Bill Text - SB157 (2017)

Relative to network adequacy and consumer rights under the managed care law.


Revision: March 29, 2017, 4:55 p.m.

SB 157 - AS AMENDED BY THE SENATE

 

03/29/2017   1042s

03/29/2017   1174s

 

2017 SESSION

17-0968

01/10

 

SENATE BILL 157

 

AN ACT relative to network adequacy and consumer rights under the managed care law.

 

SPONSORS: Sen. Feltes, Dist 15; Sen. Fuller Clark, Dist 21; Sen. Hennessey, Dist 5; Sen. Kahn, Dist 10; Sen. Lasky, Dist 13; Sen. Soucy, Dist 18; Sen. Watters, Dist 4; Sen. Woodburn, Dist 1; Rep. Luneau, Merr. 10; Rep. Williams, Hills. 4; Rep. Butler, Carr. 7

 

COMMITTEE: Health and Human Services

 

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AMENDED ANALYSIS

 

This bill adds rulemaking for persons with substance use disorder for the purposes of the managed care law.  This bill also requires health carriers to notify covered persons of their consumer rights under RSA 420-J.

 

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

03/29/2017   1042s

03/29/2017   1174s 17-0968

01/10

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Seventeen

 

AN ACT relative to network adequacy and consumer rights under the managed care law.

 

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

 

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.

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 and coverage has been denied.

3  Effective Date.  This act shall take effect January 1, 2018.