Committee Summary for Senate Health and Human Services (04/02/2025)

Bill/Time	Type	Title	Sponsor
HB117 00:02:23.840 - 8:46:09 AM	Public Hearing	relative to the substitution of biological products.	Layon, Erica(R)[A]2024
HB223 00:17:30.400 - 9:01:16 AM	Public Hearing	relative to licensing requirements for health care facilities that operate within 15 miles of a critical access hospital.	McLean, Mark(R)[A-]2024
HB732 01:57:45.480 - 10:41:31 AM	Public Hearing	to enhance informed consent and accountability in psychotropic drug prescriptions for children under Medicaid.	Cordelli, Glenn(R)[A-]2024

HB117: Erica Leon, Rockingham 13, Derry Support00:02:23.840 - 8:46:09 AM; Erica Leon introduced House Bill 117, which aims to standardize the language around interchangeable biologic products to potentially lower the cost of biologics for patients. She highlighted the financial burden of biologics and the importance of biosimilars in reducing costs. Leon discussed the safety and efficacy of biosimilars, stating there have been no unique side effects reported worldwide. She emphasized the need for updated state laws to align with potential federal changes, referencing past issues with the right to try law and epinephrine amendments. Leon also mentioned the potential savings of $2.5 million for the state.
HB117: Chris Kent, Amgen Oppose00:08:39.240 - 8:52:25 AM; Chris Kent from Amgen expressed opposition to House Bill 117, arguing that it is unnecessary and does not accomplish its intended goals. He highlighted that the bill responds to a hypothetical change in federal law, the Red Tape Elimination Act, which has not been reintroduced and may not pass. Kent also pointed out inconsistencies and confusing language within the bill as passed by the House. However, he expressed willingness to work with the committee to streamline the bill without changing the sponsor's intent.
HB117: Michael Lon Support00:12:42.600 - 8:56:28 AM; Michael Lon spoke in favor of House Bill 117, emphasizing the significant cost savings it could offer to patients and taxpayers. He stressed the importance of biosimilars in providing affordable treatment options for serious illnesses, noting the global safety record of biosimilars and the potential for the state to save $2.5 million in the first year.
HB223: Representative McLean Support00:17:30.400 - 9:01:16 AM; Representative McLean introduced House Bill 223, which aims to open up the healthcare marketplace in rural areas by adjusting licensing requirements for healthcare facilities near critical access hospitals. He cited the ongoing decline of services in rural communities and provided examples such as the closure of services in Franklin in October 2020.
HB223: Representative McLean Support00:18:35.679 - 9:02:21 AM; Representative McLean discusses the challenges faced by rural hospitals in New Hampshire, including the closure of maternity wards and the financial strain on critical access hospitals. He highlights the 15-mile exclusion zone around critical access hospitals as a barrier to healthcare development in rural areas. The bill, HB223, aims to eliminate these exclusion zones to allow for more healthcare facilities to be established, arguing that the current model is unsustainable and that innovation is needed to prevent further healthcare deserts in rural areas. He acknowledges the risk to critical access hospitals but emphasizes the need for action to address the impending crisis.
HB223: Senator Apprentice Information Only00:24:23.960 - 9:08:09 AM; Senator Apprentice asks Representative McLean about the barriers to establishing non-hospital healthcare facilities in rural areas, specifically within the 15-mile radius of critical access hospitals. Representative McLean explains that the main barrier is the exclusion zone, which requires approval from the impacted critical access hospital, making it difficult to establish new facilities. He mentions that other barriers include federal regulations on bed numbers and payer requirements.
HB223: Jerry Kerk, Retired Physician and State Rep Oppose00:40:47.520 - 9:24:33 AM; Jerry Kerk, a retired physician and former State Representative, opposes HB223. He argues that critical access hospitals are essential for rural healthcare and that the bill could negatively impact their financial stability by allowing other facilities to cherry-pick high-reimbursement patients. He emphasizes the importance of the current process, which involves an expert study to assess the impact of new facilities on existing hospitals. Kerk believes that the bill could lead to the closure of critical services and urges the committee to vote against it.
