Revision: Feb. 17, 2009, midnight
HB 30-FN-A-LOCAL – AS AMENDED BY THE HOUSE
04Feb2009… 0026h
2009 SESSION
09/01
HOUSE BILL 30-FN-A-LOCAL
AN ACT requiring operating budget reductions for fiscal year 2009.
SPONSORS: Rep. M. Smith, Straf 7; Sen. D'Allesandro, Dist 20
This bill requires certain operating budget reductions for fiscal year 2009.
This bill is a request of the office of the governor.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
04Feb2009… 0026h
09-1011
09/01
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Nine
AN ACT requiring operating budget reductions for fiscal year 2009.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Operating Budget; Judicial Branch. Notwithstanding 2007, 262:1, the appropriations for the judicial branch shall be reduced by an additional $441,000 for the fiscal year ending June 30, 2009. The reductions required by this section shall be in addition to the reductions required by 2008, 296:2 and the judicial branch's average historical lapse amount of $1,100,000 per fiscal year. The director of the administrative office of the courts shall submit to the fiscal committee of the general court and the commissioner of the department of administrative services an itemization of the reductions in expenditure classes made to implement this section on or before June 15, 2009.
2 Operating Budget; Legislative Branch. Notwithstanding 2007, 262:1, the appropriations for the legislative branch for the fiscal year ending June 30, 2009 shall be reduced by an additional $700,000. The reductions required by this section shall be in addition to the reductions required by 2008, 296:3. The legislative budget assistant shall submit to the fiscal committee of the general court an itemization of the reductions in expenditure classes made to implement this section on or before June 15, 2009.
3 Operating Budget; New Hampshire Retirement System. Notwithstanding 2007, 262:1, the appropriations for the New Hampshire retirement system, state contributions, classes 93 Normal Contribution Teachers, 94 Normal Contribution Police, and 95 Normal Contribution Firefighter, shall be reduced by a total of $1,500,000 in general funds for the fiscal year ending June 30, 2009. The executive director of the New Hampshire retirement system shall submit to the fiscal committee of the general court and the commissioner of the department of administrative services an itemization of the reductions in expenditure classes made to implement this section on or before June 15, 2009.
4 General Fund; Transfer to Highway Fund. Amend 2007, 262:26 to read as follows:
262:26 General Fund; Transfer to Highway Fund. The commissioner of administrative services shall cause to have transferred $6,750,000 from the general fund to the highway fund on January 1, 2008, and shall cause to have transferred $1,750,000 from the general fund to the highway fund on January 1, 2009.
5 Operating Budget; Transfer of Dedicated Funds. Notwithstanding RSA 6:12 and any other law to the contrary, the department of administrative services shall transfer funds from the following accounts or funds maintained separately on the books of the state to the general fund in the following amounts:
Account/Fund Amount Transferred to General Fund
Police standards and training council $2,000,000
training fund,
Fire standards and training and $2,000,000
emergency medical services fund,
Department of Safety $700,000
Reflectorized plates inventory fund,
Education credentialing fund, $1,000,000
Radiation user and laboratory fees fund, $500,000
Low level radioactive $400,000
waste management fund,
6 Department of Health and Human Services; Medicaid Reimbursement for Outpatient Hospital Services. Amend RSA 126-A:3, VII to read as follows:
VII. Medicaid Hospital Outpatient Services; Designation in Operating Budget.
(a) Notwithstanding any other provision of law to the contrary, beginning with the biennium beginning July 1, 2005 and continuing thereafter, the department shall designate in its operating budget requests specific class lines for hospital outpatient services. The department shall not increase expenditures in approved budgets for such outpatient services without prior approval. If expenditures are projected to exceed the annual appropriation, the department may recommend rate reduction for providers to offset the amount of any such deficit. The department of health and human services shall submit to the legislative fiscal committee and to the finance committees of the house and the senate, the rates that it proposes to pay for hospital outpatient services. The rates shall be subject to the prior approval of the legislative fiscal committee.
