SB 90 – AS AMENDED BY THE SENATE
04/08/09 1178s
2009 SESSION
10/01
SENATE BILL 90
AN ACT establishing a private right of action for pharmacies against health maintenance organizations.
SPONSORS: Sen. Gilmour, Dist 12; Sen. Roberge, Dist 9; Sen. Cilley, Dist 6; Rep. Case, Rock 1; Rep. Keans, Straf 1
This bill establishes a private action for pharmacies injured by violations of preferred provider requirements of health maintenance organizations.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
04/08/09 1178s
09-0958
10/01
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Nine
AN ACT establishing a private right of action for pharmacies against health maintenance organizations.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; Health Maintenance Organizations; Sanctions; Private Action by Pharmacies. Amend RSA 420-B by inserting after section 14 the following new section:
420-B:14-a Private Action by Pharmacy.
I. In addition to the sanctions provided in RSA 420-B:13, a pharmacy injured by a health maintenance organization’s violation of RSA 420-B:12, V, may bring an action for damages and for such equitable relief, including an injunction, as the court deems necessary and proper. If the court finds for the plaintiff, recovery shall be in the amount of actual damages or $1,000, whichever is greater. If the court finds that the health maintenance organization’s violation was a willful or knowing violation of RSA 420-B:12, V, it shall award up to 3 times, but not less than 2 times, such amount. In addition, a prevailing plaintiff shall be awarded the costs of the suit and reasonable attorney’s fees, as determined by the court.
II. Upon commencement of any action brought under this section, the clerk of the court shall mail a copy of the complaint or other initial pleadings to the commissioner and, upon entry of any judgment or decree in the action, shall mail a copy of such judgment or decree to the commissioner.
2 Effective Date. This act shall take effect January 1, 2010.
LBAO
09-0958
Amended 04/29/09
SB 90 FISCAL NOTE
AN ACT establishing a private right of action for pharmacies against health maintenance organizations.
FISCAL IMPACT:
The Insurance Department states this bill, as amended by the Senate (Amendment #2009-1178s), may increase state revenue, state expenditures, county expenditures, and local expenditures by an indeterminable amount in FY 2010 and each year thereafter. There will be no fiscal impact on county and local revenue.
METHODOLOGY:
The Insurance Department states this bill provides court approved recoveries to pharmacies injured by an HMO’s violation of RSA 420-B:12,V. The Department assumes any costs realized by the HMOs would probably be recovered through increased premiums. To the extent the state procures administrative services from a licensed HMO, there may be an indeterminable increase in expenditures. To the extent county and local governments purchase HMO coverage for employees there may be an indeterminable increase in expenditures. The Department states to the extent health insurance premiums increase as a result of this bill, premium tax revenue will increase.