Charitable Trust Director 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. Also, NH’s community benefit law contains “sunshine” provisions that the Legislature had already established as preferable to increased government regulation.


Other

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. In addition to coverage for part-time students, HB 1570 would allow coverage of unmarried children under age 24 who are financially dependent on and reside with the parent/policyholder. However, the Senate will vote next week on a recommendation to further study the bill.

HB 1274, relative to certain disclosures to the Department of Health & Human Services
The House passed HB 1274 to change the reporting requirements for health care practitioners with ownership interests in facilities to which s/he makes referrals. Rather than report to DHHS, practitioners will report to the appropriate licensing authority. The bill removes the reporting of the actual number of referrals made. The Senate HHS Committee has recommended passage of this bill.

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 recommended passage of HB 1704, the House tabled the bill.




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

Click Here for the NH House and Senate Web Site