(b) For the purpose of Medicaid reimbursement for outpatient hospital services, the only outpatient hospital services for which Medicaid reimbursement shall be provided are those outpatient hospital services which are:
(1) Preventive, diagnostic, therapeutic, rehabilitative, or palliative services that are furnished to outpatients;
(2) Furnished by or under the direction of a physician or dentist;
(3) Furnished in a facility that:
(A) Is licensed or formally approved as a hospital by an officially designated authority for state standard setting; and
(B) Meets the requirements for participation in Medicare as a hospital; CMS-2213-F 62; and
(4) Limited to the scope of facility services that:
(A) Would be included, in the setting delivered, in the Medicare outpatient prospective payment system (OPPS) as defined under 42 C.F.R. section 419.2(b) or are paid by Medicare as an outpatient hospital service under an alternate payment methodology;
(B) Are furnished by an outpatient hospital facility, including an entity that meets the standards for provider based status as a department of a provider set forth in 42 C.F.R. section 413.65; and
(C) Are not covered under the scope of another medical assistance service category under the state plan.
(c) The commissioner may exclude from the definition of outpatient hospital services under subparagraph (b) those types of items and services that are not generally furnished by most hospitals in the state.
7 Department of Health and Human Services; Human Immunodeficiency Virus Prevention Program. Amend 2007, 367:1 to read as follows:
367:1 Department of Health and Human Services; Human Immunodeficiency Virus Prevention Program. The department shall expend the sums of $500,000 in the fiscal year ending June 30, 2008 [and $500,000 in the fiscal year ending June 30, 2009] for the human immunodeficiency virus prevention program in the department of health and human services for the purchase of antiretroviral drugs. The department shall fund the program from funds appropriated to the department in the state operating budget in fiscal [years] year 2008 [and 2009].
8 Department of Health and Human Services; Reduction; Antiretroviral Drugs. Notwithstanding 2007, 262:1, the department of health and human services is hereby directed to reduce state general fund appropriations that were allocated pursuant to 2007, 367:1 for the purchase of antiretroviral drugs under the human immunodeficiency virus prevention program by $500,000 for the fiscal year ending June 30, 2009.
9 Positions Transferred in Department of Administrative Services to Fund 60. The source of funding for position numbers 42529, 43085, 16686, 43086, and 43084 is transferred from the general fund to the Fund 60 Self Funded Employee and Retiree Health Benefit Program. The source of funding for position number 41835 shall be 75 percent from the Fund 60 Self Funded Employee and Retiree Health Benefit Program and 25 percent from the general fund. The source of funding for position numbers 10101, 43180, 42528 shall be 50 percent from the Fund 60 Self Funded Employee and Retiree Health Benefit Program and 50 percent from the general fund.
10 Effective Date.
I. Section 4 of this act shall take effect December 31, 2008.
II. Section 9 of this act shall take effect July 1, 2008.
III. The remainder of this act shall take effect upon its passage.
LBAO
09-1011
Revised 02/11/09
HB 30 FISCAL NOTE
AN ACT requiring operating budget reductions for fiscal year 2009.
FISCAL IMPACT:
The Office of Legislative Budget Assistant, Police Standards and Training Council, Department of Safety, Department of Education, Department of Health and Human Services, and Department of Administrative Services states this bill will decrease state general fund expenditures by $4,150,360 in FY 2009, $2,413,804, in FY 2010, $2,440,833 in FY 2011, $2,472,874 in FY 2012, and $2,506,517 in FY 2013, and increase state general fund revenue by $12,100,000 in FY 2009. This bill will increase state highway fund expenditures by $5,000,000 in FY 2009, and decrease state restricted expenditures by $490,640 in FY 2009, $1,186,196 in FY 2010, $1,159,167 in FY 2011, $1,127,126 in FY 2012, and $1,093,483 in FY 2013. This bill will have no fiscal impact on county and local revenue or expenditures.
METHODOLOGY:
Section 1 - The Office of Legislative Budget Assistant states section 1 reduces Judicial Branch state general fund appropriations by $441,000 in FY 2009.
Section 2 – The Office of Legislative Budget Assistant states section 2 reduces Legislative Branch state general fund appropriations by $700,000 in FY 2009.
