House Bill 1316 was signed by Governor Hassan on May 27, 2016 to be effective July 26th 2016. This bill will require hospital’s to limit the amount they charge to “self pay” patients to the same rate they generally receive from health carriers. For those who self pay for medical treatment this is important news as some providers were billing for services at a higher rate than the amount they accepted from the insurance companies with whom providers have contractual discounts. Now, the same discounted price afforded to the big insurance companies will be passed on to the private payer.
The one exception is for those who self pay, but have another form of insurance available such as med pay, or other liability coverage. These people can still be charged at a higher rate. This may result in providers having to determine if the self pay patient has other available coverage at the time of service and open up a can of worms. Does an individual have “liability coverage” if the claim has been denied and is in litigation? Also, this will require that patients understand what Med Pay is and many do not.
This looks like a good step forward in offering fair billing to those without health insurance, but it looks like there is more work to be done. We will need to keep our eye on this! Here is the language of the bill in its final form:
139:1 Hospital Rates for Self-Pay Patients. Amend RSA 151:12-b to read as follows:
1. 151:12-b Hospital Rates for Self-Pay Patients. When billing self-pay patients for a service rendered, a hospital shall accept as payment in full an amount no greater than the amount generally billed and received by the hospital for that service for patients covered by health insurance. A hospital shall determine the amount generally billed to health carriers in a manner consistent with Section 9007 of the Patient Protection and Affordable Care Act of 2009. A hospital shall provide written notice to a self-pay patient in advance of providing a service and at the time the service is billed regarding the requirements under this section. For the purposes of this section "hospital'' means an institution which is engaged in providing to patients, under supervision of physicians, diagnostic and therapeutic services for medical diagnosis, treatment, and care of injured, disabled, or sick persons, or rehabilitation services for the rehabilitation of such persons. The term "hospital'' includes psychiatric and substance abuse treatment hospitals. In this section, "self-pay" means a patient seeking care at a hospital who does not have any form of insurance, including, but not limited to, health insurance, MedPay coverage, or any other liability coverage.
139:2 Effective Date. This act shall take effect 60 days after its passage.
Approved: May 27, 2016
Effective Date: July 26, 2016