0248-hb 1377

CHAPTER 248

HB 1377 - FINAL VERSION

AN ACT prohibiting managed care organizations from disqualifying certain physicians as providers and relative to the duties of the joint health council.

SPONSORS: Rep. Martel, Hills 45; Rep. Quandt, Rock 20, Rep. P. Katsakiores, Rock 13; Rep. Emerton, Hills 7; Rep. Donovan, Sull 11; Sen. Brown, Dist 17; Sen. Krueger, Dist 16; Sen. D'Allesandro, Dist 20

This bill prohibits managed care organizations from disqualifying its provider-network physicians who are part of such network on December 31, 2000 solely on the basis that such physicians are not certified by one of the American Board of Medical Specialties' approved boards .

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

AN ACT prohibiting managed care organizations from disqualifying certain physicians as providers and relative to the duties of the joint health council.

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

248:1 New Section; Disqualification of Certain Physicians Prohibited. Amend RSA 420-J by inserting after section 7-b the following new section:

420-J:7-c Disqualification of Certain Physicians Prohibited. A physician who is part of a health carrier's provider network on December 31, 2000, shall not be disqualified from participating in that network solely because such physician is not certified by a member board of the American Board of Medical Specialties.

248:2 Joint Health Council Duties. Amend RSA 326-B:10-a, III to read as follows:

III. The duties of the joint health council shall include, but not be limited to, determining the type of A.R.N.P. formulary, exclusionary, inclusionary, or other, and adding or altering the list of controlled and noncontrolled molecular entities on the A.R.N.P. formulary. Decisions on such additions or alterations shall be rendered within 3 months of initial consideration by the council unless there is a request for additional scientific information. Appeals of decisions of the council shall be submitted to the council in writing for further deliberation by the council. The A.R.N.P. formulary shall be updated at least annually and shall be available in paper and electronic format from the board of nursing, the board of medicine, and the board of pharmacy.

AN ACT prohibiting managed care organizations from disqualifying certain physicians as providers and relative to the duties of the joint health council.

The Board of Nursing has stated that this bill, as amended by the Senate, may increase state revenue and expenditures by an indeterminable amount in FY 2001 and each year thereafter. There will be no fiscal impact on county and local revenue or expenditures.

The Board of Nursing indicates that if the Joint Health Council chooses an inclusionary A.R.N.P. (Advanced Registered Nurse Practitioner) formulary, then there may be an increase in state general fund expenditures by an indeterminable amount in order to develop, research and print such formulary. Consequently, because the Board is required by statute to collect fees at 125% of operating costs, state general fund revenues will increase accordingly.

The Boards of Medicine and Pharmacy have indicated that this bill will have no fiscal impact on their Boards.