SB 559-FN - AS AMENDED BY THE SENATE
03/07/2024 0985s
2024 SESSION
24-3113
05/08
SENATE BILL 559-FN
AN ACT relative to the New Hampshire vaccine association.
SPONSORS: Sen. Prentiss, Dist 5; Sen. Fenton, Dist 10; Sen. Watters, Dist 4; Sen. Altschiller, Dist 24; Sen. Rosenwald, Dist 13; Sen. Perkins Kwoka, Dist 21; Sen. Whitley, Dist 15; Sen. Chandley, Dist 11; Rep. Merchant, Sull. 6
COMMITTEE: Health and Human Services
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AMENDED ANALYSIS
This bill defines biological products for purposes of the assessment determination by the New Hampshire vaccine association.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
03/07/2024 0985s 24-3113
05/08
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Four
AN ACT relative to the New Hampshire vaccine association.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Hampshire Vaccine Association; Definitions; Definition of Biological Product Added. Amend RSA 126-Q:1, III - X to read as follows:
III. "Assessable lives" means all children under 19 years of age residing in the state who have assessable coverage written or administered by an assessable entity, with the exception of children whose vaccines or biological products are paid for under the federal Vaccines for Children program, established under 42 U.S.C. section 1396s.
IV. "Assessment" means the assessable entity's liability with respect to childhood vaccines or biological products determined in accordance with this chapter. For purposes of rate setting and medical loss ratio calculations, all association assessments are considered pharmaceutical or medical benefit costs and not regulatory costs. In the event of any insolvency or similar proceeding affecting any payer, assessments shall be included in the highest priority of obligations to be paid by or on behalf of such payer.
V. "Association" means the New Hampshire vaccine association.
V-a. “Biological product” means any biological product, including monoclonal antibody products, that has been approved by the federal Food and Drug Administration and recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention to be added to the Vaccines for Children program and has been authorized by the commissioner of the department of health and human services for administration to children of the state of New Hampshire under the age of 19 years for the purposes of protecting against diseases caused by infectious pathogens.
VI. "Board" means the board of directors of the New Hampshire vaccine association.
VII. "Commissioner" means the commissioner of the department of health and human services.
VIII. "Estimated vaccine cost" means the estimated cost to the state over the course of a state fiscal year of the purchase, distribution, and administration of vaccines and biological products purchased at the federal discount rate by the department of health and human services.
IX. "Provider" means a person licensed by this state to provide health care services to persons or a partnership or corporation made up of those persons.
X. "Total non-federal program cost" means the estimated vaccine and biological products cost less the amount of federal revenue available to the state for the purchase, distribution, and administration of vaccines.
2 New Hampshire Vaccine Association; Assessment Determination. Amend RSA 126-Q:4, II(c) to read as follows:
(c) Add a reserve of up to 10 percent of the anticipated cost under subparagraph (a) for unanticipated costs associated with providing vaccines and biological products to children covered; and
3 New Hampshire Vaccine Association; Assessment Determination. Amend RSA 126-Q:4, V to read as follows:
V. The board may determine an interim assessment for new vaccines, new biological products, or unanticipated shortfalls in the association's ability to meet childhood vaccine funding needs. The board shall calculate the interim assessment in accordance with paragraph II, and the interim assessment is payable the calendar quarter that begins no less than 30 days following the establishment of the federal contract price. The board shall not impose more than one interim assessment per year, except in the case of a public health emergency declared in accordance with state or federal law.
4 Effective Date. This act shall take effect 60 days after its passage.
24-3113
Amended 4/1/24
SB 559-FN- FISCAL NOTE
AS AMENDED BY THE SENATE (AMENDMENT #2024-0985s)
AN ACT relative to the New Hampshire vaccine association.
FISCAL IMPACT: [ X ] State [ ] County [ ] Local [ ] None
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Estimated State Impact - Increase / (Decrease) | ||||||
| FY 2024 | FY 2025 | FY 2026 | FY 2027 | ||
Revenue | $0 | $717,000 - $1,700,000 | $746,000 - $1,768,000 | $776,000 - $1,839,000 | ||
Revenue Fund(s) | Assessments collected by the NH Vaccine Association | |||||
Expenditures | $0 | $717,000 - $1,700,000 | $746,000 - $1,768,000 | $776,000 - $1,839,000 | ||
Funding Source(s) | Assessments collected by the NH Vaccine Association | |||||
Appropriations | $0 | $0 | $0 | $0 | ||
Funding Source(s) | None | |||||
• Does this bill provide sufficient funding to cover estimated expenditures? [X] See Below • Does this bill authorize new positions to implement this bill? [X] No | ||||||
METHODOLOGY:
This bill adds a definition of "biological product" to RSA 126-Q, the statute governing the NH Vaccine Association (NHVA). The Department of Health and Human Services states that there is one immunization, nirsevimab (Beyfortus™), which is not currently eligible for procurement with NHVA funds that would immediately become eligible if the bill is enacted. The immunization in question has been approved and recommended by various federal entities (Food and Drug Administration, Centers for Disease Control and Prevention) for the prevention of severe disease caused by respiratory syncytial virus (RSV). The Department notes that the current contracted price for nirsevimab is $395. If it became eligible for purchase with NHVA funds, the following annual increases in revenue (in the form of an assessment on commercial insurers under the mechanism described in RSA 126-Q) and expenditures may occur, depending on the immunization uptake rate:
The Department assumes that the purchase price of the immunizations will increase by approximately 4 percent per year. The Department further assumes that an unknown number of future immunizations may also become eligible for NHVA purchase under the new definition contained in the bill.
The Insurance Department states that the bill's fiscal impact is indeterminable.
AGENCIES CONTACTED:
Department of Health and Human Services and Insurance Department
| Date | Amendment |
|---|---|
| March 7, 2024 | 2024-0985s |
| Date | Body | Type |
|---|---|---|
| Jan. 31, 2024 | Senate | Hearing |
| Feb. 15, 2024 | Senate | Floor Vote |
| Feb. 15, 2024 | Senate | Floor Vote |
| March 7, 2024 | Senate | Floor Vote |
| March 21, 2024 | Senate | Floor Vote |
| April 25, 2024 | House | Hearing |
| May 1, 2024 | House | Exec Session |
April 24, 2024: Executive Session: 05/01/2024 10:00 am LOB 210-211
April 17, 2024: Public Hearing: 04/25/2024 02:00 pm LOB 206-208
April 2, 2024: Introduced (in recess of) 03/28/2024 and referred to Health, Human Services and Elderly Affairs HJ 10
March 21, 2024: Ought to Pass: MA, VV; OT3rdg; 03/21/2024; SJ 7
March 19, 2024: Committee Report: Ought to Pass, 03/21/2024, Vote 7-0; SC 11A
March 7, 2024: Ought to Pass with Amendment 2024-0985s, MA, VV; Refer to Finance Rule 4-5; 03/07/2024; SJ 6
March 7, 2024: Sen. Prentiss Floor Amendment # 2024-0985s, AA, VV; 03/07/2024; SJ 6
Feb. 15, 2024: Committee Report: Ought to Pass, 03/07/2024, Vote 4-1; SC 9
Feb. 15, 2024: Special Order to 03/07/2024, Without Objection, MA; 02/15/2024 SJ 4
Feb. 8, 2024: Committee Report: Ought to Pass, 02/15/2024, Vote 4-1; SC 7
Jan. 25, 2024: Hearing: 01/31/2024, Room 100, SH, 10:00 am; SC 5
Dec. 14, 2023: To Be Introduced 01/03/2024 and Referred to Health and Human Services; SJ 1