HB 1725-FN – AS AMENDED BY THE HOUSE

29Mar2012… 1329h

2012 SESSION

12-3071

01/09

HOUSE BILL 1725-FN

AN ACT prohibiting health care practitioner self-referrals for medical devices.

SPONSORS: Rep. Jasper, Hills 27; Rep. Hess, Merr 9; Rep. Chandler, Carr 1; Rep. Bettencourt, Rock 4; Rep. G. Richardson, Merr 4; Rep. Pierce, Graf 9; Rep. Hagan, Rock 7; Rep. O'Brien, Hills 4; Rep. Wall, Straf 7; Sen. Lambert, Dist 13; Sen. Luther, Dist 12

COMMITTEE Judiciary

AMENDED ANALYSIS

This bill prohibits health care practitioners, including physicians, from referring, recommending, ordering, or arranging for the acquisition of medical devices for patients under their care if the medical device is supplied directly or indirectly by an entity in which the referring practitioner has a direct or indirect ownership interest.

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

29Mar2012… 1329h

12-3071

01/09

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Twelve

AN ACT prohibiting health care practitioner self-referrals for medical devices.

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

1 New Subdivision; Prohibited Self Referrals. Amend RSA 125 by inserting after section 25-c the following new subdivision:

Prohibited Self-Referrals

125:25-d Prohibited Self-Referrals.

I. In this subdivision:

(a) “Health care practitioner” means “health care practitioner” as defined in RSA 125:25-a.

(b) “Medical device” means any Food and Drug Administration class II or III implantable medical device.

(c) “Ownership interest” means “ownership interest” as defined in RSA 125:25-a.

(d) “Referral” means a health care practitioner’s request for, ordering of, or certifying or recertifying the need for, any medical device, or a health care practitioner’s request that includes the provision of any medical device, the establishment of a plan of care that includes the provision of a medical device, or the certifying or recertifying of the need for a medical device. A health care practitioner refers a person to a supplier for a medical device when the health care practitioner directly or indirectly chooses or directs or requests another to choose the supplier of the medical device.

(e) “Supplier” means an entity that sells, or arranges for or negotiates contracts for purchase or sale of, medical devices, including a manufacturer, distributor, group purchasing organization, sales agent, or other medical device supplier. The term supplier does not include the health care facility or medical office where the implant procedure is performed.

II. Notwithstanding any provision of law to the contrary, a health care practitioner, including an immediate family member, shall not:

(a) Profit indirectly or directly from the sale of a medical device by any supplier in which the health care practitioner has a direct or indirect ownership interest.

(b) Make a referral of a person to a supplier for a medical device if the health care practitioner has a direct or indirect ownership interest in the supplier.

(c) Enter into a contract or business arrangement with another entity where the purpose or effect of the contract or business arrangement is to accomplish prohibited self-referrals indirectly, such as through the use of a third party, or through the use of a cross-referral agreement. Such prohibited contracts or business arrangements shall include any arrangement that requires or has the purpose or effect of causing the purchase of such medical devices from a specific supplier as a

condition of, or incident to the provision of medical care by the health care practitioner.

III. No claim for payment shall be presented to any individual, third party payer, or other entity, for any medical device provided incident to the provision of a medical device furnished in violation of this subdivision.

IV. Failure to comply with this subdivision shall constitute an unfair or deceptive act or practice in violation of RSA 358-A.

V. In addition to penalties pursuant to paragraph IV, violators of this subdivision may be fined up to $5,000 per procedure for a first offense and a second offense may result in suspension or loss of professional licensure and up to a $10,000 fine.

2 Effective Date. This act shall take effect 90 days after its passage.

LBAO

12-3071

02/16/12

HB 1725-FN - FISCAL NOTE

AN ACT prohibiting health care practitioner self-referrals for medical devices.

FISCAL IMPACT: