HOUSE BILL 762

47th legislature - STATE OF NEW MEXICO - first session, 2005

INTRODUCED BY

Greg Payne

AN ACT

RELATING TO HEALTH CARE; PROVIDING FOR DISCLOSURE AND REPORTING REQUIREMENTS FOR HOSPITAL QUALITY INFORMATION AND CHARGE DESCRIPTION MASTER.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

     Section 1. REPORTING REQUIREMENTS--HOSPITALS.--

          A. As used in this section:

                (1) "charge description master" means a uniform schedule of charges represented by the hospital as its gross billed charge for a given service or item, regardless of payer type;

                 (2) "department" means the department of health; and

                (3) "hospital" means a general or special hospital, nonprofit or for-profit, licensed by the department.           B. A hospital shall make a written or electronic copy of its charge description master available, either by posting an electronic copy of the charge description master on the hospital's internet web site, or by making one written or electronic copy available at the hospital location.

          C. The hospital shall post a clear and conspicuous notice in its emergency department, if any, in its admissions office and in its billing office that informs patients that the hospital's charge description master is available in the manner described in Subsection B of this section.

          D. Information about charges provided pursuant to Subsection B of this section shall include information about where to obtain information regarding hospital quality, including hospital outcome studies available from the office and hospital survey information available from the joint commission for accreditation of healthcare organizations.

          E. A hospital shall not condition acceptance of a contract with a health care service plan or health insurer upon the health care service plan or health insurer waiving any provision of this section.

          F. A person may file a claim with the department alleging a violation of this section. The department shall investigate and inform the complaining person of its determination whether a violation has occurred and what action it will take.

          G. Each hospital shall file a copy of its charge description master annually with the department, in a format determined by the department.

          H. Each hospital shall calculate an estimate of the percentage increase in the hospital's gross revenue due to a price increase for charges for patient services during the twelve-month period beginning with the effective date of the charge description master filed with the department. Each hospital shall file the calculation and supporting documentation with the department, in a form prescribed by the department, at the time that the charge description master is filed. The department may compile and publish this information on its internet web site.

          I. Each hospital shall compile a list of the charges for the twenty-five services or procedures most commonly charged to patients. Each hospital shall make this list available to any person upon request. Each hospital shall file this list annually with the department, in a form prescribed by the department, along with the charge description master. After reviewing hospital filings, the department may develop a uniform reporting form for the twenty-five services or procedures most commonly charged for patients, may require hospitals to file this form with the department in a form prescribed by the department and may require hospitals to provide patients with the charges for these twenty-five services or procedures.

          J. The department may compile a list of the ten most common medicare diagnosis-related groups and the average charge for each of these diagnosis-related groups per hospital. The department may publish this information on its internet web site.

          K. Information provided the department on its internet web site pursuant to Subsections I and J of this section may inform persons where quality of care information about hospitals may be obtained, including hospital outcome studies available from the department and hospital survey information available from the joint commission for accreditation of healthcare organizations.

          L. A hospital is in violation of this section if it knowingly or negligently fails to comply with the requirements of this section.

     Section 2. EFFECTIVE DATE.--The effective date of the provisions of this act is July 1, 2005.

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