Text to be removed highlighted in red.
214:1 Managed Care Law; Network Adequacy. Amend RSA 420-J:7, II(b) to read as follows:
(b) Choice of and access to providers for specialty care, specifically addressing the needs of the chronically ill, mentally ill, persons with substance use disorder, developmentally disabled or those with a life threatening illness.
214:2 New Section; Notice of Consumer Rights. Amend RSA 420-J by inserting after section 7-d the following new section:
420-J:7-e Notice of Consumer Rights. A health carrier shall, at least annually, in a conspicuous communication as approved by the commissioner which may be included as an insert in an annual mailing or by electronic communication, notify each covered person of his or her consumer rights under this chapter, including, but not limited to, appeal rights and the ability to access services out-of-network in the event covered services are not available in-network. A health carrier shall also notify covered persons of the right to access out-of-network services when the covered person contacts the health carrier directly requesting assistance finding clinically appropriate in-network care. A health carrier shall also provide notification to covered persons of their right to appeal whenever a covered person contacts the health carrier regarding a denial of coverage or when a health carrier verbally informs the covered person of the denial of coverage.
214:3 Effective Date. This act shall take effect January 1, 2018.
Approved: July 10, 2017
Effective Date: January 01, 2018
Text to be added highlighted in green.
214:1 Managed Care Law; Network Adequacy. Amend RSA 420-J:7, II(b) to read as follows:
(b) Choice of and access to providers for specialty care, specifically addressing the needs of the chronically ill, mentally ill, persons with substance use disorder, developmentally disabled or those with a life threatening illness.
214:2 New Section; Notice of Consumer Rights. Amend RSA 420-J by inserting after section 7-d the following new section:
420-J:7-e Notice of Consumer Rights. A health carrier shall, at least annually, in a conspicuous communication as approved by the commissioner which may be included as an insert in an annual mailing or by electronic communication, notify each covered person of his or her consumer rights under this chapter, including, but not limited to, appeal rights and the ability to access services out-of-network in the event covered services are not available in-network. A health carrier shall also notify covered persons of the right to access out-of-network services when the covered person contacts the health carrier directly requesting assistance finding clinically appropriate in-network care. A health carrier shall also provide notification to covered persons of their right to appeal whenever a covered person contacts the health carrier regarding a denial of coverage or when a health carrier verbally informs the covered person of the denial of coverage.
214:3 Effective Date. This act shall take effect January 1, 2018.
Approved: July 10, 2017
Effective Date: January 01, 2018