Bill Text - HB432 (2013)

Relative to health care costs for county and state inmates.


Revision: March 29, 2013, midnight

HB 432-FN – AS AMENDED BY THE HOUSE

6Mar2013… 0324h

27Mar2013… 0907h

2013 SESSION

13-0602

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

ANALYSIS

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.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

27Mar2013… 0907h

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 county department of corrections or its agent shall pay health care facilities licensed pursuant to RSA 151 no more than 110 percent of the Medicare allowable rate for inpatient, outpatient, or emergency room care provided for prisoners in county correctional facilities.

(b) Except as provided in subparagraphs (c) through (e), and subparagraph (i), the county department of corrections or its agent shall pay independent health care providers licensed in this state no more than 125 percent of the Medicare allowable rate for care provided for prisoners in county correctional facilities.

(c) Allowances provided by hospitals shall qualify as community benefits under RSA 7:32-d, III(b).

[(c)] (d) [Hospitals] The county department of corrections shall pay health care facilities licensed pursuant to RSA 151 and reported by the department of health and human services as having a negative operating margin in the most recent year for which [hospital-audited] 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 health care facilities licensed pursuant to RSA 151, or other licensed medical providers, for the provision of medical or dental services to county prisoners at the lowest rate possible, or 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.

(i) If a county prisoner’s medical care is covered by Medicaid, the health care facility licensed pursuant to RSA 151, or the licensed health care provider, or both, shall be paid at the Medicaid rate for services provided.

2 Medical Services for State Prisoners. Amend RSA 623-C:2, I and II to read as follows:

I.(a) Except as provided in subparagraphs (b) through [(d)] (f), the state department of corrections or its agent shall pay health care facilities [and hospitals] licensed pursuant to RSA 151 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, oncology, and dialysis centers, but shall not include physician practices and community health care clinics]

(b) Except as provided in subparagraphs (c) through (e), and subparagraph (h), the state department of corrections or its agent shall pay independent health care providers licensed in this state no more than 125 percent of the Medicare allowable rate for care provided for prisoners in state correctional facilities.

(c) Allowances provided by hospitals shall qualify as community benefits under RSA 7:32-d, III(b).

(d) The state department of corrections shall pay health care facilities licensed pursuant to RSA 151 and reported by the department of health and human services as having a negative operating margin in the most recent year for which audited financial data is available no more than 125 percent of the Medicare rate.

[(c)] (e) The commissioner of the state 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 state 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 state 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.

(h) If a state prisoner’s medical care is covered by Medicaid, the facility or the licensed health care provider, or both, shall be paid at the Medicaid rate for services provided.

II. Nothing in this section shall preclude the commissioner of the state department of corrections from [having the discretion to negotiate and execute] negotiating and executing medical service rate agreements with [hospitals or] health care facilities licensed pursuant to RSA 151, or other licensed medical providers, for the provision of medical or dental services to state prisoners at the lowest rate possible, or utilizing rates in existing agreements.

3 Effective Date. This act shall take effect July 1, 2013.

LBAO

13-0602

Amended 03/28/13

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 #2013-0907h), 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.