(New Title) relative to licensing requirements for health care facilities established within a 15 mile radius of a critical access hospital and relative to transfers from freestanding hospital emergency facilities.
SB 613, titled the “Rural Health Care System Stabilization Act,” would add two main sets of requirements to New Hampshire law. First, it requires advance written notice to a critical access hospital when a new health care facility such as an ambulatory surgical center, emergency medical care center, hospital, birthing center, walk-in care center, dialysis center, or special health care service is proposed within 15 miles of that hospital’s primary location. The notice must be sent by certified mail and describe the planned facility and services.
Second, the bill creates a new statutory subdivision governing transfers from freestanding hospital emergency facilities to acute care hospitals. It defines key terms such as “freestanding hospital emergency facility,” “parent hospital,” “clinically appropriate,” and “medically necessary,” and requires transfer decisions to be based primarily on clinical appropriateness, patient safety, continuity of care, and patient choice. Patients or their representatives must be told about clinically appropriate receiving hospitals that are reasonably available, and facilities may not condition treatment or transfer on ownership affiliation, insurance status, or exclusive routing arrangements. The bill also prohibits misleading or coercive practices intended to steer patients to affiliated hospitals when other appropriate hospitals are available.
The bill would amend RSA 151 to impose new notice obligations on health care facility developers near critical access hospitals and to regulate pre-admission transfer practices at freestanding emergency facilities. It would also authorize the attorney general to adopt enforcement rules, allow enforcement under the consumer protection statute after a pattern of violations, and require the Department of Health and Human Services to give notice and an opportunity to cure before referral. The bill expressly preserves EMTALA and states that compliance with federal law is deemed compliance with the new subdivision, limiting state action where federal law controls.
Based on the bill text and available context, the measure appears to be framed as a patient-safety and rural-hospital-stabilization bill, with sponsors presenting it as a way to protect continuity of care and prevent unfair transfer practices that could disadvantage community hospitals. No committee transcript or recorded votes were provided, so there is no direct evidence of formal support or opposition in the available materials. The overall tone of the legislation is protective and regulatory rather than punitive, with an emphasis on clinical decision-making and transparency.
The main points of contention are likely to be the bill’s restrictions on how freestanding emergency facilities and their parent hospitals manage patient transfers, especially the ban on coercive or exclusive transfer arrangements and the prohibition on conditioning transfers on insurance or affiliation. Hospital systems that operate freestanding emergency departments may view the bill as limiting operational flexibility or referral relationships, while supporters are likely to argue that it prevents steering patients away from clinically appropriate hospitals and protects rural and community facilities. Another possible issue is the 15-mile notice requirement, which could be seen by facility operators as an added regulatory hurdle, though the bill does not appear to block construction or licensing outright.