HB 434 - AS INTRODUCED
1999 SESSION
HOUSE BILL 434
AN ACT providing that health care providers shall determine the appropriate course of patient treatment.
SPONSORS: Rep. Hess, Merr 11; Rep. Pilliod, Belk 3; Rep. M. Fuller Clark, Rock 36; Sen. Wheeler, Dist 21; Sen. McCarley, Dist 6
This bill provides that for covered benefits of any health insurers, health service corporations, health maintenance organization, and preferred provider arrangement, the health care provider shall determine the appropriate course of treatment and that no health care provider shall be penalized by an insurer or health plan for recommending a course of treatment.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
99-0702
01/09
STATE OF NEW HAMPSHIRE
In the Year of Our Lord One Thousand Nine Hundred and Ninety-Nine
AN ACT providing that health care providers shall determine the appropriate course of patient treatment.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; Individual Policies; Accident and Health Insurance. Amend RSA 415 by inserting after section 6-f the following new section:
415:6-g Treatment for Covered Benefits.
I. For the covered benefits of each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, to certificate holders of such insurance who are residents of this state, the health care provider, in consultation with the patient, shall determine the appropriate course of treatment, including but not limited to disease management, length of hospital stay and surgical intervention, provided that such determination of course of treatment is based on nationally published guidelines such as those promulgated by specialty societies recognized by the American Board of Medical Specialties, the Agency for Health Care Policy and Research, the National Institutes for Health, or other similar nationally recognized organizations or is within standards of good and generally accepted medical practice as reflected by scientific and peer medical literature and recognized within the organized medical community in the state of New Hampshire.
II. No health care provider shall be penalized by an accident or health insurer or health plan for recommending a course of treatment for a covered benefit as provided in paragraph I.
2 New Section; Accident and Health Insurance. Amend RSA 415 by inserting after section 18-h the following new section:
415:18-i Treatment for Covered Benefits.
I. For the covered benefits of each insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for medical or hospital expenses to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, the health care provider, in consultation with the patient, shall determine the appropriate course of treatment, including but not limited to disease management, length of hospital stay, and surgical intervention, provided that such determination of course of treatment is based on nationally published guidelines such as those promulgated by specialty societies recognized by the American Board of Medical Specialties, the Agency for Health Care Policy and Research, the National Institutes for Health, or other similar nationally recognized organizations or is within standards of good and generally accepted medical practice as reflected by scientific and peer medical literature and recognized within the organized medical community in the state of New Hampshire.
II. No health care provider shall be penalized by an accident or health insurer or health plan for recommending a course of treatment for a covered benefit as provided in paragraph I.
3 New Section; Health Service Corporations. Amend RSA 420-A by inserting after section 17-b the following new section:
420-A:17-c Treatment for Covered Benefits.
I. For the covered benefits of every health service corporation and every similar corporation licensed under the laws of another state that issues or renews any policy of individual or group blanket accident or health insurance providing benefits for medical or hospital expenses to each individual or group or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, the health care provider, in consultation with the patient, shall determine the appropriate course of treatment, including but not limited to disease management, length of hospital stay and surgical intervention, provided that such determination of course of treatment is based on nationally published guidelines such as those promulgated by specialty societies recognized by the American Board of Medical Specialties, the Agency for Health Care Policy and Research, the National Institutes for Health, or other similar nationally recognized organizations or is within standards of good and generally accepted medical practice as reflected by scientific and peer medical literature and recognized within the organized medical community in the state of New Hampshire.
II. No health care provider shall be penalized by a health service corporation or health plan for recommending a course of treatment for a covered benefit as provided in paragraph I.
4 New Section; Health Maintenance Organizations. Amend RSA 420-B by inserting after section 8-g the following new section:
420-B:8-gg Treatment for Covered Benefits.
I. For the covered benefits of every health maintenance organization and every similar corporation licensed under the laws of another state that issues or renews any policy of individual or group blanket health insurance providing benefits for medical or hospital expenses to each individual or group or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, the health care provider, in consultation with the patient, shall determine the appropriate course of treatment, including but not limited to disease management, length of hospital stay and surgical intervention, provided that such determination of course of treatment is based on nationally published guidelines such as those promulgated by specialty societies recognized by the American Board of Medical Specialties, the Agency for Health Care Policy and Research, the National Institutes for Health, or other similar nationally recognized organizations or is within standards of good and generally accepted medical practice as reflected by scientific and peer medical literature and recognized within the organized medical community in the state of New Hampshire.
II. No health care provider shall be penalized by a health maintenance organization or health plan for recommending a course of treatment for a covered benefit as provided in paragraph I.
5 Effective Date. This act shall take effect January 1, 2000.