N.H. Admin. Code § Lab 508.02

Current through Register No. 50, December 12, 2024
Section Lab 508.02 - Application of Civil Penalties
(a) The commissioner shall assess a civil penalty between $0.00 and $2,500.00 against any health care provider who without sufficient cause, as determined by the commissioner, bills an injured employee or his or her employer for services covered by insurers or self-insurers under the statute, or who fails to provide reports required under the statute.
(b) Insufficient cause shall be determined if the health care provider:
(1) Bills an employee and is aware that the matter is an accepted workers' compensation claim or that the matter is in litigation; or
(2) Bills the employee for the amount that the carrier, self-insured employer or third party administrator did not pay as a result of RSA 281-A:24 Reasonable Value of Services.
(c) The commissioner or his or her designee shall request from the health care provider the reason for the billing to the employee or employer or for the lack of report forwarded to the carrier.
(d) If the reason for the incorrect billing is in violation of RSA 281-A, the commissioner shall assess a penalty with the severity of the penalty increasing with each violation by that health care provider. The initial penalty assessment shall be $500.00.
(e) In determining the dollar amount of a civil penalty for any violation within these rules, the commissioner shall determine the penalty with the goal of preventing future misconduct, considering the following factors:
(1) The severity of the violation;
(2) The frequency of the violation;
(3) Whether the violator is a repeat offender; and
(4) Other similar factors that the commissioner finds demonstrate that the violation warrants a higher civil penalty.

N.H. Admin. Code § Lab 508.02

(See Revision Note at part heading for Lab 508) #5235, eff 9-27-91, EXPIRED: 9-27-97

New. #6631, INTERIM, eff 11-16-97, EXPIRED: 3-16-98

New. #6806, eff 7-18-98 (formerly Lab 507.02 ); ss by #8682, INTERIM, eff 7-15-06, EXPIRED: 1-11-07

New. #9019, eff 11-1-07

Amended by, Volume XXXVI Number 14, Filed April 7, 2016, Proposed by #11067, Effective 4/1/2016, Expires 4/1/2026.