HB 1511-FN-A – AS INTRODUCED
2008 SESSION
09/05
HOUSE BILL 1511-FN-A
AN ACT relative to fees for laboratory services and establishing a laboratory services fund.
SPONSORS: Rep. McLeod, Graf 2; Rep. Nordgren, Graf 9; Rep. MacKay, Merr 11
This bill requires increases in fees for laboratory services provided by the department of health and human services to be deposited in a laboratory services fund to be used for the purchase of laboratory equipment or software designed to improve services.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
08-2577
09/05
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Eight
AN ACT relative to fees for laboratory services and establishing a laboratory services fund.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Fees for Laboratory Services. Amend RSA 131:4 to read as follows:
131:4 [Service; Reimbursements] Fees for Laboratory Services; Rulemaking; Fund.
I. The commissioner of the department of health and human services shall adopt rules pursuant to RSA 541-A relative to a list of laboratory services to be provided under this chapter and a schedule of fees for such services. The fees may be waived by the commissioner when the commissioner determines it is in the best interests of the health of the public to do so. Except as provided in paragraph II, fees collected under this section shall be forwarded to the state treasurer to be deposited in the general fund.
II. There is hereby established in the office of the state treasurer the laboratory services fund. The increases in fees which were established under paragraph I effective on or after November 1, 2007 shall be deposited in the fund. The fund shall be nonlapsing and continually appropriated to the department of health and human services for the purchase of new or replacement laboratory equipment and software designated to improve services.
2 New Subparagraph; Special Fund. Amend RSA 6:12, I(b) by inserting after subparagraph (268) the following new subparagraph:
(269) Moneys deposited in the laboratory services fund established under RSA 131:4, II.
3 Effective Date. This act shall take effect upon its passage.
LBAO
08-2577
11/29/07
HB 1511-FN-A - FISCAL NOTE
AN ACT relative to fees for laboratory services and establishing a laboratory services fund.
FISCAL IMPACT:
The Department of Health and Human Services states this bill will decrease state unrestricted general fund revenue and expenditures, and increase state restricted revenue and expenditures by $500,000 in FY 2008, and by $630,000 in FY 2009 and each year thereafter. This bill will have no fiscal impact on county and local revenue or expenditures.
METHODOLOGY:
The Department of Health and Human Services states this bill would establish a non-lapsing and continually appropriated laboratory services fund for the purchase of new or replacement laboratory equipment and software designated to improve services. The fund would consist of revenues resulting from increases in laboratory services fees effective on or after November 1, 2007. Fees are currently deposited into the state general fund as unrestricted revenue. The Department recently completed the rule-making process to restructure and increase fees. The rule change to the laboratory fee schedule was restructured to align with testing activity and standard billing practices. Some fees increased and new fees were added to recover reimbursement at the billing Current Procedural Terminology (CPT) level. The Department implemented the new fee schedule on November 7, 2007.
The Department states information technology at the state Public Health Laboratories (PHL) is in need of an upgrade. The PHL has relied on the Laboratory Information Tracking System (LITS), to support its laboratory information management needs for the past eight years. LITS was developed in-house based on the Centers for Disease Control (CDC) software of the same name and is composed of distinct testing modules that do not interface. Since 1999, enhancements have been made to the LITS software, but only one testing module has been added to the software. The Department states that data from LITS is difficult to retrieve and query tools are no longer supported; LITS and a related Laboratory Billing System (LBS) are not compliant with standard industry billing practice; LITS does not cover all of the testing that is performed in the PHL (such as food, bioterrorism, chemical terrorism, shellfish, rabies and environmental samples); and LITS lacks the capability for electronic reporting to providers, including all hospitals in the State. The Department issued a Request For Information (RFI) on
LBAO
08-2577
11/29/07
April 24, 2006 to solicit information regarding solutions to provide a laboratory information management system for the PHL. The purpose of the RFI was to study the feasibility and cost/benefit of enhancing versus replacing LITS. The outcome of the RFI was to replace LITS. The Department states that revenues deposited into the newly established fund would be used for the purchase of new or replacement laboratory equipment, as well as software designated to improve services. The first priority would be the replacement of LITS and the related LBS in order to realize the full benefit of changes to the laboratory fee schedule. Also, a new system would cover all testing areas and provide essential data that is currently unavailable. The Department states that more importantly, results could be transmitted electronically from instrumentation to the laboratory information management system, and then electronically via electronic laboratory reporting directly to the healthcare provider, which is the industry standard. Electronic laboratory reporting would reduce transcription errors, save time for healthcare providers, and provide real-time reporting, which is essential in a suspect outbreak or terrorism event. The Department states another priority would be for laboratory equipment and instrumentation since diagnostic and public health testing and the related technology required are ever changing in the laboratory field.
In FY 2006, Public Health Laboratory expenditures were $3.5 million, excluding newborn screening. This was funded by federal funds of $1.2 million and general funds of $2.3 million. The lab generated fees of $566,000 were deposited into the state general fund as unrestricted revenue, which offset a portion of the general fund demand. Based on FY 2006 testing activity and information from health care providers, the Department estimates that the new fee schedule, which was effective on November 7, 2007, will generate approximately $630,000 of additional revenue annually for deposit into the newly established fund. For FY 2008, due the implementation date of the new fee schedule, it is estimated that $500,000 in revenue would be deposited into the fund. Monies in the fund would be available to fund hardware and software for a new laboratory information technology system, and any new or replacement equipment that would improve laboratory services.