Revision: Jan. 16, 2019, 9:38 a.m.
HB 658-FN - AS INTRODUCED
HOUSE BILL 658-FN
SPONSORS: Rep. Butler, Carr. 7; Rep. Marsh, Carr. 8; Rep. Knirk, Carr. 3; Sen. Sherman, Dist 24
COMMITTEE: Commerce and Consumer Affairs
This bill clarifies the content of provider contract standards under the managed care law.
This bill is a result of the commission to study greater transparency in pharmaceutical costs and rebate programs established in 2018, 350.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Nineteen
Be it Enacted by the Senate and House of Representatives in General Court convened:
(b) For every drug for which the health carrier or pharmacy benefit manager establishes a maximum allowable cost to determine the drug product reimbursement, the health carrier or pharmacy benefit manager shall:
(e) A carrier or pharmacy benefit manager shall include in its contract with the pharmacy terms limiting increases in the maximum allowable cost or other allowable payment maximums for drugs with a maximum allowable cost above $25 to 100 percent of the beginning maximum allowable cost on the first day of any 90-day period to the last day of the 90-day period, without approval of the department of insurance. The carrier shall submit requests for approval to the department of insurance by including the national drug code and the increase requested. The department shall report publicly the prescription drug name and increase in the annual report required under RSA 420-G:14-a, VI(a).
HB 658-FN- FISCAL NOTE
FISCAL IMPACT: [ X ] State [ ] County [ ] Local [ ] None
Estimated Increase / (Decrease)
[ X ] General [ ] Education [ ] Highway [ X ] Other - Administration Fund
This bill amends RSA 420-J:8, XV by limiting increases under the managed care program to the maximum allowable cost or other allowable payment for drugs within a 90-day period without Department approval. The Insurance Department states that to the extent the bill limits how fast claims costs can increase, it may impact the cost of insurance premiums and have a resulting impact on state insurance premium tax revenue. The extent of any such impact is indeterminable. The Department does not anticipate a fiscal impact to its operating budget.
The Department of Administrative Services states there would be no fiscal impact to Department revenue or expenditures.
The Department of Health and Services states there would be no fiscal impact to the Department through the Medicaid program since the Department is not defined as a health carrier regulated by the Insurance Department under RSA 420-J.
Department of Administrative Services, Insurance Department, and Department of Health and Human Services