10-R335
2010 -- H 8275
Enacted 06/09/10
J O I N T R E S
O L U T I O N
CREATING A
SPECIAL LEGISLATIVE COMMISSION TO STUDY COST
CONTAINMENT,
EFFICIENCY, AND TRANSPARENCY IN THE DELIVERY OF QUALITY PATIENT CARE AND ACCESS
BY HOSPITALS
Introduced By: Representatives Ruggiero, Marcello, and Handy
Date Introduced: June 09, 2010
RESOLVED,
That a special legislative commission be and the same
hereby is created
consisting of seventeen (17) members: three (3) of whom shall be
members of the Senate, not
more than two (2) from the same political party, to be
appointed by the President of the Senate;
three (3) of whom shall be members of the House of
Representatives, not more than two (2) from
the same political party, to be appointed by the Speaker
of the House; two (2) of whom shall be
representatives from community hospitals, one to be appointed by the
President of the Senate and
one to be appointed by the Speaker of the House; two (2)
of whom shall be representatives of
hospitals affiliated with an academic medical center that is part
of a major health care system, one
to be appointed by the President of the Senate and one
to be appointed by the Speaker of the
House; two (2) of whom
shall be representatives of the health insurance industry, one to be
appointed by the President of the Senate and one to be
appointed by the Speaker of the House;
one of whom shall be the health insurance commissioner,
or designee; one of whom shall be the
director of the Department of Health, or designee; and three
(3) physicians licensed to practice
medicine in
by the Speaker of the House, and one to be appointed by
the Rhode Island Medical Society. The
commission shall have two (2) co-chairs from among its members,
one to be appointed by the
President
of the Senate and one to be appointed by the Speaker of the House.
In
lieu of any appointment of a member of the legislature to a permanent advisory
commission, a legislative study commission, or any commission
created by a general assembly
resolution, the appointing authority may appoint a member of the
general public to serve,
provided that the majority leader or the minority leader of
the political party which is entitled to
the appointment consents to the appointment of the member
of the general public.
The
purpose of said commission shall be to study:
(1)
The establishment of procedures to provide for more efficient administration of
health
care services to citizens of this state, the
implementation of a more efficient, transparent, and
uniform rate-approval process for the purchase of health
services, in particular, health services by
hospitals, and the control of rising costs of health care in
this state, including the costs of the
provision of health insurance benefits by employers, and the
out-of-pocket costs of health
services to persons residing in this state;
(2)
The establishment of procedures to require that health insurers pay comparable
rates
to health care providers, in particular, hospitals, for
similar services to improve the efficiency and
effectiveness of communications among insurers and providers, to
minimize rate disparity among
providers, to restore competitive balance and improve
competition in the markets for health care
services in this state, and to assure the fair treatment of
all health care providers, in particular,
hospitals, of similar services and the availability of
cost-effective health care services in this state;
(3)
The advisability and implementation of payment methodologies that promote cost
containment, efficiency, and transparency, including global
payment reimbursement for total care
per patient, rather than inequitable reimbursement and
other unfair payment terms that adversely
affect quality patient care and access by reducing the
resources that health care providers can
devote to patient care;
(4)
The establishment of procedures for the review of provider contracts and rates,
in
particular hospital provider contracts and rates, to determine
if: (i) The proposed terms are
reasonable, fair, and equitable, and the rates set equitably
among all hospitals without undue
discrimination or preference; and (ii) The aggregate reimbursement
rates of the hospital are
related reasonably to the aggregate costs of the hospital,
considering such standards, measures,
and guidelines that are relevant, each weighted as appropriate,
including without limitation: (A)
Per diem
payment; (B) Payment per stay; (C) Case mix adjusted payment per stay indexed
to
average payment; (D) Case mix adjusted payment per stay
indexed to Medicare payment; (E)
Cost per adjusted
discharged; (F) Uncompensated care; (G) Teaching costs; (H) License fee
imposed by the Department of Health or other agency; (I) DSH
payments; (J) Innovative
methodologists; and (K) Any publicly reported quality measures such
as Department of Health
licensure surveys, CMS Core Measures, and patient satisfaction
surveys;
(5)
The establishment of a procedure for the disclosure by hospitals of third-party
Rhode
Island insurance contracts
to assure transparency and efficiency; and
(6)
The development and establishment of a state-based health insurance exchange,
as
provided under the “Patient Protection and Affordable Care Act,”
H.R. 3590, signed into law
March 23, 2010, and as
modified by the “Health Care and Education Reconciliation Act,” of
2010, H.R. 4872, to ensure
insurance exchange, as required by such acts, by 2014.
In making its examination and investigation, the commission shall consult with
the
Rhode Island Department of
Health, the
commissioner, the Rhode Island Department of the Attorney General,
the
Department of Human
Services, health care economists, and other individuals or organizations
with expertise in state and federal health care payment methodologies
and rates. The commission
shall use data and other information gathered in the course
of such consultations as a basis for its
findings and recommendations.
The commission shall also consult with a reasonable variety of classes of
individuals
and organizations likely to be affected by its
recommendations, including without limitation, the
Hospital
Association of
Forthwith upon passage of this resolution, the members of the commission shall
meet at
the call of the President of the Senate and the Speaker
of the House and organize, and thereafter,
shall meet regularly with all due diligence to carry out
its purpose and finalize its
recommendations as soon as practicable. The first meeting of the
commission shall be held no
later than September 15, 2010. Vacancies in the commission
shall be filled in like manner as the
original appointment.
The
members of the commission shall receive no compensation for their services.
All
departments and agencies of the state shall furnish such advice and
information,
documentary and otherwise, to said commission and its agents as
is deemed necessary or
appropriate to facilitate the purposes of this resolution,
including without limitation, full subpoena
power, which may only be exercised with the prior approval
of the President of the Senate and the
Speaker
of the House.
The
Joint Committee on Legislative Services is hereby authorized and directed to
provide
suitable offices and staff for the commission; and be it
further
RESOLVED, That the commission shall report its
findings and recommendations to the
clerk of the Senate and the clerk of the House of
Representatives on study purposes (1) through
(5) no
later than March 31, 2011, and on study purpose (6) no later than May 31, 2011,
and the
commission shall expire on December 31, 2011.
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LC02841
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