SB63 (2009) Detail

Relative to ensuring consumer access to care upon the termination of a participating provider.


SB 63-FN – AS INTRODUCED

2009 SESSION

09-0451

01/09

SENATE BILL 63-FN

AN ACT relative to ensuring consumer access to care upon the termination of a participating provider.

SPONSORS: Sen. Sgambati, Dist 4; Sen. Reynolds, Dist 2; Sen. Kelly, Dist 10; Sen. Gallus, Dist 1; Rep. Arsenault, Belk 4; Rep. Reever, Belk 4; Rep. Nordgren, Graf 9; Rep. Donovan, Sull 4; Rep. Batula, Hills 19

COMMITTEE: Health and Human Services

ANALYSIS

This bill requires a participating provider terminating a contract within a health carrier’s network to submit a report to the commissioner of the department of health and human services demonstrating that the network adequacy will not be adversely affected by such termination.

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

09-0451

01/09

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Nine

AN ACT relative to ensuring consumer access to care upon the termination of a participating provider.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 New Paragraph; Managed Care; Network Adequacy. Amend RSA 420-J:7 by inserting after paragraph IV the following new paragraph:

V. Upon termination of a contract of a participating provider in a health carrier’s network and an extension of the period of continued access to care subsequent to a provider contract termination under RSA 420-J:7-d, the commissioner shall require the health carrier to submit a report demonstrating that network adequacy is not adversely affected by such termination if it is determined that the provider is located in or services a health professional shortage area, a physician scarcity area, or a medically underserved area or population as defined by the Centers for Medicare and Medicaid Services or the department of health and human services.

2 Effective Date. This act shall take effect 60 days after its passage.

LBAO

09-0451

01/02/09

SB 63-FN - FISCAL NOTE

AN ACT relative to ensuring consumer access to care upon the termination of a participating provider.

FISCAL IMPACT:

The Department of Insurance states this bill may have an indeterminable fiscal impact on state revenue in FY 2009 and each year thereafter. This bill would have no fiscal impact on state, county, and local expenditures, or county and local revenue.

METHODOLOGY:

The Department of Insurance states this bill would require the commissioner to review a report submitted by a health insurance carrier writing a managed care plan when a participating provider is leaving the carrier’s network and the provider is in a certain area (such area to be determined by either the Center for Medicaid and Medicare Service or NH Department of Health and Human Services). The report shall demonstrate that the carrier still can satisfy the network adequacy standards absent the withdrawing participating provider. The State is self funded and is not subject to these carrier based requirements. The Department states that New Hampshire collects premium tax on health insurance premiums and to the extent premiums change in response to this bill, state revenue may be impacted. The Department states that network adequacy provisions under RSA 420-J:7 already require an annual filing, and the new reporting requirement seems to require an interim filing in the event of network disruptions. The Department assumes that this is not a significant administrative burden.

The Department of Health and Human Services states this bill would have no fiscal impact on their Department.

Links

SB63 at GenCourtMobile

Action Dates

Date Body Type

Bill Text Revisions

SB63 Revision: 14728 Date: Jan. 20, 2009, midnight

Docket