HB223: Nick Veis, CEO of Bedford Ambulatory Surgical Center Support00:49:38.799 - 9:33:24 AM; Nick Veis supports HB223, arguing that the current system, which he compares to the certificate of need process, raises healthcare costs and limits competition. He believes that rural hospitals should not be overly concerned about the bill, as the real need is to support federally qualified rural health centers. Veis emphasizes the importance of competition in lowering healthcare costs, particularly in rural areas where costs are high. He advocates for public-private partnerships and innovation to improve healthcare access and affordability.
HB223: Ben Bradley, representing New Hampshire's acute care and critical access hospitals Oppose01:12:36.440 - 9:56:22 AM; Ben Bradley, representing New Hampshire's acute care and critical access hospitals, expressed opposition to HB223. He highlighted the financial challenges faced by critical access hospitals, which have low volumes and high fixed costs, and are heavily dependent on public payers like Medicare and Medicaid. Bradley argued that the bill could threaten the financial viability of these hospitals, potentially leading to closures and the creation of access deserts for essential services like maternity and emergency care. He referenced a 2019 bipartisan study committee that recommended legislation to protect these hospitals, which became law in 2020. Bradley criticized HB223 for breaking faith with this negotiated statute and urged the committee to find it inexpedient to legislate.
HB223: Kena Peri, Chief Operating Officer and Chief Nursing Officer at Littleton Regional Healthcare in Littleton, New Hampshire Oppose01:19:50.159 - 10:03:36 AM; Kena Peri, from Littleton Regional Healthcare, opposed HB223, emphasizing the importance of critical access hospitals in rural communities. She provided a real-life example of how the opening of a Convenient MD facility near Littleton Regional Healthcare led to loss of volume, revenue, and staff, and disrupted the continuity of care. Peri argued that the bill threatens rural healthcare by eliminating notice and consent requirements for new healthcare facilities within 15 miles of critical access hospitals. She stressed the need for support to maintain the stability and quality of healthcare in rural New Hampshire.
HB223: Ryan Hansen, Senior Vice President at Convenient MD Support01:28:36.679 - 10:12:22 AM; Ryan Hansen from Convenient MD supported HB223, discussing the challenges of the current critical access process. He explained that the process creates a divide between hospitals and private practices, making it difficult to establish partnerships. Hansen detailed the lengthy and costly process of opening new facilities, including the risk of signing leases before going through the critical access process. He contrasted this with the more collaborative approach in Massachusetts, where transfer agreements foster partnerships between urgent care centers and hospitals.
HB223: Selena Frost, healthcare professional Support01:35:26.440 - 10:19:12 AM; Selena Frost expressed strong support for HB223, emphasizing the importance of urgent care centers in bridging the gap between primary care and emergency services. She highlighted the cost-saving potential and the reduction of strain on emergency rooms and primary care offices. Frost argued that the bill would improve access to necessary healthcare, particularly in rural and underserved communities, and urged a collaborative approach among all healthcare entities to enhance patient outcomes and system efficiency.
HB223: Representative Timothy Horan from Strafford County District 10, Durham Oppose01:49:51.280 - 10:33:37 AM; Representative Timothy Horan from Durham opposed HB223, arguing that the laws of economics do not apply to healthcare in the same way as in other industries. He emphasized the unique challenges and responsibilities of small rural hospitals, which have high overhead and rely on a payer mix that includes Medicare and Medicaid. Horan suggested that the bill could undermine the stability of these hospitals and advocated for maintaining the current protections for critical access hospitals.
HB223: Courtney Tanner, Senior Director of Government Relations at Dartmouth Health Oppose01:53:57.760 - 10:37:43 AM; Courtney Tanner from Dartmouth Health opposed HB223, underscoring the challenges faced by hospitals, particularly in the North Country. She highlighted the importance of balancing privilege and responsibility in healthcare and the need to protect the payer mix and patient population that supports rural hospitals. Tanner emphasized Dartmouth Health's investment in the North Country, including initiatives to support maternal health infrastructure, and argued that the bill could jeopardize the vitality of their system.
