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Thursday, May 17, 2012

Senate approves repealing hospital certification process

CONCORD – Lawmakers seeking to do away with the certification process for New Hampshire hospitals may have to wait at least five years before they get their way.

The state Senate voted Wednesday to approve an amended version of HB 1617, which proposed to do away with the certificate of need process for hospitals and medical centers. The version matched the bill’s original intent, proposing to do away with the certification process. But as opposed to the original bill, it opted to do so five years from now.

The original bill passed the House of Representatives last month, but the amended version will now return to the House for further consideration.

“This is a reasonable compromise that puts all of us on record … that we need a comprehensive approach to certificate of need,” Senate Majority Leader Jeb Bradley, R-Wolfeboro, said Wednesday as he proposed the amendment.

“There needs to be a thorough look through the process,” Bradley said. “This gives us time to do that.”

House Republicans initially proposed the bill this fall seeking to encourage competition and growth in the health care sector.

“We have a regulatory process in place which stifles competition and prevents new entries,” Rep. Marilinda Garcia, R-Salem, said earlier this year. Garcia sponsored a similar bill, HB 1642, seeking to exempt for-profit specialty hospitals from the certification process.

Medical professionals and hospital officials, however, opposed both proposals, saying repealing or amending the certification process would invite medical centers who serve only patients with full insurance coverage. This would leave traditional hospitals serving those patients on Medicare and Medicaid who are unable to pay for their own care, Steve Ahnen, president of the New Hampshire Hospital Association, said earlier this year.

This would force hospitals to absorb those costs not covered by the federal programs, possibly at the cost of other hospital programs, he said.

“Every hospital in the state of New Hampshire takes care of patients without regard to pay or without regard to the insurance they have,” Ahnen said. “But (these for-profit institutions) say they can’t be all things to all people. … That’s a very dangerous precedent to set.”

Both the for-profit exemption and the outright repeal bill passed the House earlier this spring, but they stalled in the Senate. Earlier this month, Senators elected to table the for-profit exemption bill, and on Wednesday, they altered the repeal proposal, to give lawmakers more time to address the certificate of need process.

“(The certification process is) a miserable failure. … It’s late and this is as good as it’s going to get, but there’s no question that feet need to be held to the fire,” Sen. Ray White, R-Bedford, said Wednesday.

“On one hand, people can say (the process) hasn’t kept health care costs in check … but is the answer to get rid of it?” asked Tom Bunnell, director of the Health Policy Institute at the University of New Hampshire School of Law. “Or is the answer to make it more effective? … This is a good compromise.”

Jake Berry can be reached at 594-6402 or jberry@nashuatelegraph.com.