TITLE LX
CORRECTION AND PUNISHMENT
Chapter 623-C
MEDICAL SERVICES FOR PRISONERS
Section 623-C:1
623-C:1 Medical Services for County Prisoners. –
I. (a) Except as provided in subparagraphs (b) through (g), the county department of corrections or its agent shall pay health care facilities licensed pursuant to RSA 151 no more than 110 percent of the Medicare allowable rate for inpatient, outpatient, or emergency room care provided for prisoners in county correctional facilities.
(b) Except as provided in subparagraphs (c) through (e), and subparagraph (i), the county department of corrections or its agent shall pay independent health care providers licensed in this state no more than 125 percent of the Medicare allowable rate for care provided for prisoners in county correctional facilities.
(c) Allowances provided by hospitals shall qualify as community benefits under RSA 7:32-d, III(b).
(d) The county department of corrections shall pay health care facilities licensed pursuant to RSA 151 and reported by the department of health and human services as having a negative operating margin in the most recent year for which audited financial data is available no more than 125 percent of the Medicare rate.
(e) Nothing in this section shall preclude the superintendent of a county correctional facility from negotiating and executing medical service rate agreements with health care facilities licensed pursuant to RSA 151, or other licensed medical providers, for the provision of medical or dental services to county prisoners at the lowest rate possible, or utilizing rates in existing agreements.
(f) The superintendent of a county correctional facility may waive the application of subparagraph (a) if the superintendent determines such action is necessary to ensure prisoner access to medically necessary care.
(g) The superintendent of a county correctional facility may waive the application of subparagraph (a) if the superintendent determines such action to be necessary for the efficient operations of the county correctional facility.
(h) The superintendent of a county correctional facility may at any time audit any claim or seek clarification on any payment made pursuant to this section, or both. Upon request by the superintendent, the provider shall furnish information on pricing methodology and shall detail any internal process controls for ensuring accurate pricing of claims processed under this section. Claim information shall be provided in the industry standard format, including but not limited to the application of global surgery provisions, billing for surgical assistants, and bundling.
(i) If a county prisoner's medical care is covered by Medicaid, the health care facility licensed pursuant to RSA 151, or the licensed health care provider, or both, shall be paid at the Medicaid rate for services provided.
II. Pharmacists shall substitute generically equivalent drug products for all legend and non-legend prescriptions paid for by the county department of corrections, including the medicaid program, unless the prescribing practitioner specifies that the brand name drug product is medically necessary. Such notification shall be in the practitioner's own handwriting and shall be retained in the pharmacist's file. The superintendent may waive the application of RSA 623-C:1, I if the superintendent determines such action is necessary to ensure the availability of prescription and other pharmaceutical services to persons served by the county or to avert serious economic hardship in the provision of prescriptions and other pharmaceutical services. The county commissioners shall adopt necessary rules and regulations to implement this paragraph.
Source. 2004, 218:1, eff. June 11, 2004. 2013, 85:1, eff. July 1, 2013.
Section 623-C:1-a
623-C:1-a Use of Restraints on Pregnant Women in County Correctional Custody. –
I. The use of restraints on pregnant women under county correctional custody shall be limited to absolute necessity only. The use of restraints shall be considered absolutely necessary only when there is evidence of imminent risk of escape or harm to the pregnant woman, her fetus or newborn, or others, and these risks cannot be managed by other reasonable means, including but not limited to, enhanced security measures in the area, or increased staffing.
II. Pregnant residents classified to a halfway house or transitional housing unit shall not be restrained. All other pregnant residents may be restrained only if absolutely necessary, and if deemed absolutely necessary, may be restrained as follows:
(a) In the first, second, and third trimester, front handcuffs only. If wrist restraints must be applied, they shall have a chain between the wrists and shall be applied in such a way that the pregnant woman may be able to protect herself and her fetus in the event of a forward fall (in front of her body). No belly chains, leg restraints, or ankle restraints shall be used under any circumstances. No additional restraints shall be used during transportation unless approved by the county correctional facility's chief medical officer after an individualized determination is made that there is an extraordinary medical or security circumstance that dictates restraints be used to ensure the safety and security of the resident or detainee, the staff of the county correctional facility, other residents or detainees, or the public; except that if the doctor, nurse or other health professional treating the resident or detainee requests that restraints not be used, the corrections officer accompanying the resident or detainee shall immediately remove all restraints unless the correctional officer can identify there is an extraordinary risk to the public and receives authorization from the superintendent of the county correctional facility or designee. This authorization shall be documented in an incident report which shall, at a minimum, contain the following:
(1) The rationale for use or conditions that led to the conclusion that restraints were necessary and specify whether and what kind of alternatives were tried/considered.