Section 3 – The Office of Legislative Budget Assistant states section 3 reduces New Hampshire Retirement System state general fund appropriations for state normal contributions, and normal contributions on behalf of local teacher, police and fire members by a total of $1,500,000 in FY 2009.
Section 4 – The Office of Legislative Budget Assistant states section 4 would increase state general fund revenue and highway fund expenditures by $5,000,000 in FY 2009 as a result of a transfer from the state highway fund. Chapter 262, Laws of 2007 (Operating Budget) transferred $6.75M from the state general fund to the state highway fund in both FY 2008 and FY 2009. In FY 2009, this section would transfer $5,000,000 back to the state general fund, and $1,750,000 would remain in the highway fund.
Section 5 – The Police Standards and Training Council states this section transfers $2,000,000 in FY 2009 from the Police Standards and Training Council Training Fund to the state general fund, thereby increasing state general fund revenue. The Council estimated that the fund balance as of January 15, 2009 was approximately $3,000,000.
The Department of Safety states this section transfers $2,000,000 in FY 2009 from the Fire Standards and Training and Emergency Medical Services Fund to the state general fund, thereby increasing state general fund revenue. The Department states this section also transfers $1,600,000 in FY 2009 from the Reflectorized Plate Inventory Fund to the state general fund, thereby increasing state general fund revenue.
The Department of Education states this section transfers $1,000,000 in FY 2009 from the Education Credentialing Fund to the state general fund, thereby increasing state general fund revenue.
The Department of Health and Human Services states this section transfers $500,000 in FY 2009 from the Radiation User and Laboratory Fees Fund to the state general fund, thereby increasing state general fund revenue.
The total increase in state general fund revenue as a result of this section is $7,100,000 in FY 2009.
Section 6 – The Department of Health and Human Services states this section mirrors 42 CFR §440.20 that took effect on December 8, 2008. The federal regulation aligns the definition of Medicaid reimbursable outpatient hospital services with Medicare reimbursable outpatient hospital services. More specifically, it requires that only services unique to a hospital setting may be reimbursed as outpatient hospital services and those services not unique to the hospital setting (such as a physician office visit for example) must be reimbursed pursuant to the specific payment methodology laid out for that category of service within the Medicaid State Plan. In New Hampshire this regulation limits the use of Revenue Code 510, a facility charge, to outpatient hospital claims for services unique to a hospital setting. It will similarly restrict the use of Code 510 for services covered under other categories in the State Plan that are not unique to the hospital setting. This regulation also ensures compatibility in payment standards for all providers of the same service irrespective of the setting in which the service is provided as required by both federal law and the State Plan. New Hampshire hospitals have been paid approximately $5 million in Code 510 charges annually, of which approximately 72% or $3,600,000 were for physician office billings. The impact of the federal regulation varies from state to state based on the nuances of each state’s Medicaid program. States for which this regulation presents a particular complex of negative outcomes have been requesting that the incoming Obama Administration repeal the regulation. If the federal regulation is repealed, and section 6 becomes law, it will allow New Hampshire to continue to realize a cost avoidance of approximately $3,600,000 annually, of which 50% or $1,800,000 would be state general funds. Assuming that the federal law took effect on December 8, 2008, state general fund savings have been estimated at approximately $1,000,000 for FY 2009.
Section 7 – The Department of Health and Human Services states this section would remove the requirement that the Department expend $500,000 in FY 2009 for the purchase of antiretroviral drugs under the human immunodeficiency virus (HIV) program. The Department states other funding sources have become available for this purpose, which will allow the Department to reduce state general fund appropriations by $500,000.
Section 8 – The Department of Administrative Services states this section changes the source of funding for various positions from the state general fund to the self funded employee and retiree health benefit program (fund 60). Based on salaries obtained from the Affinity Budget System, and assuming an effective date upon passage, the Department estimates state general fund expenditures will decrease and state restricted expenditures will increase by $509,360 in FY 2009, $613,804 in FY 2010, $640,833 in FY 2011, $672,874 in FY 2012, and $706,517 in FY 2013.
Section 9 – No impact.