CHAPTER 210

SB 133-FN – FINAL VERSION

03/12/2015 0641s

15Apr2015… 1192h

3June2015… 2009h

2015 SESSION

15-0959

01/06

SENATE BILL 133-FN

AN ACT relative to certain health care data, certain workers’ compensation medical claim data collected by the insurance department, and medical costs paid under workers’ compensation.

SPONSORS: Sen. Bradley, Dist 3; Rep. S. Schmidt, Carr 6; Rep. McMahon, Rock 7

COMMITTEE: Health and Human Services

AMENDED ANALYSIS

This bill requires the insurance commissioner to consult with certain groups and organizations and to make a report by December 2015 to the legislature and the governor with recommendations on options for including workers’ compensation data in the New Hampshire comprehensive health information system.

This bill also clarifies certain payments for medical costs under workers’ compensation.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

03/12/2015 0641s

15Apr2015… 1192h

3June2015… 2009h

15-0959

01/06

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Fifteen

AN ACT relative to certain health care data, certain workers’ compensation medical claim data collected by the insurance department, and medical costs paid under workers’ compensation.

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

210:1 New Paragraph; Development of a Comprehensive Health Care Information System. Amend RSA 420-G:11-a by inserting after paragraph II the following new paragraph:

III. The department shall make available to the public a public use data set for purposes of facilitating transparency in health care costs.

210:2 New Section; Advisory Organizations; Required Activity. Amend RSA 412 by inserting after section 37-a the following new section:

412:37-b Advisory Organizations; Required Activity. The commissioner shall consult with workers’ compensation advisory organizations, workers’ compensation carriers, and third party administrators or self-insureds regarding the most effective options for including workers’ compensation medical claims data in the New Hampshire comprehensive health information system, as defined under RSA 420-G:11-a. The commissioner shall make a report with recommendations on options for including workers’ compensation medical claims data in the New Hampshire comprehensive health information system on or before December 1, 2015 to the speaker of the house of representatives, the president of the senate, the governor, and the chairpersons of the house and senate committees having jurisdiction over health and human services.

210:3 Workers’ Compensation; Payment for Reasonable Value of Services. RSA 281-A:24, I is repealed and reenacted to read as follows:

I.(a) The employer or the employer’s insurance carrier shall pay the reasonable value of medical services provided under this chapter.

(b) The health care provider shall have the burden of establishing that its bill for services is reasonable.

(c) Effort shall be made to resolve any dispute as to the reasonable value of service prior to applying to the commissioner for resolution of such a dispute.

(d) Whenever an injured employee receives medical or hospital service or other remedial care under the provisions of this chapter and a dispute arises between the employer or the employer’s insurance carrier and the person, firm, or corporation rendering such service or care as to the reasonable value of the service or care, the commissioner shall have exclusive jurisdiction to determine the reasonable value of such service or care. Any interested party may petition for a hearing and all interested parties shall be entitled to notice and hearing if it is determined that all reasonable efforts to resolve the dispute have failed.

(e) The commissioner or the commissioner’s authorized representative shall make a finding as to the reasonable value of such services or care rendered.

(f) Any party in interest aggrieved by such a finding may appeal to the compensation appeals board under RSA 281-A:43.

210:4 Effective Date. This act shall take effect 60 days after its passage.

Approved: July 6, 2015

Effective Date: September 4, 2015