HB 1702-FN-A – AS INTRODUCED
2006 SESSION
01/10
HOUSE BILL 1702-FN-A
AN ACT establishing a New Hampshire health access corporation, continually appropriating a special fund, and allowing the healthy kids corporation to cover adults.
SPONSORS: Rep. Schmidt, Straf 4; Rep. French, Merr 5; Sen. Fuller Clark, Dist 24
This bill establishes a New Hampshire health access corporation and health access fund modeled on the healthy kids corporation and allows the healthy kids corporation to cover adults.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
06-2257
01/10
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Six
AN ACT establishing a New Hampshire health access corporation, continually appropriating a special fund, and allowing the healthy kids corporation to cover adults.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Hampshire Healthy Kids Corporation; Adults Added. Amend RSA 126-H:2 to read as follows:
126-H:2 Corporation Established. There is hereby created a body politic and corporate having a distinct legal existence separate from the state and not constituting a department of state government, to be known as the New Hampshire healthy kids corporation to carry out the provisions of this chapter. The corporation is hereby deemed to be a public instrumentality and the exercise by the authority of the powers conferred by this chapter shall be deemed and held to be the performance of public and essential governmental functions of the state. The corporation shall be a private nonprofit corporation and shall have all the powers necessary to carry out the purposes of this chapter, including, but not limited to, the power to receive and accept grants, loans, or advances of funds from any public or private agency and to receive and accept from any source, contributions of money, property, labor, or any other thing of value, to be held, used, and applied for the purposes of this chapter. Notwithstanding any other provision of law, any payments made by the corporation for insurance coverage for children and adults under this chapter, either directly or indirectly, shall be exempt from the premium tax under RSA 400-A:32.
2 Adults Added; Pilot Sites Deleted. Amend RSA 126-H:5, I(a) to read as follows:
(a) Organize school children groups and other groups to facilitate the provision of preventive health care services to children [at no more than 5 geographic pilot sites] and adults and to provide comprehensive health insurance coverage to children and adults.
3 Adults Added. Amend RSA 126-H:5, I(c) to read as follows;
(c) Consult appropriate professional organizations and establish standards for preventive health care services and providers and comprehensive insurance benefits appropriate to children and adults.
4 Adult Added. Amend RSA 126-H:5, II to read as follows:
II. Coverage under the corporation's program shall be secondary to any other available private coverage held by the participant child, adult, or family member. The corporation may establish procedures for coordinating benefits under this program with benefits under other public and private coverage.
5 Adults Added. Amend RSA 126-H:6, II to read as follows:
II. The eligibility criteria which children [and], their family members, and adults must meet in order to participate in the program.
6 Confidentiality. Amend RSA 126-H:8 to read as follows:
126-H:8 Confidentiality. Notwithstanding any provision of law to the contrary, the corporation shall have access to the medical records of an adult, and a child, upon receipt of permission from a parent or guardian of the child. Such medical records may be maintained by state and local agencies. Any confidential information obtained by the corporation pursuant to this section shall remain confidential and shall not be subject to RSA 91-A.
7 New Chapter; New Hampshire Health Access Corporation. Amend RSA by inserting after chapter 126-K the following new chapter:
CHAPTER 126-L
NEW HAMPSHIRE HEALTH ACCESS CORPORATION
126-L:1 Purpose. Many New Hampshire citizens lack adequate access to health care services and experience diminished health outcomes because they cannot obtain affordable health insurance coverage. The purpose of this chapter is to address this problem by promoting the availability of affordable health insurance for persons who would otherwise be without coverage. Under this market-oriented approach, the New Hampshire health access corporation contracts with health insurers to provide the needed coverage. Eligibility is designed to include persons who can demonstrate that they are uninsured because they are without access to affordable coverage and to exclude persons who have access to other health insurance coverage that is within their means.
126-L:2 Definitions. In this chapter:
I. “Board” means the health access board established in RSA 126-L:4.
II. “Corporation” means the New Hampshire health access corporation established in this chapter.
III. “Health insurer” means any entity licensed to provide health insurance pursuant to title 37 or any other provider of health care services approved by the commissioner of the insurance department.
IV. “Medicaid waiver” means a section 1115 research and demonstration waiver application or a section 1915(b) freedom of choice waiver application approved by the Health Care Financing Administration.