HB732: Clen Cordelli, representing Tuftonborough, Wolfeboro, and Ossipee Support01:57:45.480 - 10:41:31 AM; Representative Cordelli introduced House Bill 732, emphasizing the importance of parents' rights and transparency regarding psychotropic drug prescriptions for children under Medicaid. He highlighted the risks associated with these drugs, such as addiction, suicidal ideation, aggression, and hallucinations, and stressed that parents should be informed about these risks. The bill mandates that FDA medication guides must be presented to parents when their children are prescribed psychotropic drugs under Medicaid. Cordelli noted that these guidelines are required by federal law and are meant to be easily understandable, covering risks and side effects. The bill aims to ensure that providers review these guidelines with parents and obtain written informed consent. He also mentioned a letter of support from the consumer representative on an FDA drug advisory committee and set the effective date of the legislation a year out to allow time for awareness and preparation.
HB732: Senator Apprentice Information Only02:01:48.280 - 10:45:34 AM; Senator Apprentice questioned the necessity of the bill, specifically focusing on lines 25 and 26, which mention reporting medical care providers to the Board of Medicine for failing to comply with informed consent and medication guide requirements. He sought clarification on whether parents of minor children are not being properly consented when their children receive prescriptions. Cordelli responded by emphasizing the bill's aim to ensure parents are aware of the risks and possible benefits of the medications their children might take, mentioning his experience on the education committee where ADHD and medication prescriptions are commonly discussed.
HB732: Senator Long Information Only02:04:18.920 - 10:48:04 AM; Senator Long inquired about the potential added costs of requiring the review of FDA guidelines by prescribing physicians. Cordelli stated that the guidelines are freely available online, but acknowledged that printing and reviewing them with parents might incur some costs. Long shared his personal experience with his son's ADHD diagnosis and medication, expressing concerns about the practicality of requiring such reviews for every prescription.
HB732: Jonathan Ballard, Chief Medical Officer at the New Hampshire Department of Health and Human Services Information Only02:08:33.360 - 10:52:19 AM; Dr. Ballard, along with colleagues David Journey and Rob Berry, provided informational testimony about the medical and administrative implications of House Bill 732. He explained that the bill introduces additional requirements specifically for Medicaid beneficiaries, which differs from the usual practice of treating patients regardless of their payer source. Ballard discussed the consent-to-treat document required by Medicaid and all insurers, noting it is typically administered annually. He also addressed the broad definition of psychotropic medications in the bill, which could include medications beyond those used for psychiatric conditions, and raised concerns about the practical application of the bill in various medical settings, including emergency situations. He mentioned the potential impact on a small portion of the population and the logistical issues related to knowing the payer source at the time of prescription.
HB732: David Journey, Deputy Medicaid Director Information Only02:16:00.920 - 10:59:46 AM; David Journey discussed the cost projections associated with implementing House Bill 732, estimating a range of one to two and a half million dollars. He explained that the costs stem from two main areas: the resources needed to oversee the legislation and potential medical costs due to decreased access to care or increased care settings due to the bill's requirements. Journey detailed the process of monitoring compliance, which would involve both automated claims auditing and manual chart reviews to ensure that enhanced informed consent was provided and documented.
HB732: Rob Barry, General Counsel of the Division of Medicaid Information Only02:16:51.558 - 11:00:37 AM; Rob Barry provided detailed information on the process of suspending Medicaid providers, emphasizing the necessity of providing notice and appeal rights to the providers. He explained that the process is lengthy and involves multiple stages including initial review, notice of suspension, and appeal, which can take significant time and resources. He also raised concerns about the vagueness in the legislation regarding the duration of suspension and suggested the need for explicit rule-making authority to clarify these aspects.
HB732: Kathy Stratton, CEO of the New Hampshire Medical Society Oppose02:20:02.240 - 11:03:48 AM; Kathy Stratton expressed opposition to HB732, highlighting several concerns. She noted that the bill had initially gone unnoticed by the society due to internal transitions. She criticized the proposed standard for informed consent based on FDA guidelines as being too complex and lengthy, suggesting it would not effectively ensure understanding. She emphasized the importance of the existing physician-patient dialogue for informed consent, which allows for personalized feedback and discussion. Additionally, she pointed out the administrative burden the bill would impose, including the need for lengthy documents and the lack of accommodations for electronic or other forms of delivery. Stratton also expressed concerns about the bill's potential to create different standards for Medicaid and non-Medicaid patients, which would complicate physician practices.

Rochefort, David(Chairman)(R)	Avard, Kevin(V Chairman)(R)[C+]2024	Birdsell, Regina(R)[C+]2024
Prentiss, Suzanne(D)[F]2024	Long, Pat(D)