NHHA LEGISLATIVE UPDATE


June 10, 2005

During this hectic week at the State House:

SB 125 passed, repealing geographic rating and medical underwriting as factors in calculating premiums for small group insurance. SB 214 passed, providing for pretrial screening panels with unanimous findings admissible in court. And the Senate passed their version of the budget after restoring $6,000,000 in funding for Indirect Medical Education.

SMALL GROUP INSURANCE

Passage of SB 125 is a big victory for us and for Governor Lynch. The House vote this week was 280 to 89! Several years ago we vigorously supported Governor Shaheen's successful initiative to require community rating for small group coverage. Two years ago we vigorously opposed Governor Benson's successful SB 110 switch to medical underwriting and geographic rating for small groups. This year we were delighted to join governor Lynch and small employers statewide in supporting the now successful repeal of the Benson plan. Special thanks to Governor Lynch for making repeal of SB 110 a cornerstone of his campaign.

MEDICAL LIABILITY

Passage of SB 214, the screening panel malpractice bill, is a huge victory for doctors and hospitals. The House vote of 218 - 115 was a big and very pleasant surprise for all of us, especially given the opposition of the Judiciary Committee. Next week we'll send out information about how each Representative in your area voted so you can thank those who made this victory possible.

MEDICAID BUDGET

The action on the Senate budget reduced the hospital payment reduction relative to the House budget from $32 million to $26 million. The Senators Larsen and Green effort to restore funding, including funding the entire hospital cut failed. So our next step is to concentrate on improving our position in the Committee of Conference process when House and Senate leaders meet to reconcile the differences between the House and Senate budgets. BEGINNING THIS AFTERNOON we'll be asking you for certain data that we need to bolster our case. We're counting on you to respond ASAP!

PROMPT PAY

Both the House and Senate passed Senate Bill 78, a big victory for hospitals and physicians who have fought for years to get insurers to pay claims in a timely manner. SB 78 addresses loopholes in the 4-year old statute. Insurers will now be bound by law for all previously submitted claims as well as initial claims. SB 78 remedies the burden placed on providers due to insurers’ different interpretations of a “Clean Claim”. Finally, payment of interest to hospitals on overdue claims will be automatic.

SB 78 Highlights:

· Clean Claims: Must be paid within 30 days (currently 45 days) of receipt of clean paper claims and 15 days of receipt of a clean electronic claim.

· Denied and Pended Claims: Insurers must inform providers within 15 days (electronic claims) or 30 days (paper claims) of the reason to deny or pend, and what additional information is required. After additional documentation is received, the insurer must adjudicate the claim within 45 days. If the insurer fails to notify the provider, the claim must be treated as a clean claim and be paid within 30/45 days.

· Overdue Claims: Clean claims not paid within the required timeframe will be subject to automatic interest payments in addition to the claim amount. SB 78 removes the burdensome provision that requires providers to inform the insurer of the interest payment due. The mandatory automatic interest payment should result in quicker initial payments.



Go to http://www.nhha.org/nhha/state_law/bills.php to view the list of bills NHHA will be tracking in 2005.  Additional bills will be added as we become aware of them.