126-L:3 Corporation Established. There is hereby created a body politic and corporate having a distinct legal existence separate from the state and not constituting a department of state government, to be known as the New Hampshire health access corporation to carry out the provisions of this chapter. The corporation is hereby deemed to be a public instrumentality and the exercise by the authority of the powers conferred by this chapter shall be deemed and held to be the performance of public and essential governmental functions of the state. The corporation shall be a private nonprofit corporation and shall have all the powers necessary to carry out the purposes of this chapter, including, but not limited to, the power to receive and accept grants, loans, or advances of funds from any public or private agency and to receive and accept from any source, contributions of money, property, labor, or any other thing of value, to be held, used, and applied for the purposes of this chapter.
126-L:4 Health Access Board.
I. The powers of the corporation shall be vested in 16 members who shall hold 3-year terms of office as follows:
(a) A public member, appointed by the governor.
(b) A member of the house of representatives, appointed by the speaker of the house of representatives.
(c) A member of the senate, appointed by the president of the senate.
(d) The commissioner of the insurance department, or designee.
(e) The commissioner of the department of health and human services, or designee.
(f) Two representatives of the business community, appointed by the governor.
(g) One member appointed by the New Hampshire Hospital Association.
(h) One member appointed by the New Hampshire Academy of Family Practice.
(i) One member appointed by the New Hampshire Nurses Association.
(j) One member appointed by the Business and Industry Association of New Hampshire.
(k) One member appointed by the New Hampshire Medical Society.
(l) Four members-at-large, appointed by the health access board of directors.
II. The initial terms of office shall be as follows: the members in subparagraphs I(a) and (g) and one member in subparagraph (f) shall serve for 1 year; one member in subparagraph (f) and the members in subparagraphs I(h) and (k) shall serve for 2 years; and the members in subparagraphs I(i), (j) shall serve for 3 years. The other members in subparagraphs I(b), (c), (d) and (e) shall serve terms which are coterminous with their terms in office. Two of the 4 members in subparagraph I(l) shall serve for 1 year, one shall serve for 2 years, and one shall serve for 3 years.
III. The members shall elect annually from among their number a chairperson and such officers as they may determine. A member shall hold office until a successor has been appointed and qualified. Members shall receive no salary for the performance of their duties under this chapter, but each member shall be reimbursed for reasonable expenses incurred in carrying out duties under this chapter. Any such expenses by board members shall have prior approval by 7 members of the board of directors before reimbursement. A member of the board of directors may be removed for cause by the official who appointed that member.
IV. There shall be no liability on the part of, and no cause of action shall arise against, any member of the board of directors, or its employees or agents, for any action they take in the performance of their powers and duties under this chapter.
V. The corporation shall not be deemed an insurer. The officers, directors, and employees of the corporation shall not be deemed to be the agents of an insurer. Neither the corporation nor any officer, director, or employee of the corporation shall be subject to the licensing requirements of the insurance code or the rules of the department of insurance. However, the department of insurance may require that any marketing representative utilized and compensated by the corporation be appointed as a representative of the health insurers with which the corporation contracts.
VI. Except as provided in RSA 126-L:6, I, the board shall have complete fiscal control over the corporation and shall be responsible for all corporate operations.
126-L:5 Meetings of Board. Meetings shall be held at the call of the chairperson or when 5 members so request. Nine members of the board shall constitute a quorum and the affirmative vote of 9 members shall be necessary for any action taken by the authority. No vacancy in the membership of the board shall impair the right of a quorum to exercise all the rights and perform all the duties of the corporation.
126-L:6 Powers and Duties.
I. The corporation shall develop eligibility criteria and provider selection criteria which shall be approved by the legislative fiscal committee prior to their implementation by the corporation. Any subsequent modification of these criteria shall be approved by the legislative fiscal committee prior to their implementation. In this paragraph “eligibility criteria” means those criteria which adults must meet in order to participate in the program and “provider selection criteria” means those criteria that health insurers must meet in order to offer benefits under the program.
II. Following receipt of the approval required in paragraph I, the corporation shall take all actions necessary to implement the program, including but not limited to:
(a) Organizing purchasing groups to facilitate the provision of preventive health care services and comprehensive health insurance coverage to adults.
