SB 457-FN - AS INTRODUCED
2024 SESSION
24-3010
05/08
SENATE BILL 457-FN
AN ACT relative to inpatient psychiatric services authorization and utilization review.
SPONSORS: Sen. Gannon, Dist 23; Sen. Gendreau, Dist 1; Sen. Ricciardi, Dist 9; Sen. Soucy, Dist 18; Sen. Rosenwald, Dist 13; Sen. Watters, Dist 4; Sen. Chandley, Dist 11; Rep. Guthrie, Rock. 15; Rep. M. Pearson, Rock. 34; Rep. Phillips, Rock. 7; Rep. Piemonte, Rock. 9
COMMITTEE: Health and Human Services
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ANALYSIS
This bill directs the commissioner of the department of health and human services to establish uniform guidelines for inpatient psychiatric services under the managed care law.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
24-3010
05/08
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Four
AN ACT relative to inpatient psychiatric services authorization and utilization review.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Paragraph; Managed Care Law; Utilization Review. Amend RSA 420-J:6 by inserting after paragraph VI the following new paragraph:
VII. The commissioner shall establish uniform guidelines for inpatient psychiatric services authorization and utilization review. The uniform guidelines shall establish a single set of criteria for admission, continued stay, discharge determinations, and retrospective review. The guidelines shall prohibit utilization review during the first 30 days of inpatient or residential behavioral health admission, provided that the treating facility notifies the health plan of the admission and the treatment plan within 2 days of the admission and performs daily clinical review of the covered person.
2 Effective Date. This act shall take effect 60 days after its passage.
24-3010
Revised 1/12/24
SB 457-FN- FISCAL NOTE
AS INTRODUCED
AN ACT relative to inpatient psychiatric services authorization and utilization review.
FISCAL IMPACT: [ X ] State [ ] County [ ] Local [ ] None
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Estimated State Impact - Increase / (Decrease) | ||||||
| FY 2024 | FY 2025 | FY 2026 | FY 2027 | ||
Revenue | $0 | Indeterminable Increase | Indeterminable Increase | Indeterminable Increase | ||
Revenue Fund(s) | Insurance premium tax | |||||
Expenditures | $0 | Indeterminable Increase | Indeterminable Increase | Indeterminable Increase | ||
Funding Source(s) | Insurance Assessments RSA 400-A:39 | |||||
Appropriations | $0 | $0 | $0 | $0 | ||
Funding Source(s) | None | |||||
• Does this bill provide sufficient funding to cover estimated expenditures? [X] Yes • Does this bill authorize new positions to implement this bill? [X] No | ||||||
METHODOLOGY:
This bill amends the state's managed care law by requiring the Insurance Department to implement uniform guidelines that limit utilization review for inpatient psychiatric services. The bill stipulates that the guidelines shall prohibit utilization review during the first 30 days of inpatient or residential admission, provided the treating facility notifies the insurer within 2 days of admission and performs daily clinical reviews of the covered person. The Department assumes the bill would result in increased lengths of inpatient or residential admissions and increases in the total cost of a related claims. The Department states the extent of this increase is anticipated to be potentially significant, but indeterminable at this time. Any increase in claims costs will, in turn, result in an increase in insurance premium tax revenue. The Department states that the extent of this increase is indeterminable, but potentially significant.
The Department indicates it would need to retain experts to develop the guidelines because the Department does not employ medical experts. The cost of such experts is unknown at this time, but could not be absorbed by the department's budget for consultants. This would be a recurring expense as any guidelines developed would need to be reviewed on a periodic basis to ensure that they are consistent with evolving generally accepted medical standards. This increased cost would be recovered through the insurance assessments allowed pursuant to RSA 400-A:39.
It is assumed that any fiscal impact will begin in FY 2025.
AGENCIES CONTACTED:
Insurance Department
| Date | Body | Type |
|---|---|---|
| Jan. 10, 2024 | Senate | Hearing |
March 7, 2024: Refer to Interim Study, MA, VV; 03/07/2024; SJ 6
Feb. 21, 2024: Committee Report: Referred to Interim Study, 03/07/2024; Vote 5-0; CC; SC 9
Jan. 4, 2024: Hearing: 01/10/2024, Room 101, LOB, 01:45 pm; SC 2
Dec. 12, 2023: To Be Introduced 01/03/2024 and Referred to Health and Human Services; SJ 1