CHAPTER 205
HB 43 – FINAL VERSION
15Feb2007… 0005h
11Apr2007… 0745h
05/24/07 1661s
2007 SESSION
05/10
HOUSE BILL 43
AN ACT relative to the procedure for establishing Medicaid reimbursement rates; relative to reimbursement rates for hospital-based physician and outpatient services; and establishing a committee to study Medicaid payments for hospital-based physician and outpatient services.
SPONSORS: Rep. C. McMahon, Rock 4; Rep. Emerson, Ches 7; Rep. Donovan, Sull 4; Rep. MacKay, Merr 11; Rep. Batula, Hills 19
COMMITTEE: Health, Human Services and Elderly Affairs
This bill:
I. Directs the department of health and human services to review medicaid reimbursement rates every 2 years and establishes certain reporting requirements relative to such rates.
II. Establishes a committee to study Medicaid payments for hospital-based physician and outpatient services billed using the National Uniform Billing Committee Revenue Code 510 and maintains reimbursement policies, rates, and related billing instructions for physician services provided by hospital-based physicians and outpatient services in effect as of January 1, 2007 pending further action of the general court or fiscal committee.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
15Feb2007… 0005h
11Apr2007… 0745h
05/24/07 1661s
07-0145
05/10
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Seven
AN ACT relative to the procedure for establishing Medicaid reimbursement rates; relative to reimbursement rates for hospital-based physician and outpatient services; and establishing a committee to study Medicaid payments for hospital-based physician and outpatient services.
Be it Enacted by the Senate and House of Representatives in General Court convened:
205:1 New Section; Medicaid Reimbursement Rates. Amend RSA 126-A by inserting after section 18-a the following new section:
126-A:18-b Medicaid Reimbursement Rates.
I. Every 2 years, the department of health and human services shall review Medicaid reimbursement rates based on:
(a) The following benchmarks:
(1) Medicare rates.
(2) Medicaid rates in other New England states.
(3) Reimbursement rates of managed care companies and other commercial payers.
(4) Actual provider costs.
(b) Information and testimony gathered from a public hearing, held as part of the biennial rate setting process, at which time providers, beneficiaries and their representatives, and other concerned residents shall be given a reasonable opportunity to review and comment on the rates, rate setting methodologies, and justifications.
(c) Applicable state and federal law and regulations relative to specific Medicaid services.
II. On or before October 1 prior to each biennial legislative session and prior to submitting the department’s budget request under RSA 9:4, the department of health and human services shall submit a report relative to the reimbursement rates, the methodologies underlying the establishment of such rates, and justifications for such rates to the speaker of the house of representatives, the senate president, the house clerk, the senate clerk, the state library, and the health and human services oversight committee established in RSA 126-A:13. The report also shall be used to formulate the department’s budget request under RSA 9:4.
III. In addition to the biennial report under paragraph II, the department of health and human services shall submit an annual report relative to Medicaid reimbursement rates to the health and human services oversight committee established in RSA 126-A:13. The report shall address any questions raised by the committee and shall summarize the department’s economic analysis and rate setting policy for the prior fiscal year and include any recommendations for the next fiscal year.
205:2 Committee Established. There is established a committee to study Medicaid payments for hospital-based physician and outpatient services.
205:3 Membership and Compensation.
I. The members of the committee shall be as follows:
(a) Four members of the house of representatives, appointed by the speaker of the house of representatives.
(b) Two members of the senate, appointed by the president of the senate.
II. Members of the committee shall receive mileage at the legislative rate when attending to the duties of the committee.
205:4 Duties. The committee shall study current Medicaid reimbursement policies for hospital-based physician and outpatient services billed using the National Uniform Billing Committee Revenue Code 510, including differences in billing instructions from the New Hampshire Medicaid program and the Centers for Medicare and Medicaid Services (CMS) for comparable services covered by Medicare.
205:5 Chairperson; Quorum. The members of the study committee shall elect a chairperson from among the members. The first meeting of the committee shall be called by the first-named house member. The first meeting of the committee shall be held within 45 days of the effective date of this section. Four members of the committee shall constitute a quorum.
205:6 Report. The committee shall report its findings and any recommendations for proposed legislation to the speaker of the house of representatives, the president of the senate, the house clerk, the senate clerk, the governor, and the state library on or before November 15, 2007.
205:7 Reimbursement Policy and Rates. Notwithstanding any provision of law, except as provided in this section, the reimbursement policies, rates, and related billing instructions, for physicians services provided by hospital-based physicians and outpatient services in effect as of January 1, 2007 shall be the policies, rates, and billing instructions used by the department of health and human services. The department of health and human services shall not submit to the Centers for Medicare and Medicaid Services any Medicaid state plan amendments related to or affecting the policies, rates, and related billing practices for hospital-based physicians and outpatient services prior to November 30, 2007. Any change to these reimbursement policies, rates and related billing instructions prior to further action by the general court shall require the prior approval of the fiscal committee.
205:8 Effective Date. This act shall take effect upon passage.
Approved: June 25, 2007
Effective: June 25, 2007