Senate Bill No. 484–Committee on Human
Resources and Facilities

 

March 26, 2001

____________

 

Referred to Committee on Human Resources and Facilities

 

SUMMARY—Revises provisions requiring major hospitals to reduce their billed charges for certain services. (BDR 40‑1233)

 

FISCAL NOTE:            Effect on Local Government: No.

                                    Effect on the State: No.

 

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EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

 

AN ACT relating to the cost of health care; revising the provisions requiring major hospitals to reduce their billed charges for certain services; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

1-1    Section 1. Chapter 439B of NRS is hereby amended by adding thereto

1-2  a new section to read as follows:

1-3    1.  A major hospital shall reduce or discount the total billed charge

1-4  for hospital services provided each day to a diverted emergency inpatient

1-5  to not more than 150 percent of the average daily operating revenue per

1-6  inpatient of that hospital, as specified for the most recent period for

1-7  which the department has published the average daily operating revenue

1-8  per inpatient of that hospital, if:

1-9    (a) The inpatient:

1-10      (1) Has no insurance or other contractual provision for the

1-11  payment of the charge by a third party; or

1-12      (2) Has insurance or another contractual provision for the payment

1-13  of the charge by a third party, but the hospital does not have a current

1-14  agreement, contract or other arrangement with the insurer or third party

1-15  for the payment of covered services;

1-16    (b) The inpatient is not eligible for coverage by a state or federal

1-17  program of public assistance that would provide for the payment of the

1-18  charge;

1-19    (c) The inpatient makes reasonable arrangements within 30 days after

1-20  discharge to pay his hospital bill; and

2-1    (d) The provisions of NRS 439B.260 do not require a greater

2-2  reduction or discount in the total billed charge for those services.

2-3    2.  The department shall, not less than annually, publish the average

2-4  daily operating revenue per inpatient of each major hospital for each

2-5  calendar year or for a shorter period as the department deems

2-6  appropriate.

2-7    3.  A major hospital or patient who disputes the reasonableness of the

2-8  arrangements made pursuant to paragraph (c) of subsection 1 may

2-9  submit the dispute to the office for hospital patients for resolution as

2-10  provided in NRS 232.543.

2-11    4.  As used in this section:

2-12    (a) “Diverted emergency inpatient” means a patient who is admitted to

2-13  a major hospital upon diversion from another hospital that lacked

2-14  sufficient resources to provide the emergency services and care needed by

2-15  that patient.

2-16    (b) “Emergency services and care” has the meaning ascribed to it in

2-17  NRS 439B.410.

2-18    Sec. 2.  NRS 439B.260 is hereby amended to read as follows:

2-19    439B.260  1.  [A] Except as otherwise provided in section 1 of this

2-20  act, a major hospital shall reduce or discount the total billed charge by at

2-21  least 30 percent for hospital services provided to an inpatient who:

2-22    (a) Has no insurance or other contractual provision for the payment of

2-23  the charge by a third party;

2-24    (b) Is not eligible for coverage by a state or federal program of public

2-25  assistance that would provide for the payment of the charge; and

2-26    (c) Makes reasonable arrangements within 30 days after discharge to

2-27  pay his hospital bill.

2-28    2.  A major hospital or patient who disputes the reasonableness of

2-29  arrangements made pursuant to paragraph (c) of subsection 1 may submit

2-30  the dispute to the office for hospital patients for resolution as provided in

2-31  NRS 232.543.

2-32    3.  A major hospital shall reduce or discount the total billed charge of

2-33  its outpatient pharmacy by at least 30 percent to a patient who is eligible

2-34  for Medicare.

2-35    Sec. 3.  NRS 232.543 is hereby amended to read as follows:

2-36    232.543  1.  There is hereby created within the consumer affairs

2-37  division of the department an office for hospital patients.

2-38    2.  The administrator of the office:

2-39    (a) Is responsible for the operation of the office, which must be easily

2-40  accessible to the clientele of the office.

2-41    (b) Must be appointed by the director.

2-42    (c) Is in the unclassified service of the state.

2-43    (d) Shall appoint and supervise such additional employees as are

2-44  necessary to carry out the duties of the office. The employees of the office

2-45  are in the classified service of the state.

2-46    (e) Shall submit a written report quarterly to the department of human

2-47  resources and the legislative committee on health care concerning the

2-48  activities of the office, including, but not limited to, the number of

2-49  complaints received by the office, the number and type of disputes heard,

3-1  mediated, arbitrated or resolved through alternative means of dispute

3-2  resolution by the administrator and the outcome of the mediation,

3-3  arbitration or alternative means of dispute resolution.

3-4    3.  The administrator of the office may, upon request made by either

3-5  party, hear, mediate, arbitrate or resolve by alternative means of dispute

3-6  resolution disputes between patients and hospitals. The administrator may

3-7  decline to hear a case which in his opinion is trivial, without merit or

3-8  beyond the scope of his jurisdiction. The administrator may hear, mediate,

3-9  arbitrate or resolve through alternative means of dispute resolution disputes

3-10  regarding:

3-11    (a) The accuracy or amount of charges billed to the patient;

3-12    (b) The reasonableness of arrangements made pursuant to paragraph (c)

3-13  of subsection 1 of NRS 439B.260[;] or paragraph (c) of subsection 1 of

3-14  section 1 of this act; and

3-15    (c) Such other matters related to the charges for care provided to a

3-16  patient as the administrator determines appropriate for arbitration,

3-17  mediation or other alternative means of dispute resolution.

3-18    4.  The decision of the administrator is a final decision for the purpose

3-19  of judicial review.

3-20    5.  Each hospital, other than federal and state hospitals, with 49 or more

3-21  licensed or approved hospital beds shall pay an annual assessment for the

3-22  support of the office. On or before July 15 of each year, the director of the

3-23  department of human resources shall notify each hospital of its assessment

3-24  for the fiscal year. Payment of the assessment is due on or before

3-25  September 15. Late payments bear interest at the rate of 1 percent per

3-26  month or fraction thereof.

3-27    6.  The total amount assessed pursuant to subsection 5 for a fiscal year

3-28  must be $100,000 adjusted by the percentage change between January 1,

3-29  1991, and January 1 of the year in which the fees are assessed, in the

3-30  Consumer Price Index (All Items) published by the United States

3-31  Department of Labor.

3-32    7.  The total amount assessed must be divided by the total number of

3-33  patient days of care provided in the previous calendar year by the hospitals

3-34  subject to the assessment. For each hospital, the assessment must be the

3-35  result of this calculation multiplied by its number of patient days of care

3-36  for the preceding calendar year.

3-37    Sec. 4.  This act becomes effective on July 1, 2001.

 

3-38  H