Eric Kropp

Dear Chairman Hunt and committee members, I am writing as a Bow resident and an independent family physician practicing in Concord in strong support of HB 1347. A health system should not deny a patient access to a specialist on the sole basis that their PCP is not employed by that system. This bill provides for equitable access to specialty care without imposing new financial obligations on specialists or insurers. In the last several years, appropriate and necessary specialist referrals have at times been refused solely because I, as an independent Primary Care Physician, was not employed by the same healthcare organization. With the consolidation and acquisitions of specialty practices by healthcare corporations in New Hampshire, there were no equivalent in-state alternatives, and my patients were forced to travel to Maine or Massachusetts for rheumatology and dermatology care. This was not about clinical appropriateness or insurance coverage; the specialists accepted the patients’ insurance. Patients were being coerced into changing their primary care provider to one within the health system in order to access specialty care. The American Medical Association recently adopted a policy directly addressing this issue, stating that health systems should not require patients to switch PCPs in order to access specialty care and that these practices are ethically unacceptable and harmful to patient welfare. This undermines patient autonomy, disrupts continuity of care, and limits access to healthcare. It prevents primary care practices (specifically independent practices) from collaborating with our specialist peers for optimal patient care. In rural areas especially, limiting referral access effectively eliminates specialty care for many patients. This kind of discrimination harms healthcare delivery and erodes patient trust in New Hampshire’s healthcare systems. In some cases, it drives patients out of the state for specialty care. HB 1347 protects patient choice, supports independent practice, and ensures equitable access to specialty care without imposing new costs on healthcare systems or insurers. It is urgently needed, and I hope that you will vote to pass HB 1347. Thank you for your kind consideration. Please feel free to contact me should you have any questions. Sincerely, Eric Kropp, MD