(b) Arranging for the collection of any premium, in an amount to be determined by the board of directors, from all participants to provide for payment for preventive health care services or premiums for comprehensive health insurance coverage and for the actual or estimated administrative expenses incurred during the period for which payments are made.
(c) Consulting appropriate professional organizations and establishing standards for preventive health care services and providers and comprehensive insurance benefits appropriate to adults.
(d) Establishing participation criteria and, if appropriate, contracting with a health insurer or licensed insurance administrator to provide administrative services to the corporation.
(e) Contracting with health insurers, in accordance with standards established by the corporation, to provide comprehensive insurance coverage and preventive health care services to participants.
(f) Developing and implementing a plan to publicize the New Hampshire health access corporation, the eligibility requirements of the program, and the procedures for enrollment in the program and to maintain public awareness of the corporation and the program.
(g) Securing staff necessary to properly administer the corporation. Staff costs shall be funded from such private or public funds as become available. The board of directors shall determine the number of staff members necessary to administer the corporation.
III. Coverage under the corporation's program shall be secondary to any other available private coverage held by the participant. The corporation may establish procedures for coordinating benefits under this program with benefits under other public and private coverage.
126-L:7 Adoption of Policy. The corporation may adopt policies, pursuant to its own procedures, relative to:
I. The conduct of its business, including the administrative and accounting procedures for operation of the corporation.
II. The procedures under which applicants to and participants in the program may have grievances reviewed by an impartial body and reported to the board of directors of the corporation.
III. Application procedures.
IV. Schedules of fees and other charges to be made by the corporation and the health insurers in renewing, acting upon, or accepting applications under this chapter and any other matters related to such applications as the corporation may deem necessary.
V. Confidentiality of medical records obtained under this chapter.
VI. Such other matters as are necessary to carry out the powers and duties of the corporation.
126-L:8 New Hampshire Health Access Fund. There is hereby established in the office of the state treasurer a fund to be known as the New Hampshire health access fund. The New Hampshire health access corporation established in RSA 126-L:3 is authorized to accept public sector and private sector grants, gifts, donations, and appropriations of any kind to further the goals of the corporation. Public sector appropriations shall be deposited in the New Hampshire health access fund and may be expended by the New Hampshire health access corporation to accomplish the purposes of RSA 126-L. The moneys in the fund shall be nonlapsing and shall be continually appropriated to the corporation. Other revenues of the corporation such as grants, gifts, donations, and participant premium payments shall not be considered revenue of the state, but rather shall be funds of the corporation to be deposited as determined by the New Hampshire health access board of directors.
8 New Subparagraph; Special Fund. Amend RSA 6:12, I by inserting after subparagraph (242) the following new subparagraph:
(243) Moneys received under RSA 126-L which shall be credited to the New Hampshire health access fund established in RSA 126-L:8.
9 Applicability. The commissioner of health and human services shall call the first meeting of the health access board, established in RSA 126-L:4 inserted by section 7 of this act, within one year of the effective date of section 7 of this act or federal approval of the medicaid waiver, whichever first occurs.
10 Repeal. RSA 126-H:6, VI, relative to pilot sites, is repealed.
11 Effective Date. This act shall take effect 60 days after its passage.
LBAO
06-2257
Revised 1/17/06
HB 1702 FISCAL NOTE
AN ACT establishing a New Hampshire health access corporation, continually appropriating a special fund, and allowing the healthy kids corporation to cover adults.
FISCAL IMPACT:
The Departments of Health and Human Services and Insurance state this bill will have no fiscal impact on state, county, and local revenue or expenditures.
METHODOLOGY:
The Department of Health and Human Services states this bill creates a non-profit organization, the New Hampshire Health Access Corporation, to administer an affordable statewide health plan for adults. This bill does not require the Legislature to support this program with state funds.
The Insurance Department states this bill amends the NH Healthy Kids (NHHK) Corporation chapter so that NHHK is permitted to cover adults. This bill also creates the NH Health Access Corporation (NHHAC) which is empowered to contract with health insurers to cover certain state citizens. This bill does not create a specific funding mechanism, and does not appear to impact the insurance marketplace. Coverage efforts are focused on the uninsured. The Department assumes there will be no impact on health insurance costs, and therefore, will have no impact on premium tax revenue.