N.H. Bill Would Certify Affiliations

Lebanon — A bill before the New Hampshire Senate would establish a new certification process for approving cooperative agreements between health care providers.

Senate Bill 308, the Health Care Delivery Innovation Through Cooperation Act, would call on the attorney general to grant “certificates of public advantage” to agreements in which hospitals or other providers agree to share patients, personnel, medical equipment and other resources.

Currently, hospitals may consult with the attorney general on proposals to affiliate, to consider whether the cooperative agreement raises any legal questions about restricting market competition. But it is more of a preventive measure aimed at avoiding potential antitrust lawsuits rather than an actual requirement. Technically, the hospitals don’t need the attorney general’s approval.

Rep. Laurie Harding, D-Lebanon, is among those who support the bill.

“I think that hospitals have no choice but to work more closely,” said Harding, a nurse and vice chairwoman of the House Health, Human Services and Elderly Affairs committee. “Nothing is required of the hospitals in this bill. This bill will enhance business opportunities and push institutions and organizations that should have been working together a long time ago to do just that, now.”

The bill, still in the Senate Health, Education and Human Services Committee, outlines criteria that the attorney general would consider in reviewing affiliations between health care providers. The impact on quality, costs and access, as well as the financial conditions of the providers, are among the criteria.

The attorney general could consider, for example, whether a small hospital would be forced to close if it did not link up with a larger institution.

The process would take no more than 90 days and certificates would be issued for no fewer than five years — unless the providers are seeking less time than that — and may be renewed.

The bill’s primary sponsor is state Sen. Bob Odell, R-Lempster, and it also as the support of Upper Valley lawmaker Sen. David Pierce, D-Lebanon.— Chris Fleisher