Bill Text: NH HB619 | 2017 | Regular Session | Introduced
Bill Title: Relative to medical services for prisoners.
Spectrum: Slight Partisan Bill (Democrat 5-2)
Status: (Introduced - Dead) 2017-10-19 - Committee Report: Ought to Pass with Amendment #2017-2428h for 01/03/2018 (Vote 16-0; Consent Calendar) [HB619 Detail]
Download: New_Hampshire-2017-HB619-Introduced.html
HB 619-FN-LOCAL - AS INTRODUCED
2017 SESSION
17-0168
04/01
HOUSE BILL 619-FN-LOCAL
AN ACT relative to medical services for prisoners.
SPONSORS: Rep. Snow, Hills. 42; Rep. J. MacKay, Merr. 14; Rep. Freitas, Hills. 14; Rep. Fothergill, Coos 1; Rep. Kenison, Merr. 15; Sen. D'Allesandro, Dist 20; Sen. Carson, Dist 14
COMMITTEE: Municipal and County Government
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ANALYSIS
This bill requires payment for medical care for state and county prisoners from Medicaid or a private insurer before payment from the state or county will be made.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
17-0168
04/01
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Seventeen
AN ACT relative to medical services for prisoners.
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(i) to read as follows:
(i)(1) A county prisoner who has Medicaid or private health insurance and receives inpatient, outpatient, or emergency room medical care at a health care facility licensed pursuant to RSA 151 or from an independent health care provider licensed in this state for a period of 24 hours or more, shall first authorize a claim for payment of medical care from Medicaid or his or her private health insurer. The county department of corrections or its agent shall then pay any balance not paid by Medicaid or the private health insurer.
(2) 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(h) to read as follows:
(h)(1) A state prisoner who has Medicaid or private health insurance and receives inpatient, outpatient, or emergency room medical care at a health care facility licensed pursuant to RSA 151 or from an independent health care provider licensed in this state for a period of 24 hours or more, shall first authorize a claim for payment of medical care from Medicaid or his or her private health insurer. The state department of corrections or its agent shall then pay any balance not paid by Medicaid or the private health insurer.
(2) 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.
3 Effective Date. This act shall take effect 60 days after its passage.
17-0168
1/23/17
HB 619-FN-LOCAL- FISCAL NOTE
as introduced
AN ACT relative to medical services for prisoners.
FISCAL IMPACT: [ X ] State [ X ] County [ ] Local [ ] None
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| Estimated Increase / (Decrease) | |||
STATE: | FY 2018 | FY 2019 | FY 2020 | FY 2021 |
Appropriation | $0 | $0 | $0 | $0 |
Revenue | $0 | $0 | $0 | $0 |
Expenditures | Indeterminable | Indeterminable | Indeterminable | Indeterminable |
Funding Source: | [ X ] General [ ] Education [ ] Highway [ ] Other | |||
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COUNTY: |
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Revenue | $0 | $0 | $0 | $0 |
Expenditures | Indeterminable | Indeterminable | Indeterminable | Indeterminable |
METHODOLOGY:
This bill requires that incarcerated persons who have either Medicaid or private insurance have that insurance pay first, before the Department of Corrections or counties incur any liability. Under current law, the Department of Corrections or its agent shall pay licensed health care facilities no more than 110 percent of the Medicare allowable rate of inpatient, outpatient, or emergency room care provided for prisoners in state correctional facilities when a person is not Medicaid eligible nor carries private insurance. The Department or its agent shall pay independent health care providers no more than 125 percent of the Medicare allowable rate for care provided for prisoners in state correctional facilties.
Under this bill, a prisoner who has Medicaid or private health insurance and receives inpatient, outpatient or emergency room medical care for a period of 24 hours or more shall first authorize a claim for payment of medical costs from Medicaid or his or her private health insurer. The Department will then pay any balance not paid by Medicaid or the private health insurer. The Department assumes this bill would result in the Department being billed for the difference not covered by the networked rate established by the private insurance carrier and Medicaid. The following table shows the inpatient charges as billed to the Department of Corrections and paid by Medicaid in FY 2016.
| Service Type | Total Billed | Total Paid by Medicaid | Difference |
| Inpatient | $7,047,298 | $1,892,321 | $5,154,977 |
If this bill passes, the Department of Corrections assumes providers would be able to bill the Department for the difference between the facility rate and Medicaid rates which was about $5.15 million in FY 2016.
The Department of Health and Human Services states it cannot estimate the fiscal impact of this bill due to several technical difficulties included in the legislation. The Department assumes any claim for Medicaid reimbursement for all of the medical services specified in the proposed legislation except inpatient hospitalization for more than 24 hours, will be denied pursuant to the inmate coverage exclusion set forth in 42 CFR 435.1010. Additionally, the Department states this bill provides that counties and the Department of Corrections would be responsible for any balance not paid by Medicaid for inpatient hospital stays in excess of 24 hours for inmates enrolled in Medicaid which is inconsistent with 42 CFR 447.15. Further, this bill suggests an inmate can authorize a Medicaid claim which is inconsistent with Medicaid claims and billing procedures. The Department states that if the claim for Medicaid reimbursement is denied based upon the inmate coverage exclusion, the county or the Department of Corrections will be responsible for 100 percent of such services. The Department assumes that if the claim for Medicaid reimbursement is for inpatient hospitalization of more than 24 hours for a Medicaid eligible inmate and the hospital is a Medicaid provider, 50 percent of the allowable charges will be paid by the federal government and 50 percent will be paid by the county, the Department of Corrections, or the Department of Health and Human Services depending upon whether memoranda of understanding exist among those entities.
The New Hampshire Association of Counties states this bill could have an indeterminable fiscal impact on counties. County corrections currently make every attempt to secure payment from private providers and/or Medicaid for medical care of county inmates. Expenditures and costs recovered vary based on medical services provided, the service provider, and how much the private providers are willing to cover in terms of cost.
The Insurance Department states it does not expect this bill to impact insurance premiums or costs.
AGENCIES CONTACTED:
Department of Corrections, New Hampshire Association of Counties, Department of Health and Human Services, and Insurance Department
