Revision: March 27, 2014, midnight
HB 1281-FN – AS AMENDED BY THE HOUSE
12Mar2014… 0832h
2014 SESSION
01/04
HOUSE BILL 1281-FN
AN ACT relative to copayments for certain specialists.
SPONSORS: Rep. D. Sullivan, Hills 42; Rep. Sapareto, Rock 6; Rep. Major, Rock 14; Rep.?Weyler, Rock 13; Sen. Woodburn, Dist 1; Sen. Larsen, Dist 15; Sen. Bradley, Dist 3; Sen. Soucy, Dist 18
COMMITTEE: Commerce and Consumer Affairs
This bill declares that under individual policies copayments, coinsurance, or office deductibles for chiropractors and physical therapists shall not be greater than such amounts charged for the services of primary care physicians or osteopaths licensed under RSA 329. Insurers offering group policies shall offer an optional plan which requires that copayments, coinsurance, or office deductibles for chiropractors and physical therapists shall not be greater than such amounts charged for the services of primary care physicians or osteopaths licensed under RSA 329.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
12Mar2014… 0832h
14-2370
01/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Fourteen
AN ACT relative to copayments for certain specialists.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; Insurance; Individual; Copayments for Certain Specialists. Amend RSA 415 by inserting after section 6-r the following new section:
415:6-s Copayments, Coinsurance, or Office Visit Deductibles for Certain Specialists. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance that constitutes health coverage for the services of chiropractors licensed under RSA 316-A, or physical therapists licensed under RSA 328-A, shall not charge a copayment, coinsurance, or office visit deductible that is greater than the copayment, coinsurance, or office visit deductible amount charged to the insured for the services of a primary care physician or osteopath licensed under RSA?329.
2 New Section; Insurance; Group; Copayments for Certain Specialists. Amend RSA 415 by inserting after section 18-w the following new section:
415:18-x Copayments, Coinsurance, or Office Visit Deductibles for Certain Specialists. Each insurer that issues or renews any policy of group or blanket accident or health insurance that constitutes health coverage for the services of chiropractors licensed under RSA 316-A, or physical therapists licensed under RSA 328-A, shall offer an optional plan which shall not charge a copayment, coinsurance, or office visit deductible that is greater than the copayment, coinsurance, or office visit deductible amount charged to the insured for the services of a primary care physician or osteopath licensed under RSA 329.
3 Health Service Corporations; Copayments for Certain Specialists. Amend RSA 420-A:2 to read as follows:
420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-s, RSA 415:18, V, RSA 415:18, VII(g), RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA?415:18-x, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.
4 Health Maintenance Corporations; Copayments for Certain Specialists. Amend RSA 420-B:20, III to read as follows:
III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-s, RSA 415:18, VII(g), RSA 415:18, VII-a, RSA?415:18, XVI and XVII, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA?415:18-x, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.
5 Applicability; Effective Date. The provisions of sections 1 and 2 of this act shall take effect and apply January 1, 2015 to health insurance plans effective on or after January 1, 2015 and sold exclusively off the federally-facilitated exchange. For health insurance plans sold through the federally-facilitated exchange and those same plans sold off the federally-facilitated exchange, the provisions of sections 1 and 2 shall take effect and apply January 1, 2016.
6 Effective Date.
I. Sections 1 and 2 of this act shall take effect as provided in section 5 of this act.
II. The remainder of this act shall take effect 60 days after its passage.
LBAO
14-2370
10/24/13
HB 1281-FN - FISCAL NOTE
AN ACT relative to copayments for certain specialists.
FISCAL IMPACT:
The Department of Insurance states this bill, as introduced, will have an indeterminable impact on state revenues, and county and local expenditures in FY 2014 and each year thereafter. This bill will have no fiscal impact on state expenditures, or county and local revenues.
METHODOLOGY:
The Department of Insurance states this bill limits health insurance plan designs involving copayments, coinsurance, or deductibles. The bill would limit out-of-pocket amounts, attributable to these plan design features, for certain services provided by chiropractors or physical therapists to what the out-of-pocket amount would be for services provided by a primary care physician or osteopath. The Department indicates to the extent the limits affect plan costs; there may be an impact on insurance premium tax collections.
The Department of Administrative Services states this bill will have no fiscal impact on the state employee and retiree health benefit program. The Department states the program is self-funded and not subject to the provisions of this bill. In addition, the Department indicates co-payments for the state employees’ coverage are controlled by collective bargaining agreements and the co-payments currently are the same for specialty providers and primary care physicians.