June 10, 2003
Senate Passes State Budget - Onto Committee of Conference
The New Hampshire Senate passed House Bill 1 and House Bill 2, the 2004/2005 budget and budget trailer bills. The Senate added about $80 million more in State funds than the House budget passed in April. The Federal $84 million windfall gave the Senate the ability to restore funding in critical health, Medicaid, mental health, tobacco and drug prevention programs cut by the House. In addition, the Senate included much needed provider protections that prohibit rate reductions as well as reductions in funding levels that disproportionately affect individual provider categories.
The Committee of Conference on the budget begins meeting Tuesday, June 10th with an expected completion date of June 20th. House conferees are Representatives Neal Kurk, Michael Whalley, Ken Weyler, Rogers Johnson, and Mary Jane Wallner. Alternates are Reps. Gene Chandler (Speaker of the House), Fran Wendelboe, Larry Emerton, Robert Wheeler, and Marjorie Smith. As of this writing, Senate Conferees have not yet been named.Conference committee deliberations on the budget are expected to be very difficult and contentious. House leadership and the Governor do not agree with the Senate over the increases in spending, and the use of one-time funding used to fill large funding gaps. The process is further complicated by the requirement that approval among the conferees be unanimous.
NHHA will be watching very closely and attending all meetings of the Conference Committee.Loss of Opportunity - Medical & Hospital Liability
Last week, the House passed and the Senate concurred on Senate Bill 119, which overrules the decision in Lord v. Lovett* (146 N.H. 232, NH Supreme Court decision of April 4, 2001) and eliminates the "Loss of Opportunity" doctrine, while preserving a medical liability plaintiff's right to claim damages for aggravation of an underlying condition on the same legal basis as before Lord v. Lovett was decided. The bill also preserves the patient's rights to recover damages for new harm proximately caused by medical negligence, regardless of the patient's underlying condition, based on the reasoning in an Ohio court decision, McMullen v. Ohio State University Hospitals. The Legislature determined that the passage of SB 119 is a necessary step in holding down the escalating costs of medical malpractice insurance.
Lord v. Lovett broadened the opportunity to recover damages in medical injury cases through the recognition of the so-called loss of opportunity doctrine by incorrectly applying the burden of proof requirements in the existing medical malpractice statute.Small Group Health Insurance Bill Passes
The House passed Senate Bill 110 which changes how small group health insurance can be sold in the state. The Senate concurred with the House amendments and the bill now will go to the Governor who is expected to sign it. Small groups will now be defined as 1-50 employees, rather than 1-100 under current law. The bill’s proponents expect more insurance companies to do business in the state, however underwriting criteria (age, geography, industry, health status) are expected to result in higher costs for some small businesses. The NH Insurance Department will be required to collect premium data to evaluate the bill’s impact. The new law goes into effect January 1, 2004.
Certificate of Need - Committee of Conference appointed
The Senate has disagreed with House revisions to Senate Bill 163, and differences will be addressed in a Committee of Conference. As passed by the Senate, SB 163 would retain the CON Board and make operating leases reviewable. The House gutted the Senate version and included provisions intended to deregulate New Hampshire's health care market, including abolishing the CON Board, transferring the CON review function to DHHS, limiting CON regulatory oversight to inpatient services only, and creating an option for rural hospitals to have outpatient services reviewed for CON. The Committee of Conference will meet on June 13. Conferees are Senators Andre Martel (Manchester), Robert Flanders (Antrim), Iris Estabrook (Durham), Representatives Peter Batula (Merrimack), Pamela Price (Nashua), Charles McMahon (Windham), and Sandra Harris (Claremont).
Status of Other Health Care Bills
HB 104 – Hospitals and Safe Havens to Assume Custody of Abandoned Infants. Effective June 4, 2003, HB 104 requires a hospital or safe haven (police or fire station) to assume temporary custody of an abandoned infant (no more than 7 days old). Within 24 hours after the hospital assumes care of the child, hospital staff must notify the Department of Health & Human Services (DHHS) and law enforcement officials. DHHS will immediately assume care of the child and will be responsible for all medical care and costs incurred by the hospital. The law creates an exception to the crime of endangering the welfare of a child when the parent delivers the child to a hospital or safe haven and does not express intent to return for the child. NHHA is obtaining information from DHHS regarding reporting procedures for hospitals to follow.
HB 172 – Study Committee on Property Taxes and Community Benefit Law. This bill extends last year’s study and expands the committee’s scope of inquiry to the state’s community benefits statute, and to physician practices owned by not-for-profit healthcare organizations, as well as consideration of
HB 287 – Malpractice Commission. This bill establishes an 18-member professional malpractice claims commission to study the professional malpractice claims panel under RSA 519-A and determine how this panel can be used to control the cost of liability insurance. Two members of the commission will represent hospitals. Passed the House and Senate with Amendment. House non-concurred with Senate Amendment; Bill goes to Committee of Conference.HB 470– This bill requires health insurers to keep provider’s personal information confidential; that the fact that a health carrier does not include in its network a hospital with which a health care professional holds privileges is not grounds to refuse to select such health care professional as a participating provider. HB 470 establishes a committee to study current insurance market trends and insurance carrier non-payment discrimination.
HB 663 – Medicaid Funding of Nursing Homes - This bill establishes a statutory county-state finance commission; extends and amends the payment provisions for counties relative to the nonfederal share of nursing home facility services; adds a county official to the health services planning and review board. Passed the House with Amendment. Passed the Senate with Amendment.
HB 670 – Establishing a procedure for release by a state agency of statistical information for research purposes. During the tenure of the privacy task force, several state agencies, acting cautiously, barred access to data, which had traditionally been available for legitimate public research. Passed the House and Senate with Amendment. House non-concur with Senate Amendment. Bill goes to Committee of Conference.
SB 69 – Nursing Workforce. This bill consolidates the career incentive loan program and the nursing leveraged scholarship loan program into the workforce incentive program. It includes a forgivable loan component and a loan repayment program for people who work in designated shortage areas.
SB 78 – Health Care Information Council. This bill establishes the NH health care information council, which shall implement and maintain a statewide healthcare database. Passed the Senate with Amendment. Retained in House Health & Human Services Committee.
SB 128 – Vital Records and Health Statistics. The contents of this bill are included in House Bill 2. It transfers the Bureau of Vital Records and Health Statistics from the Department of Health & Human Services to the Department of State.
Bills Retained in Committee
HB 652 – Qualified wellness and disease management programs.
HB 759 - Personal health and financial information privacy. This bill requires an insurance licensee to obtain authorization before disclosing nonpublic personal health and financial information about customers. Retained in House Commerce Committee.
HB 760 - Tobacco Tax Increase. Establishes the NH healthy families fund and increases the tobacco tax. Retained in House Ways & Means Committee.
HB 832 – Privacy of Medical records. This bill establishes parameters for the privacy of medical records. Retained in House Commerce Committee.
Bills Killed
HB 149 – Quality Assurance Programs This bill, as amended by the House, would have required disclosure of information regarding the cause or contributing cause of patient injury.
HB 290 – Loss of Opportunity. This bill would have codified the Loss of Opportunity doctrine in statute. If passed, this could have cost providers up to $34 increase in their liability insurance premiums.
HB 788 – Certificate of Need. This bill would have abolished the CON Board and transferred the CON function to the Department of HHS.