(2) The name of each person who reviewed these conditions and concluded that restraints were warranted.
(3) The type of restraints used and in what manner.
(4) How frequently the use of restraints was reevaluated and by whom and result of such reassessments.
(5) Change in conditions that led to the conclusion that restraints were no longer necessary.
(6) When restraints were removed.
(7) Length of time or total duration of restraint use.
(b) The life of the infant and or mother shall not be put at risk. Any additional restraint shall be the least restrictive possible.
III. Advance planning among members of the pregnant female's health care team, including on site, hospital-based, and corrections professionals shall be conducted before hospital admittance to prepare for any foreseen circumstances which may involve the use of restraint. During transportation for labor or delivery, after delivery, or while in postpartum recovery, a resident shall not be restrained, unless approved by the county correctional facility's chief medical officer after an individualized determination is made that there is some other extraordinary medical or security circumstance that dictates restraints be used to ensure the safety and security of the resident or detainee. If the doctor, nurse, or other health professional treating the resident or detainee requests that restraints not be used, the corrections officer accompanying the resident or detainee shall immediately remove all restraints. Restraints, if previously authorized prior to the medical staff requiring them removed, may be reapplied once the medical professional determines the immediate threat to the mother or child has passed. Any additional restraint shall be the least restrictive possible and approval of such restraint shall be documented in writing with the reason for the restraint as required in subparagraph II(a). An incarcerated pregnant person in labor, delivery, and postpartum recovery shall be given the maximum level of privacy possible. If possible, any corrections officer present in the room should be of the same gender and shall stand in a place that grants as much privacy as possible. "Postpartum recovery" means, as determined by her physician, the period immediately following delivery, including the entire period a woman is in the hospital or infirmary after birth. If restraints are used while the inmate is in labor or in the hospital during recovery after delivery, the superintendent of the county correctional facility shall make written findings as to the reasons why mechanical restraints were necessary to prevent escape or to ensure the safety of the inmate, medical, and correctional personnel, or the public.
Source. 2022, 229:1, eff. Aug. 16, 2022.
Section 623-C:2
623-C:2 Medical Services for State Prisoners. –
I. (a) Except as provided in subparagraphs (b) through (f), the state department of corrections or its agent shall pay health care facilities licensed pursuant to RSA 151 no more than 110 percent of the Medicare allowable rate for inpatient, outpatient, or emergency room care provided for prisoners in state correctional facilities.
(b) Except as provided in subparagraphs (c) through (e), and subparagraph (h), the state department of corrections or its agent shall pay independent health care providers licensed in this state no more than 125 percent of the Medicare allowable rate for care provided for prisoners in state correctional facilities.
(c) Allowances provided by hospitals shall qualify as community benefits under RSA 7:32-d, III(b).
(d) The state department of corrections shall pay health care facilities licensed pursuant to RSA 151 and reported by the department of health and human services as having a negative operating margin in the most recent year for which audited financial data is available no more than 125 percent of the Medicare rate.
(e) The commissioner of the state department of corrections may waive the application of subparagraph (a) if the commissioner determines such action is necessary to ensure prisoner access to medically necessary care.
(f) The commissioner of the state department of corrections may waive the application of subparagraph (a) if the commissioner determines such action to be necessary for the efficient operations of the state correctional facility.
(g) The commissioner of the state department of corrections may at any time audit any claim or seek clarification on any payment made pursuant to this section, or both. Upon request by the commissioner, the provider shall furnish information on pricing methodology and shall detail any internal process controls for ensuring accurate pricing of claims processed under this section. Claim information shall be provided in the industry standard format, including but not limited to the application of global surgery provisions, billing for surgical assistants, and bundling.
(h) If a state prisoner's medical care is covered by Medicaid, the facility or the licensed health care provider, or both, shall be paid at the Medicaid rate for services provided.
II. Nothing in this section shall preclude the commissioner of the state department of corrections from negotiating and executing medical service rate agreements with health care facilities licensed pursuant to RSA 151, or other licensed medical providers, for the provision of medical or dental services to state prisoners at the lowest rate possible, or utilizing rates in existing agreements.
