Glossary Check: N.H. 'Health Care Provider'

23 Nov, 2022 Frank Ferreri

                               

Concord, NH (WorkersCompensation.com) -- While understanding what a "health care provider" is isn't all that tough, as with so many things, a legal definition of that term can be important if a workers' compensation case arises. 

For New Hampshire, the following provides a short crib sheet on how state law defines "health care" provider and what's covered by the term.

In the Granite State, "health care provider" includes doctors, chiropractors, rehabilitation providers, health services, health care facilities, and health maintenance organizations. Relatedly:

  • "Health services " means clinically related diagnostic, treatment, or rehabilitative services, as well as preventive services, and includes, without limitation, alcohol, drug abuse, and mental health services.
  • "Health care facility" means hospitals, ambulatory surgical facilities, specialty hospitals and licensed nursing homes including all services and property owned by such. Health care facilities also include facilities that are publicly or privately owned or for-profit or not-for-profit, and which are licensed or required to be licensed in whole or in part by the state.
  • "Health maintenance organization" means a public or private organization, organized under the laws of any state or the federal government that --
    • Provides or otherwise makes available to enrolled participants health care services, including at least the following basic health care services: usual physician services, hospitalization, laboratory, x-ray, emergency and preventive services, and out-of-area coverage
    • Is compensated, except for co-payments, for the provision of the basic health care services to enrolled participants on a predetermined periodic basis without regard to the date on which health care services are provided. A predetermined periodic basis shall be fixed without regard to the frequency, extent, or kind of health care service actually provided
    • Provides physician services primarily:
      1. Directly through physicians who are either employees or partners of such organization
      2. Through arrangements with individual physicians or one or more groups of physicians organized in a group practice or individual basis

Compliance information from New Hampshire and the rest of the U.S. is available from WorkCompResearch


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    About The Author

    • Frank Ferreri

      Frank Ferreri, M.A., J.D. covers workers' compensation legal issues. He has published books, articles, and other material on multiple areas of employment, insurance, and disability law. Frank received his master's degree from the University of South Florida and juris doctor from the University of Florida Levin College of Law.

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