Bill Details - SB63 (2019)

SB 63 - AS AMENDED BY THE SENATE

 

03/21/2019   1209s

2019 SESSION

19-1103

01/05

 

SENATE BILL 63

 

AN ACT relative to sharing of insurer rebates with enrollees.

 

SPONSORS: Sen. Morgan, Dist 23; Sen. Hennessey, Dist 5; Sen. Cavanaugh, Dist 16; Sen. Sherman, Dist 24

 

COMMITTEE: Commerce

 

─────────────────────────────────────────────────────────────────

 

ANALYSIS

 

This bill requires insurers to certify on an annual basis to the department of insurance that they are making available to their enrollees a percentage of rebates.

 

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

 

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

03/21/2019   1209s 19-1103

01/05

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Nineteen

 

AN ACT relative to sharing of insurer rebates with enrollees.

 

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

 

1  New Section; Accident and Health Insurance; Cost Sharing.  Amend RSA 415-A by inserting after section 6 the following new section:

415-A:7  Establishing Excess Cost Sharing.

I.  In this section:

(a)  "Insurer" means an entity subject to the insurance laws and rules of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including a policy of insurance, health service corporation, health maintenance organization, preferred provider agreement, or any other entity providing accident and health insurance.

(b)  "Rebate" means:

(1)  Negotiated price concessions including, but not limited to, base rebates and reasonable estimates of any price protection rebates and performance-based rebates that may accrue directly or indirectly to the insurer during the coverage year from a manufacturer, dispensing pharmacy, or other party to the transaction; and

(2)  Reasonable estimates of any fees and other administrative costs that are passed through to the health carrier and serve to reduce the insurer's prescription drug liabilities for the coverage year.

II.  An insurer shall annually, commencing on November 1, 2019, certify to the department of insurance that, during the prior benefit year, the insurer made available to enrollees at the point of sale at least 75 percent of the rebates received by such insurer.

III.  Any insurer that violates any provision of this section may at the discretion of the commissioner be subject to paragraph (a) or (b), or both:

(a)  Its certificate of authority may be indefinitely suspended or revoked.

(b)  A civil fine not to exceed $2,500 may be imposed for each violation.  Repeated violations of the same provision shall constitute separate civil offenses.

IV.  In making the disclosures required under this section, an insurer shall not publish or otherwise reveal information regarding the amount of rebates it receives, including, but not limited to, information regarding the amount of rebates it receives on a product-, manufacturer-, or pharmacy-specific basis.  Such information is protected as a trade secret, is not a public record subject to disclosure under RSA 91-A:1, and shall not be disclosed directly or indirectly.  An insurer shall impose the confidentiality provision of this section on any vendor or third party that performs health care or administrative services on behalf of the insurer that may receive or have access to rebate information.

2  Repeal.  RSA 415-A:7, relative to sharing of insurer rebates with enrollees, is repealed.

3  Effective Date.  

I.  Section 2 of this act shall take effect July 1, 2024.

II.  The remainder of this act shall take effect 60 days after its passage.

 

LBAO

19-1103

Amended 4/5/19

 

SB 63- FISCAL NOTE

AS AMENDED BY THE SENATE (AMENDMENT #2019-1209s)

 

AN ACT relative to sharing of insurer rebates with enrollees.

 

FISCAL IMPACT:      [ X ] State              [ X ] County               [ X ] Local              [    ] None

 

 

 

Estimated Increase / (Decrease)

STATE:

FY 2020

FY 2021

FY 2022

FY 2023

   Appropriation

Indeterminable

Indeterminable

Indeterminable

Indeterminable

   Revenue

$0

$0

$0

$0

   Expenditures

$0

$0

$0

$0

Funding Source:

  [ X ] General            [    ] Education            [    ] Highway           [ X ] Other - Insurance Premium Tax Revenue

 

 

 

 

 

COUNTY:

 

 

 

 

   Revenue

$0

$0

$0

$0

   Expenditures

Indeterminable

Indeterminable

Indeterminable

Indeterminable

 

 

 

 

 

LOCAL:

 

 

 

 

   Revenue

$0

$0

$0

$0

   Expenditures

Indeterminable

Indeterminable

Indeterminable

Indeterminable

 

METHODOLOGY:

This bill requires insurers to certify on an annual basis to the department of insurance that they are making available to their enrollees a percentage of rebates.  The Insurance Department indicates it is unable to determine what might happen to rebates if the bill passes or how rebates may be affected when the requirement is repealed on July 1, 2024.  There may be an impact on claim costs and premiums, which may impact premium tax revenue.

 

AGENCIES CONTACTED:

Insurance Department

 

Docket

Date Status
Jan. 3, 2019 Introduced 01/03/2019 and Referred to Commerce; SJ 4
Feb. 19, 2019 Hearing: 02/19/2019, Room 100, SH, 02:15 pm; SC 11
March 21, 2019 Committee Report: Ought to Pass, 03/21/2019; SC 14
March 21, 2019 Sen. Bradley Floor Amendment # 2019-1209s, AA, VV; 03/21/2019; SJ 9
March 21, 2019 Ought to Pass with Amendment 2019-1209s, MA, VV; OT3rdg; 03/21/2019; SJ 9
March 20, 2019 Introduced 03/20/2019 and referred to Commerce and Consumer Affairs HJ 11 P. 72
April 24, 2019 Public Hearing: 04/24/2019 10:00 am LOB 302
May 16, 2019 Full Committee Work Session: 05/16/2019 09:30 am LOB 302
May 21, 2019 Executive Session: 05/21/2019 11:00 am LOB 302

Action Dates

Date Body Type
Feb. 19, 2019 Senate Hearing
March 21, 2019 Senate Floor Vote
April 24, 2019 House Hearing
May 21, 2019 House Exec Session

Bill Text Revisions

SB63 Revision: 5026 Date: Jan. 17, 2019, 5:44 p.m.
SB63 Revision: 5652 Date: April 9, 2019, 11:07 a.m.