Hold on to your hats, because New Hampshire could enact one of the toughest “anti-self-referral” statutes in the US.  If HB 1725 passes and you are a New Hampshire physician (a) who may profit, indirectly or directly, from the sale of an FDA class II or class II medical device or (b) who may perform a procedure involving the device, you could be charged with (1) an unfair or deceptive act or practice in violation of NH Consumer Protection statute, and (2) a fine of $5000 for a first offense and loss of your license for a second offense.  Ouch!

In addition, HB 1725 as passed by the NH House in March specifically disallows any claims for payment for “any medical device provided” in violation of this proposed law.

So, what’s going on?  Is there a problem with physician owned distributors in New Hampshire?  I am not aware of any.   At the same time, there are certainly physicians who have been active in creating and inventing particular devices in association with academic medical centers or medical device manufacturing firms to make newer and improved devices.  Is this a “problem” that the State feels is necessary to correct at the moment?  Or does the NH House think the laws should be “clarified” prior to an “onslaught” of distributors.

We already have a law in place that requires a physician to disclose to patients the physician’s ownership interest in any health care facility that the physician may refer patients.  It seems to work well because it does not impede care.  It seems to me that this could be extended to devices, as well.  HB 1725, on the other hand, directly impedes care in those circumstances where a physician has a monetary interest in the device.  Certainly, it is a good idea for full disclosure of some sort of interest to be made, but HB 1725, as presently written, does not allow the physician to even consider the use of a device that the physician herself may have a monetary interest in, or may wish to employ to help a patient.

My sense is that a “bad story” came to certain legislators’ attention.  We will see on April 19 how the NH Senate addresses the bill.