10-R341
2010 -- S 3021
Enacted 06/10/10
S E N A T E R E
S O L U T I O N
CREATING A
SPECIAL SENATE COMMISSION TO STUDY COST CONTAINMENT, EFFICIENCY, AND
TRANSPARENCY IN THE DELIVERY OF QUALITY PATIENT CARE AND ACCESS BY HOSPITALS
Introduced By: Senators Miller, Algiere, and Sosnowski
Date Introduced: June 10, 2010
RESOLVED,
That a special senate commission be and the same is
hereby 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;
two (2) of whom shall be representatives from community
hospitals, to be appointed by the
President of the Senate;
two (2) of whom shall be representatives of hospitals affiliated with an
academic medical center that is part of a major health care
system, to be appointed by the
President of the Senate;
four (4) of whom shall be representatives of each of the four health
insurance providers licensed in the State of
Senate; one of whom shall
be the health insurance commissioner, or his or her designee; one of
whom shall be the director of the Department of Health, or
his or her designee; one of whom shall
be the director of Human Services, or his or her
designee; and two (2) of whom shall be
physicians licensed to practice medicine in
the Senate; and one of whom shall be a registered nurse,
to be appointed by the President of the
Senate. The commission shall have two (2) co-chairs from
among its members, to be appointed
by the President of the Senate.
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 advisability and implementation of a requirement 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;
At
its discretion, the Commission may also study:
(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 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.
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 on study purposes (1) through (5) no
later than March 31, 2011, and on
optional study purpose (6) no later than May 31, 2011, and the
commission shall expire on
December 31, 2011.
=======
LC02936
=======