SB 71-FN – AS INTRODUCED

2011 SESSION

11-1002

01/09

SENATE BILL 71-FN

AN ACT relative to health care fees in workers’ compensation.

SPONSORS: Sen. Boutin, Dist 16

COMMITTEE: Commerce

ANALYSIS

This bill clarifies medical fees and reimbursement levels for health care services under workers’ compensation 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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

11-1002

01/09

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Eleven

AN ACT relative to health care fees in workers’ compensation.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 Workers’ Compensation; Medical Fees. RSA 281-A:24 is repealed and reenacted to read as follows:

281-A:24 Medical Fees; Reimbursement Levels.

I. The commissioner shall adopt rules, pursuant to RSA 541-A, to establish a fee schedule, including Medicare coding and reimbursement rules, for all medical services that is based on that applicable to Medicare. The physician fee schedule shall apply a uniform conversion factor of up to 150 percent of Medicare base reimbursement rates in determining reimbursement levels. The fee schedule applicable to in-patient and out-patient hospital services shall be based on Medicare’s prospective payment system Diagnostic Related Groups (DRG) and ambulatory surgical center fee schedules, respectively, and shall provide a uniform conversion factor of up to 150 percent of Medicare based reimbursement rates in determining reimbursement levels. Reimbursement for durable medical equipment shall be limited to that reimbursed under Medicare.

II. Reimbursement rates shall be adjusted in accordance with adjustments to Medicare. In the absence of a contract providing otherwise, the fee schedule reimbursement rates shall be the maximum reimbursement permitted. The commissioner is authorized to conduct a study, no less frequently than every 3 years, relative to access to medical services. If the commissioner finds reimbursement levels have resulted in a systemic decline in access to medical treatment, he or she shall recommend to the legislature to adjust the fee schedule accordingly.

2 Applicability. Rules adopted pursuant to RSA 541-A relative to the fee schedule as required under section 1 of this act shall be effective January 1, 2012.

3 Effective Date. This act shall take effect upon its passage.

LBAO

11-1002

02/02/11

SB 71-FN - FISCAL NOTE

AN ACT relative to health care fees in workers’ compensation.

FISCAL IMPACT:

Due to time constraints, the Office of Legislative Budget Assistant is unable to provide a fiscal note for this bill at this time. When completed, the fiscal note will be forwarded to the Senate Clerk's Office.