Revision: April 9, 2019, 11:07 a.m.
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
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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.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
03/21/2019 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.
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.
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
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| 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 | |||
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COUNTY: |
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Revenue | $0 | $0 | $0 | $0 |
Expenditures | Indeterminable | Indeterminable | Indeterminable | Indeterminable |
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LOCAL: |
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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