SB 613 — 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 - AS INTRODUCEDAMENDED BY THE SENATE 03/26/2026 1177s SESSION 26-2215 09/06 SENATE BILL 613 AN ACT relative to licensing requirements for health care facilities established within a 15 mile radius of a critical access hospital.hospital and relative to transfers from freestanding hospital emergency facilities.

Health and Human Services ───────────────────────────────────────────────────────────────── AMENDED ANALYSIS This billbill: requires a health care facility to provide certified, written notice to a critical access hospital if the facility will be located within a 15 mile radius of the critical access hospital.

I.

Requires a health care facility to provide certified, written notice to a critical access hospital if the facility will be located within a 15 mile radius of the critical access hospital.

II.

Establishes standards governing the transfer of patients from freestanding hospital emergency facilities to acute care hospitals to ensure that such transfers are based primarily on clinical appropriateness, patient safety, continuity of care, and patient choice.

III.

Bans coercive or exclusive transfer practices, reinforces EMTALA requirements, and gives the state authority to enforce violations.

SB 613 - AS INTRODUCEDAMENDED BY THE SENATE 03/26/2026 1177s 26-2215 09/06 STATE OF NEW HAMPSHIRE In the Year of Our Lord Two Thousand Twenty-Six AN ACT relative to licensing requirements for health care facilities established within a 15 mile radius of a critical access hospital.hospital and relative to transfers from freestanding hospital emergency facilities.

ThisSections 1 and 2 of this act shall be known as the "Rural Health Care System Stabilization Act".

3 EffectivePurpose. Date.

The purpose of section 4 of this act is to protect patient safety and continuity of care by ensuring that transfers from freestanding hospital emergency facilities are based on clinical appropriateness, patient needs, and regional access to hospital services.

Section 4 of this act further seeks to prevent practices that may undermine community hospitals through coercive or exclusive transfer arrangements that are not clinically justified.

4 New Subdivision;

Transfers from Freestanding Hospital Emergency Facilities.

Amend RSA 151 by inserting after section 53 the following new subdivision:

Transfers from Freestanding Hospital Emergency Facilities 151:54 Definitions.

In this subdivision:

I.

“Freestanding hospital emergency facility” or “FHEF” means a facility licensed under this chapter that is geographically separate from an acute care hospital and provides emergency medical services on behalf of, or in affiliation with, a parent hospital.

II.

“Parent hospital” means an acute care hospital that owns, controls, or operates a freestanding hospital emergency facility, directly or indirectly.

III.

“Clinically appropriate” means consistent with the judgment of the treating physician, the patient’s medical condition, and applicable regional emergency medical services protocols.

SB 613 - AS AMENDED BY THE SENATE - Page 2 - IV.

“Transfer” means the movement of a patient from a freestanding hospital emergency facility to another licensed hospital or health care facility for the purpose of providing continued medical care, and shall not include discharge to home or referral for non-emergent outpatient services.

V.

“Medically necessary” means determined by the treating physician or qualified practitioner to be required to prevent or address a material deterioration of the patient’s medical condition, consistent with applicable standards of care.

151:55 Transfer Standards.

I.

When a transfer from a freestanding hospital emergency facility to an acute care hospital is medically necessary, the facility shall ensure that transfer decisions are based primarily on clinical appropriateness, patient safety, continuity of care, and patient choice.

II.

A patient, or the patient’s legal representative when applicable, shall be informed of available receiving hospitals that are clinically appropriate and reasonably available, provided that such discussion does not delay screening, stabilization, or transfer required under federal law.

III.

No freestanding hospital emergency facility shall require or condition treatment, stabilization, or transfer upon selection of a receiving hospital based primarily on ownership or affiliation.

IV.

If a patient is unable to participate in the selection of a receiving hospital, the facility shall arrange transfer to an appropriate hospital consistent with:

(a) RSA 153-A:1 and RSA 151:19, VII;

(b) State-designated trauma, stroke, or specialty care systems;

(c) Federal and state law governing emergency medical treatment and transfer;