New Hampshire Revised Statutes 281-A:24 – Payment for Reasonable Value of Services
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I. (a) The employer or the employer’s insurance carrier shall pay the reasonable value of medical services provided under this chapter.
(b) The health care provider shall have the burden of establishing that its bill for services is reasonable.
(c) Effort shall be made to resolve any dispute as to the reasonable value of service prior to applying to the commissioner for resolution of such a dispute.
(d) Whenever an injured employee receives medical or hospital service or other remedial care under the provisions of this chapter and a dispute arises between the employer or the employer’s insurance carrier and the person, firm, or corporation rendering such service or care as to the reasonable value of the service or care, the commissioner shall have exclusive jurisdiction to determine the reasonable value of such service or care. Any interested party may petition for a hearing and all interested parties shall be entitled to notice and hearing if it is determined that all reasonable efforts to resolve the dispute have failed.
(e) The commissioner or the commissioner’s authorized representative shall make a finding as to the reasonable value of such services or care rendered.
(f) Any party in interest aggrieved by such a finding may appeal to the compensation appeals board under N.H. Rev. Stat. § 281-A:43.
II. If the commissioner finds that a health care provider, health care facility, or rehabilitation provider has required unnecessary treatment, hospitalization, rehabilitation services or office visits, or other excessive charges, the health care provider, health care facility, or rehabilitation provider shall not receive payment under this chapter from a carrier, employer, or employee for the excessive fees or unnecessary treatment, hospitalization, rehabilitation services, or visits. In addition, the health care provider, health care facility, or rehabilitation provider shall be required to return to the carrier, self-insurer, employer or injured employee any such fees or charges already collected.
III, IV. [Repealed.]
V. The commissioner shall assess a civil penalty not to exceed $2,500 for violations of this section which are willful or which demonstrate a pattern of improperly charging or overcharging employers or workers’ compensation insurers.
(b) The health care provider shall have the burden of establishing that its bill for services is reasonable.
Terms Used In New Hampshire Revised Statutes 281-A:24
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
- Board: means the compensation appeals board established in N. See New Hampshire Revised Statutes 281-A:2
- Commissioner: means the labor commissioner appointed as provided in RSA 273. See New Hampshire Revised Statutes 281-A:2
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- employee: includes persons who regularly operate businesses or practice their trades, professions, or occupations, whether individually, or in partnership, or association with other persons, whether or not they hire others as employees. See New Hampshire Revised Statutes 281-A:2
- Employer: with respect to private employment, means:
(a) A person, partnership, association, corporation, or legal representative of a person, partnership, association or corporation who employs one or more persons whether in one or more trades, businesses, professions or occupations and whether in one or more locations. See New Hampshire Revised Statutes 281-A:2 - Health care facility: means hospitals, ambulatory surgical facilities, specialty hospitals and licensed nursing homes including all services and property owned by such. See New Hampshire Revised Statutes 281-A:2
- Health care provider: as used in this chapter includes doctors, chiropractors, rehabilitation providers, health services, health care facilities, and health maintenance organizations. See New Hampshire Revised Statutes 281-A:2
- Insurance carrier: shall include any corporation licensed to sell insurance in this state from which an employer has obtained a workers' compensation insurance policy in accordance with the provisions of this chapter. See New Hampshire Revised Statutes 281-A:2
- Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
- person: may extend and be applied to bodies corporate and politic as well as to individuals. See New Hampshire Revised Statutes 21:9
- petition: when used in connection with the equity jurisdiction of the superior court, and referring to a document filed with the court, shall mean complaint, and "petitioner" shall mean plaintiff. See New Hampshire Revised Statutes 21:51
- Rehabilitation provider: as used in this chapter includes any person certified as a vocational rehabilitation provider under N. See New Hampshire Revised Statutes 281-A:2
(c) Effort shall be made to resolve any dispute as to the reasonable value of service prior to applying to the commissioner for resolution of such a dispute.
(d) Whenever an injured employee receives medical or hospital service or other remedial care under the provisions of this chapter and a dispute arises between the employer or the employer’s insurance carrier and the person, firm, or corporation rendering such service or care as to the reasonable value of the service or care, the commissioner shall have exclusive jurisdiction to determine the reasonable value of such service or care. Any interested party may petition for a hearing and all interested parties shall be entitled to notice and hearing if it is determined that all reasonable efforts to resolve the dispute have failed.
(e) The commissioner or the commissioner’s authorized representative shall make a finding as to the reasonable value of such services or care rendered.
(f) Any party in interest aggrieved by such a finding may appeal to the compensation appeals board under N.H. Rev. Stat. § 281-A:43.
II. If the commissioner finds that a health care provider, health care facility, or rehabilitation provider has required unnecessary treatment, hospitalization, rehabilitation services or office visits, or other excessive charges, the health care provider, health care facility, or rehabilitation provider shall not receive payment under this chapter from a carrier, employer, or employee for the excessive fees or unnecessary treatment, hospitalization, rehabilitation services, or visits. In addition, the health care provider, health care facility, or rehabilitation provider shall be required to return to the carrier, self-insurer, employer or injured employee any such fees or charges already collected.
III, IV. [Repealed.]
V. The commissioner shall assess a civil penalty not to exceed $2,500 for violations of this section which are willful or which demonstrate a pattern of improperly charging or overcharging employers or workers’ compensation insurers.