RSA 151:4-a. Requirements for Licensure Near Critical Access Hospitals.

I. In this section: (a) "Health care services" means any of the following currently provided by the critical access hospital to the service area: inpatient care, inpatient or outpatient surgery, emergency services, labor and delivery services, addiction and recovery services, mental health services, or coordination with emergency response systems. (b) "Material adverse impact" means that granting the application would more likely than not tangibly minimize the critical access hospital's ability to continue providing the health care services. (c) "Service area" means the area by which a majority of patients are served by the critical access hospital according to the hospital discharge data provided by the critical access hospital in accordance with RSA 126:25. II. (a) Any person or entity proposing to establish a hospital within a radius of 15 miles of the primary physical location of a New Hampshire hospital certified as a critical access hospital pursuant to 42 C.F.R 485.610(b) and (c), shall give written notice of the intent to establish a health care facility within a 15 mile radius with a description of the facility to the chief executive officer of the hospital by certified mail. (b) If, within 30 days of receipt of the notification under subparagraph (a), the critical access hospital notifies the department of health and human services that it objects to the establishment of the proposed health care facility and articulates a detailed basis for its objection, an expert report shall be completed by an independent contractor retained by the department and approved by the critical access hospital and proposed health care facility to determine whether or not the new facility will have a material adverse impact. If, after proposing 3 independent contractors in a period not to exceed 30 days, the critical access hospital and proposed health care facility cannot agree on an independent contractor selected by the commissioner of the department of health and human services, the commissioner shall independently designate the independent contractor to perform the assessment and create the expert report. The expert report shall be prepared as follows: (1) The report shall include how the proposed project will impact the health care services in the service area in terms of utilization, patient charges, market share, physician referral patterns, personnel resources, and referral sources. (2) The proposed health care facility and critical access hospital shall provide any information requested by the expert to complete its report. Information obtained at the request of the expert shall not be considered confidential under RSA 151:13, unless the department determines that it should be exempt from disclosure under RSA 91-A:5. (3) Within 30 days of retention of the expert, the department shall publish a notice on the department's Internet website to notify the public of the proposed health care facility and solicit public comment for a period of at least 7 calendar days. All public comments shall be provided to the expert for use in the analysis. (4) The report shall be completed within 90 days of the retention of the expert unless an extension is granted by the department. Such an extension shall not exceed 30 days. (5) If the report finds that the proposed health care facility will have a material adverse impact, then the proposed health care facility shall not be allowed to apply for licensure. If the proposed health care facility fails to provide the requested information to the expert, for which the expert is unable to complete its findings, the proposed health care facility shall not be allowed to apply for licensure. If the critical access hospital fails to provide the requested information to the expert, for which the expert is unable to complete its findings, no material adverse impact shall be found and the facility may apply for licensure. (6) The cost of any fees associated with the retention and work completed by an independent contractor to comply with the provisions of this subparagraph shall be shared equally between the proposed health care facility and the critical access hospital. These costs shall be paid for in advance of any services performed. (7) The department of health and human services shall provide a copy of the report within 10 days of receipt to the proposed health care facility and critical access hospital. (c) The person or entity seeking to establish the proposed health care facility and the critical access hospital shall have the right to request a rehearing by the commissioner of the department of health and human services pursuant to RSA 541:3 and to appeal by petition to the supreme court pursuant to RSA 541:6 the expert's findings. If the proposed health care facility chooses to move forward with the licensing process prior to all appeal rights being exhausted, the proposed health care facility shall do so at its own risk and shall not hold the critical access hospital or the department liable for any costs incurred. The appellant shall bear all costs of the state in connection with any rehearing or petition for appeal, including the state's attorneys' fees. Source: Source. 2020, 39:64, eff. July 1, 2020. 2025, 141:459, eff. Aug. 26, 2025.