Bill Text - SB63 (2020)

Relative to sharing of insurer rebates with enrollees.


Revision: July 23, 2020, 11:34 a.m.

CHAPTER 15

SB 63 - FINAL VERSION

 

03/21/2019   1209s

8Jan2020... 2794h

2020 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

 

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

 

AMENDED ANALYSIS

 

This bill requires insurers to file an annual report 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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.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

8Jan2020... 2794h 19-1103

01/05

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Twenty

 

AN ACT relative to sharing of insurer rebates with enrollees.

 

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

 

15:1New 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.  All rebates remitted by or on behalf of a pharmaceutical manufacturer, developer or labeler, directly or indirectly, to an insurer, or to a pharmacy benefits manager under contract with an insurer, related to its prescription drug benefits shall be remitted in one or both of the following ways:

(a)  Remitted directly to the covered person at the point of sale to reduce the out-of- pocket cost to the covered person associated with a particular prescription drug;

(b)  Remitted to, and retained by, the insurer.  Rebates remitted to the insurer shall be applied by the insurer in its plan design and in future plan years to offset the premium for covered persons.

III.  Beginning November 1, 2020 and annually thereafter, an insurer shall file with the commissioner a report in the manner and form determined by the commissioner demonstrating the manner in which the insurer has complied with this section.

IV.  Any insurer that violates any provision of this section may, at the discretion of the commissioner, be subject to subparagraph (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.

V.  In making the disclosures required under this section, an insurer shall not be required by the department to 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.

15:2  Repeal.  RSA 415-A:7, relative to sharing of insurer rebates with enrollees, is repealed.

15:3  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.

 

Approved: July 17, 2020

Effective Date:

I. Section 2 shall take effect July 1, 2024.

II. Remainder shall take effect September 15, 2020.

 

 

 

CHAPTER 15

SB 63 - FINAL VERSION

 

03/21/2019   1209s

8Jan2020... 2794h

2020 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

 

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

 

AMENDED ANALYSIS

 

This bill requires insurers to file an annual report 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

8Jan2020... 2794h 19-1103

01/05

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Twenty

 

AN ACT relative to sharing of insurer rebates with enrollees.

 

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

 

15:1New 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.  All rebates remitted by or on behalf of a pharmaceutical manufacturer, developer or labeler, directly or indirectly, to an insurer, or to a pharmacy benefits manager under contract with an insurer, related to its prescription drug benefits shall be remitted in one or both of the following ways:

(a)  Remitted directly to the covered person at the point of sale to reduce the out-of- pocket cost to the covered person associated with a particular prescription drug;

(b)  Remitted to, and retained by, the insurer.  Rebates remitted to the insurer shall be applied by the insurer in its plan design and in future plan years to offset the premium for covered persons.

III.  Beginning November 1, 2020 and annually thereafter, an insurer shall file with the commissioner a report in the manner and form determined by the commissioner demonstrating the manner in which the insurer has complied with this section.

IV.  Any insurer that violates any provision of this section may, at the discretion of the commissioner, be subject to subparagraph (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.

V.  In making the disclosures required under this section, an insurer shall not be required by the department to 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.

15:2  Repeal.  RSA 415-A:7, relative to sharing of insurer rebates with enrollees, is repealed.

15:3  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.

 

Approved: July 17, 2020

Effective Date:

I. Section 2 shall take effect July 1, 2024.

II. Remainder shall take effect September 15, 2020.