Amendment to bar DHHS contracts with hospitals that violate patient bill of rights draws sharp questions

Representative Jess Edwards introduced a non‑germane amendment to House Bill 519 seeking to add a statute provision that would prevent the Department of Health and Human Services from contracting with any hospital "found in violation of the patient bill of rights" (testimony cited RSA language). The amendment prompted testimony from a patient advocate, hospital leaders and the DHHS contracts director at a House Finance Committee hearing.

Why it matters: witnesses described a recent, widely publicized case in which a patient said she was denied a kidney transplant because she had not received a COVID‑19 vaccine. Supporters of the amendment said stronger enforcement is needed to ensure hospitals follow the patient bill of rights. Hospital representatives and DHHS officials warned the amendment's enforcement language is unclear, could have unintended consequences for contracted services and lacks a remediation process.

What witnesses said Representative Jess Edwards said the amendment would add language to RSA 151 that ties contracting eligibility to compliance with the patient bill of rights and said he planned to use HB519 as the vehicle to carry the amendment to the House floor.

Melissa Blasick, representing Rebuild NH and a co‑sponsor of the statute change enacted in 2022, described the case of Shannon Buttermore: "She was being denied a kidney transplant by Dartmouth Hitchcock Medical Center for not receiving the COVID 19 vaccine," Blasick said, and added that a public campaign and legal engagement were needed to obtain relief in that case.

Matthew Hood, vice president for government relations at Dartmouth Health, said enforcement questions are central: "If someone feels that the patient bill of rights has been violated, what are they going to do? ... they'd still have to go to the superior court to prove a violation," he told the committee. Hood also warned that some contract terminations could affect large patient populations, including Medicaid recipients served by Dartmouth Health.

Ben Bradley of the New Hampshire Hospital Association said the association could not support the non‑germane amendment in its current form and urged collaborative review of enforcement mechanisms. "For these reasons, we we can't support the non Germain amendment," he said in testimony.

Robert Moore, contracts director at DHHS, provided counts of current department contracting activity and described standard contract remedies. "We have somewhere between, 23 to 24 active contracts with 6 to 7 hospitals," Moore said; he added that all state contracts include a standard clause obligating contractors to comply with applicable laws and describing corrective‑action and default steps.

Unresolved questions and committee action Committee members pressed for clarity about scope and enforcement: whether the amendment would strip existing contracts immediately, whether contracts could be cured through corrective action, and how patient‑level remedies would be handled. Witnesses offered different readings; several asked the committee to develop a remediation and enforcement process before adopting a broad contracting prohibition.

Representative Edwards said he planned to press the amendment forward quickly to put the issue before the House. Committee leadership scheduled a division 3 work session for Friday at 10:00 a.m. to consider the amendment and said the bill and amendment will be revisited at the committee's executive session next week; no final vote occurred at the hearing.

Ending The committee heard testimony from patient advocates, hospital officials and DHHS staff but did not adopt or reject the proposed amendment. Committee members asked DHHS and hospital representatives to provide follow‑up information about the number and nature of state contracts, enforcement options and potential continuity‑of‑care impacts before further action.