relative to licensing requirements for health care facilities established within a 15 mile radius of a critical access hospital and relative to transfers from freestanding hospital emergency facilities.
What changed between versions
The bill's title and scope were expanded to cover not just licensing notice requirements near critical access hospitals, but also transfers from freestanding hospital emergency facilities. The act name now applies only to sections 1 and 2 rather than the entire bill.
A new Section 3 states the purpose of the transfer provisions: to protect patient safety and continuity of care, ensure transfers are based on clinical appropriateness and regional access, and prevent practices that undermine community hospitals through coercive or exclusive transfer arrangements not clinically justified.
New RSA 151:54 defines key terms: 'Freestanding hospital emergency facility' (FHEF) as a geographically separate ER affiliated with a parent hospital; 'Parent hospital' as the acute care hospital that owns/controls the FHEF; 'Clinically appropriate'; 'Transfer' (excluding discharge to home or non-emergent referrals); and 'Medically necessary.'
New RSA 151:55 establishes transfer standards: transfers must be based primarily on clinical appropriateness, patient safety, continuity of care, and patient choice; patients must be informed of available clinically appropriate receiving hospitals; no facility can condition treatment or transfer on selecting a hospital based on ownership or affiliation; if the patient cannot participate in selection, transfer must follow state trauma/stroke/specialty systems, federal and state emergency law, and the patient's medical condition.
New RSA 151:56 prohibits FHEFs (and their owners/operators) from engaging in materially misleading communication or coercive conduct to direct patient transfers to an affiliated or parent hospital when another clinically appropriate hospital is reasonably available. The analysis also notes the state gains authority to enforce violations.