Legislative Update
October 31, 2003
Malpractice Commission files interim report
The Malpractice Study Commission, created by the Legislature,
has filed an interim report, and will complete its work over
the next few weeks. The Commission has looked at the
prelitigation screening panel process in use in Maine and
Massachusetts, as well as the NH Superior Court rules on
alternative dispute resolution (ADR). The Maine panel system
encourages the resolution of claims early in the process, thus
reducing litigation costs, and contributing in part to
significantly lower malpractice premiums in Maine than New
Hampshire. The Commission concluded that RSA 519-A (NH's
prelitigation panel statute) should be repealed and re-enacted
with a more efficient mechanism to resolve medical malpractice
claims. The Commission will meet over the next two weeks to
finalize its recommendations for legislation for 2004. A final
report will be filed by late November.
View the
Commission's interim report.
Legislative Report on Hospitals' Tax-Exempt Status
Released
The legislative study committee on not-for-profit hospitals'
tax-exempt status and community benefits has filed its final
report. The committee, established in 2002, was extended a
year to review hospital financial, community benefits, and tax
data. The Committee's final recommendations include amending
NH's community benefits statute to increase the time period
for the filing of the community needs assessment from 3 to 5
years and to require healthcare charitable trusts to file
audited financial statements with the Attorney General's
Office. To address concerns about the state's Business
Enterprise Tax (BET), the committee recommends that the
Department of Revenue Administration review its BET rules
relative to physician practices that are exempt from the BET.
This report is significantly less harsh toward hospitals than
the interim report filed last year. While some committee
members felt strongly that hospitals should pay either
property taxes and/or state business taxes, no such
recommendations appear in the report.
View the Committee's report.
October 23, 2003
Legislators are continuing work on bills from the 2003
session that were retained in committee, as well as winding
down study committees and preparing reports and
recommendations for legislation for the 2005 legislative
session.
HIGHLIGHTS
Malpractice Commission. In response to the sharp rise in
malpractice insurance premiums, the Legislature created a
commission to study malpractice claims under RSA 519-A.
Commission membership is made up of legislators, physicians,
dentists, hospitals, insurance carriers, attorneys, and the
courts. Although RSA 519-A permits the conduct of
pre-litigation hearing panels, the law has been ineffective.
The Commission has examined Maine’s prelitigation screening
panel statute, as well as Massachusetts’ medical malpractice
tribunal system. New Hampshire Superior Court’s rules on
alternative dispute resolution (ADR) have been examined as
well. The Commission must submit its findings and
recommendations to the Governor and the Legislature by
November 1, 2003.
Hospitals and Taxes. The legislative study committee on not-for-profit hospitals’ tax exempt status and community benefits will complete its work by November 1, 2003. The committee agreed on the recommendations to be included in their final report. They will recommend legislation to amend the community benefits statute to increase the time period for the filing of the community needs assessment from 3 to 5 years and to require healthcare charitable trusts to file audited financial statements to the Attorney General's Office. To address concerns about the state’s Business Enterprise Tax (BET), the committee will recommend legislation seeking "fair and equitable enforcement" of the BET.
Nurse Practice Act. There was a great deal of concern recently around Senate Bill 199, which was passed by the Senate and subsequently held in the House. SB 199 updated the 25-year old Nurse Practice Act with many needed revisions. However, over the summer the bill was again revised resulting in the removal of some of the Board of Nursing’s authority over adoption of its regulations. The current version of SB 199 retains the Board’s authority over licensure and curriculum approval, but there’s a question as to how much of the Board’s authority over the practice of nursing is being moved from administrative rule into the statute. The final version of the bill will be unveiled next week.
Waiver of Network Adequacy – Pilot Program. Another retained bill, HB 265, proposes to allow health plans to waive network adequacy requirements, thus providing incentives to providers to improve care. This is a “pay-for-performance” program designed to align financial reward with improved outcomes. The request for a waiver would be subject to a public hearing and be granted by the Insurance Commissioner. However, such arrangements are already permitted under the current statute and regulations. This would simply provide specific statutory language as to legislative intent.
Contracting Process between Health Insurers and Providers.
A legislative study committee is reviewing current statutory
requirements on the contracting process between insurers and
providers; current contract negotiation and contract dispute
processes; the role of the Insurance Department in the
contract dispute process; Any Willing Provider (AWP); and how
cost shifting and the uninsured impact the contracting
process. Insurers testified against AWP stating concerns about
not being able to manage their networks and maintain NCQA
accreditation. Another session was devoted to the contracting
process, and questions regarding anti-trust prohibitions on
sharing of rate information, and concerns regarding whether
small hospitals are at a disadvantage when they negotiate
their contracts. The committee’s last meeting will be October
28th at 1:00.
To view any of these bills, go to
http://www.nhha.org/state_law/bills/bills.php.