III. Pharmacists shall substitute generically equivalent drug products for all legend and non-legend prescriptions paid for by the department of corrections, including the Medicaid program, unless the prescribing practitioner specifies that the brand name drug product is medically necessary. Such notification shall be in the practitioner's own handwriting and shall be retained in the pharmacist's file. The commissioner of the department of corrections may waive the application of RSA 623-C:2, I if the commissioner determines such action is necessary to ensure the availability of prescription and other pharmaceutical services to persons served by the state or to avert serious economic hardship in the provision of prescriptions and other pharmaceutical services. For Medicaid fee for service clients, no prior authorization for generically equivalent drugs shall be required.
Source. 2004, 218:1, eff. June 11, 2004. 2009, 144:264, eff. Aug. 28, 2009. 2013, 85:2, eff. July 1, 2013. 2015, 276:208, eff. July 1, 2015.
Section 623-C:2-a
623-C:2-a Use of Restraints on Pregnant Women in State Correctional Custody. –
I. The use of restraints on pregnant women under state correctional custody shall be limited to absolute necessity only. The use of restraints shall be considered absolutely necessary only when there is evidence of imminent risk of escape or harm to the pregnant woman, her fetus or newborn, or others, and these risks cannot be managed by other reasonable means, including but not limited to, enhanced security measures in the area, or increased staffing.
II. Pregnant residents classified to a halfway house or transitional housing unit shall not be restrained. All other pregnant residents may be restrained only if absolutely necessary, and if deemed absolutely necessary, may be restrained as follows:
(a) In the first, second, and third trimester, front handcuffs only. If wrist restraints must be applied, they shall have a chain between the wrists and shall be applied in such a way that the pregnant woman may be able to protect herself and her fetus in the event of a forward fall (in front of her body). No belly chains, leg restraints, or ankle restraints shall be used under any circumstances. No additional restraints shall be used during transportation unless approved by the director of medical and forensic services after an individualized determination is made that there is an extraordinary medical or security circumstance that dictates restraints be used to ensure the safety and security of the resident or detainee, the staff of the state correctional facility, other residents or detainees, or the public; except that if the doctor, nurse or other health professional treating the resident or detainee requests that restraints not be used, the corrections officer accompanying the resident or detainee shall immediately remove all restraints unless the correctional officer can identify there is an extraordinary risk to the public and receives authorization from the warden of the correctional facility or designee. This authorization shall be documented in an incident report which shall, at a minimum, contain the following:
(1) The rationale for use or conditions that led to the conclusion that restraints were necessary and specify whether and what kind of alternatives were tried/considered.
(2) The name of each person who reviewed these conditions and concluded that restraints were warranted.
(3) The type of restraints used and in what manner.
(4) How frequently the use of restraints was reevaluated and by whom and result of such reassessments.
(5) Change in conditions that led to the conclusion that restraints were no longer necessary.
(6) When restraints were removed.
(7) Length of time or total duration of restraint use.
(b) The life of the infant and or mother shall not be put at risk. Any additional restraint shall be the least restrictive possible.
III. Advance planning among members of the pregnant female's health care team, including on site, hospital-based, and corrections professionals shall be conducted before hospital admittance to prepare for any foreseen circumstances which may involve the use of restraint. During transportation for labor or delivery, after delivery, or while in postpartum recovery, a resident shall not be restrained, unless approved by the director of medical and forensic services after an individualized determination is made that there is some other extraordinary medical or security circumstance that dictates restraints be used to ensure the safety and security of the resident or detainee. If the doctor, nurse, or other health professional treating the resident or detainee requests that restraints not be used, the corrections officer accompanying the resident or detainee shall immediately remove all restraints. Restraints, if previously authorized prior to the medical staff requiring them removed, may be reapplied once the medical professional determines the immediate threat to the mother or child has passed. Any additional restraint shall be the least restrictive possible and approval of such restraint shall be documented in writing with the reason for the restraint as required in subparagraph II(a). An incarcerated pregnant person in labor, delivery, and postpartum recovery shall be given the maximum level of privacy possible. If possible, any corrections officer present in the room should be of the same gender and shall stand in a place that grants as much privacy as possible. "Postpartum recovery" means, as determined by her physician, the period immediately following delivery, including the entire period a woman is in the hospital or infirmary after birth. If restraints are used while the inmate is in labor or in the hospital during recovery after delivery, the warden of the state correctional facility shall make written findings as to the reasons why mechanical restraints were necessary to prevent escape or to ensure the safety of the inmate, medical, and correctional personnel, or the public.
Source. 2022, 229:2, eff. Aug. 16, 2022.