Revision: March 19, 2013, midnight
HB 432-FN – AS AMENDED BY THE HOUSE
6Mar2013… 0324h
2013 SESSION
04/01
HOUSE BILL 432-FN
AN ACT relative to health care costs for county and state inmates.
SPONSORS: Rep. Pantelakos, Rock 25; Rep. Shurtleff, Merr 11; Rep. Charron, Rock 4
COMMITTEE: Health, Human Services and Elderly Affairs
This bill amends the procedures for reimbursement by the county and state departments of corrections for the costs of inmate medical care.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
6Mar2013… 0324h
13-0602
04/01
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Thirteen
AN ACT relative to health care costs for county and state inmates.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Medical Services for County Prisoners. Amend RSA 623-C:1, I to read as follows:
I.(a) Except as provided in subparagraphs (b) through [(f), no hospital or emergency room shall charge a county or its agent] (g) the department of corrections or its agent shall pay health care facilities and hospitals at no more than 110 percent of the Medicare allowable rate for inpatient or emergency room care provided for prisoners in county correctional facilities. In this chapter, “health care facilities” mean ambulatory and specialty-medical services centers licensed under RSA 151, and shall include but not be limited to surgical, rehabilitation, long-term care, oncology, radiology/imaging centers, and dialysis centers, and shall also include physician, nurse practitioner, dental, and allied health care practices, and community health care clinics operating under a licensed healthcare facility.
(b) Except as provided in subparagraphs (c) through (e), the department of corrections or its agent shall pay the following providers no more than 125 percent of the Medicare allowable rate for care provided for prisoners in county correctional facilities:
(1) Physicians and surgeons licensed pursuant to RSA 329.
(2) Podiatrists licensed pursuant to RSA 315.
(3) Dentists licensed pursuant to RSA 317-A.
(4) Optometrists licensed pursuant to RSA 327.
(5) Advanced practice registered nurses licensed pursuant to RSA 326-B:18.
(6) Physician assistants licensed pursuant to RSA 328-D.
(7) Physical therapists licensed pursuant to RSA 328-A.
(8) Athletic trainers licensed pursuant to RSA 326-G.
(9) Occupational therapists licensed pursuant to RSA 326-C.
(10) Speech and language pathologists licensed pursuant to RSA 326-F.
(11) Respiratory therapists licensed pursuant to RSA 326-E.
(12) Recreational therapists licensed pursuant to RSA 326-J.
(13) Dietitians licensed pursuant to RSA 326-H.
(14) Audiologists licensed pursuant to RSA 137-F.
(15) Pharmacies licensed pursuant to RSA 318.
(16) Durable medical equipment providers.
(c) Allowances provided by hospitals shall qualify as community benefits under RSA 7:32-d, III(b).
[(c)] (d) Hospitals reported by the department of health and human services as having a negative operating margin in the most recent year for which hospital-audited financial data is available shall charge no more than 125 percent of the Medicare rate.
[(d)] (e) Nothing in this section shall preclude the superintendent of a county correctional facility from negotiating and executing medical service rate agreements with hospitals, health care facilities, or other licensed medical providers for the provision of medical or dental services to prisoners at the lowest rate possible, or from utilizing rates in existing agreements.
(f) The superintendent of a county correctional facility may waive the application of subparagraph (a) if the superintendent determines such action is necessary to ensure prisoner access to medically necessary care.
[(e) The superintendent of a county correctional facility may waive the application of subparagraph (a) if the superintendent determines such action to be necessary for the efficient operations of the county correctional facility.
(f) Nothing in this paragraph shall require a hospital to admit any person]
(g) The superintendent of a county correctional facility may waive the application of subparagraph (a) if the superintendent determines such action to be necessary for the efficient operations of the county correctional facility.
(h) The superintendent of a county correctional facility may at any time audit any claim or seek clarification on any payment made pursuant to this section, or both. Upon request by the superintendent, the provider shall furnish information on pricing methodology and shall detail any internal process controls for ensuring accurate pricing of claims processed under this section. Claim information shall be provided in the industry standard format, including but not limited to the application of global surgery provisions, billing for surgical assistants, and bundling.
2 Medical Services for State Prisoners. Amend RSA 623-C:2, I to read as follows:
I. (a) Except as provided in subparagraphs (b) through [(d)] (f), the department of corrections or its agent shall pay health care facilities and hospitals at no more than 110 percent of the Medicare allowable rate for inpatient, outpatient, or emergency room care provided for prisoners in state correctional facilities. In this chapter, “health care facilities” mean ambulatory and specialty-medical services centers licensed under RSA 151, and shall include but not be limited to surgical, rehabilitation, long term care, oncology, radiology/imaging centers, and dialysis centers, [but shall not] and shall also include physician [practices and community health care clinics], nurse practitioner, dental, and allied health care practices, and community health care clinics operating under a licensed healthcare facility.
(b) Except as provided in subparagraphs (c) through (e), the department of corrections or its agent shall pay the following providers no more than 125 percent of the Medicare allowable rate for care provided for prisoners in state correctional facilities:
(1) Physicians and surgeons licensed pursuant to RSA 329.
(2) Podiatrists licensed pursuant to RSA 315.
(3) Dentists licensed pursuant to RSA 317-A.
(4) Optometrists licensed pursuant to RSA 327.
(5) Advanced practice registered nurses licensed pursuant to RSA 326-B:18.
(6) Physician assistants licensed pursuant to RSA 328-D.
(7) Physical therapists licensed pursuant to RSA 328-A.
(8) Athletic trainers licensed pursuant to RSA 326-G.
(9) Occupational therapists licensed pursuant to RSA 326-C.
(10) Speech and language pathologists licensed pursuant to RSA 326-F.
(11) Respiratory therapists licensed pursuant to RSA 326-E.
(12) Recreational therapists licensed pursuant to RSA 326-J.
(13) Dietitians licensed pursuant to RSA 326-H.
(14) Audiologists licensed pursuant to RSA 137-F.
(15) Pharmacies licensed pursuant to RSA 318.
(16) Durable medical equipment providers.
(c) Allowances provided by hospitals shall qualify as community benefits under RSA 7:32-d, III(b).
(d) Hospitals reported by the department of health and human services as having a negative operating margin in the most recent year for which hospital-audited financial data is available shall charge no more than 125 percent of the Medicare rate.
[(c)] (e) The commissioner of the department of corrections may waive the application of subparagraph (a) if the commissioner determines such action is necessary to ensure prisoner access to medically necessary care.
[(d)] (f) The commissioner of the department of corrections may waive the application of subparagraph (a) if the commissioner determines such action to be necessary for the efficient operations of the state correctional facility.
(g) The commissioner of the department of corrections may at any time audit any claim or seek clarification on any payment made pursuant to this section, or both. Upon request by the commissioner, the provider shall furnish information on pricing methodology and shall detail any internal process controls for ensuring accurate pricing of claims processed under this section. Claim information shall be provided in the industry standard format, including but not limited to the application of global surgery provisions, billing for surgical assistants, and bundling.
3 Effective Date. This act shall take effect July 1, 2013.
LBAO
13-0602
Amended 03/18/13
HB 432 FISCAL NOTE
AN ACT relative to health care costs for county and state inmates.
FISCAL IMPACT:
The Office of Legislative Budget Assistant is unable to complete a fiscal note for this bill, as amended by the House (Amendment #2013-0324h), as it is awaiting information from the Department of Corrections and the New Hampshire Association of Counties. When completed, the fiscal note will be forwarded to the House Clerk's Office.