SB 425 – AS AMENDED BY THE SENATE
03/13/08 0275s
2008 SESSION
01/03
SENATE BILL 425
AN ACT relative to the data collection practices of health care providers and relative to the development of a comprehensive uninsured health care database.
SPONSORS: Sen. Hassan, Dist 23; Sen. Fuller Clark, Dist 24; Sen. Cilley, Dist 6; Sen. Sgambati, Dist 4; Rep. Bergin, Hills 6; Rep. McLeod, Graf 2; Rep. Nord, Rock 1
COMMITTEE: Health and Human Services
This bill requires health care providers that submit health care claims electronically for reimbursement to submit health care claims data for any person who is uninsured and whose care is not paid for by a governmental program to the department of health and human services.
This bill also requires the commissioner of the insurance department and the commissioner of the department of health and human services to enter into a memorandum of understanding for collaboration in the development of a comprehensive uninsured health care database. The bill grants rulemaking authority to the commissioners for the purposes of the collaborative effort.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
03/13/08 0275s
08-2791
01/03
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Eight
AN ACT relative to the data collection practices of health care providers and relative to the development of a comprehensive uninsured health care database.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Health Care Data Collection. RSA 126:25, II is repealed and reenacted to read as follows:
II. A health care provider that is licensed by the state or lawfully providing health care services in New Hampshire and that submits its health care claims electronically for reimbursement shall submit health care claim data for any person who receives health care services and does not have health insurance and whose care is not paid for by a governmental program to the department of health and human services or its agent. The health care claims data shall be submitted in a format that is consistent with the claims data submitted electronically for reimbursement and shall include service level remittance information for each billed service that includes patient demographics, provider information, charge payment information, and clinical diagnosis and procedure codes.
2 New Chapter; Comprehensive Uninsured Health Care Database. Amend RSA by inserting after chapter 126-Q the following new chapter:
CHAPTER 126-R
COMPREHENSIVE UNINSURED HEALTH CARE DATABASE
126-R:1 Database Development and Use.
I. The commissioner of the insurance department and the commissioner of the department of health and human services shall enter into a memorandum of understanding for collaboration in the development of a comprehensive uninsured health care database. The memorandum of understanding shall include a description of the uninsured database, the criteria and procedures for the collection and the release of the uninsured data set, and the requirements for reporting information on the uninsured.
II. To the extent allowed by the Health Information Portability and Accountability Act (HIPAA), the data shall be available as a resource tool for policy analysts, insurers, legislators, employers, health care providers, purchasers of health care, and state agencies to review the uninsured population’s utilization of health care, the cost of services provided to the uninsured, and the effect of that utilization on the commercial insurance market.
III. The comprehensive uninsured health care database shall not include any data that contains direct personal identifiers. For purposes of this section, “direct personal identifiers” shall include information relating to an individual that contains primary identifiers, such as the individual’s name, street address, e-mail address, telephone number, and social security number.
126-R:2 Rulemaking Authority.
I. The commissioner of the department of health and human services, in consultation with the commissioner of the insurance department, shall adopt rules under RSA 541-A as may be necessary to provide for the reporting and release of uninsured health care data.
II. The commissioner of the insurance department, in consultation with the commissioner of the department of health and human services, shall adopt rules under RSA 541-A as may be necessary to provide for the collection of uninsured health care data.
3 Effective Date. This act shall take effect January 1, 2009.
LBAO
08-2791
Amended 04/10/08
SB 425 FISCAL NOTE
AN ACT relative to the data collection practices of health care providers and relative to the development of a comprehensive uninsured health care database.
FISCAL IMPACT:
The Department of Health and Human Services, and Department of Insurance state this bill, as amended by the Senate (Amendment #2008-0275s), will increase state expenditures by $120,000 in FY 2009, and by $75,000 in FY 2010 and each year thereafter. This bill may increase state revenue by an indeterminable amount 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 (DHHS) states this bill requires health care providers to submit health care claim data to the DHHS for any person who receives health care services and does not have health insurance and whose care is not paid for by a governmental program. The bill also requires the Department of Insurance (DOI) and DHHS to enter into a memorandum of understanding for collaboration in the development of a comprehensive uninsured health care database and to adopt administrative rules necessary to provide for the reporting and release of uninsured health care data. DHHS assumes the cost of the database will be shared in some undetermined fashion between DHHS and DOI. DHHS assumes an uninsured population of 100,000 and 5 claims per individual resulting in 500,000 claims annually. The Department estimates the cost per claim would be $0.15, resulting in an annual cost to the state of $75,000 (500,000 claims X $0.15 per claim). Additional required system changes in the first year only would be approximately $45,000.
The Department of Insurance (DOI) states it is not clear whether DHHS or the DOI would be responsible for collecting claim data. The Department estimates 500,000 claims per year with a processing cost of $0.15 per claim, resulting in a total cost of $75,000 annually. The Department assumes a one-time contract would be needed to create the infrastructure to process these claims at a cost of $45,000. The Department states it is not clear if these costs would be paid from the State general fund or from DOI funds. The Department further assumes this bill will increase a provider’s administrative costs for services provided to uninsured patients. The Department believes that revenues from uninsured patients are less than uninsured patient’s healthcare costs and that this shortfall must be funded through other sources, typically other payers. The Department states to the extent insurers increase their premiums to reflect any increased provider costs, and to the extent these costs are absorbed by employers, the State would realize an increase in insurance premium tax revenue.