Revision: Jan. 18, 2023, 5:20 p.m.
SB 72-FN - AS INTRODUCED
2023 SESSION
23-0951
05/08
SENATE BILL 72-FN
AN ACT relative to provider credentialing procedures.
SPONSORS: Sen. Soucy, Dist 18; Sen. Watters, Dist 4; Sen. Gannon, Dist 23; Sen. Whitley, Dist 15; Sen. Rosenwald, Dist 13; Sen. Chandley, Dist 11; Sen. D'Allesandro, Dist 20; Rep. Nagel, Belk. 6; Rep. J. Murphy, Graf. 12; Rep. Ebel, Merr. 7; Rep. Tellez, Hills. 40
COMMITTEE: Executive Departments and Administration
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ANALYSIS
This bill provides that a demographic change shall not result in a disruption in the network participation status of a health care provider. The bill also provides that the insurance commissioner may adopt rules relative to dispute resolution involving provider credentialing procedures.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
23-0951
05/08
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Three
AN ACT relative to provider credentialing procedures.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Credentialing Verification Procedures. Amend RSA 420-J:4, IV to read as follows:
IV. A health carrier shall require all participating providers to notify the health carrier of changes in the status of any items listed in this section at any time, and shall identify for participating providers the individual or department to whom they should report such changes. However, any changes in provider demographics, to include practice location or practice ownership, shall not result in any disruption in the network participation status of provider.
2 New Paragraph; Credentialing Verification Procedures. Amend RSA 420-J:4 by inserting after paragraph VI the following new paragraph:
VII. Disputes regarding a health carrier not meeting the requirements of this section shall be referred to the department, and the commissioner may establish rules under RSA 541-A to resolve such disputes, including any remedies deemed appropriate by the commissioner.
3 Effective Date. This act shall take effect 60 days after its passage.
23-0951
1/9/23
SB 72-FN- FISCAL NOTE
AS INTRODUCED
AN ACT relative to provider credentialing procedures.
FISCAL IMPACT: [ X ] State [ ] County [ ] Local [ ] None
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| Estimated Increase / (Decrease) | |||
STATE: | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
Appropriation | $0 | $0 | $0 | $0 |
Revenue | $0 | $0 | $0 | $0 |
Expenditures | $0 | Indeterminable | Indeterminable | Indeterminable |
Funding Source: | [ ] General [ ] Education [ ] Highway [ X ] Other - Insurance Department Administrative Assessment | |||
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METHODOLOGY:
The Insurance Department indicates this bill would amend RSA 420-J:4 relative to provider credentialing verification procedures. The bill seeks to preserve network participation status of providers, in cases where there are demographic changes, including the practice location and/or practice ownership. To the extent these changes preclude network participation status of a provider, this bill may result in increased access to healthcare providers, compared to current law. The Department assumes the number of affected providers would be small, and the fiscal impact to premiums, and premium tax revenues would be negligible and indeterminable at this time.
The bill also requires the Insurance Commissioner to adjudicate disputes between health carriers and providers. In doing so, the Insurance Commissioner has the authority and discretion to establish rules to resolve said disputes. The Department lacks the ability to estimate the frequency of such disputes and consequently states any cost associated are indeterminable.
AGENCIES CONTACTED:
Insurance Department