HB275 (2025) Detail

Relative to health carrier credentialing requirements.


HB 275-FN - AS INTRODUCED

 

 

2025 SESSION

25-0551

05/08

 

HOUSE BILL 275-FN

 

AN ACT relative to health carrier credentialing requirements.

 

SPONSORS: Rep. Flanagan, Hills. 45

 

COMMITTEE: Commerce and Consumer Affairs

 

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ANALYSIS

 

This bill provides that the cost of any additional program or certification required by the health carrier as part of its credentialing procedure or provider eligibility determination shall be the responsibility of the health carrier.

 

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

25-0551

05/08

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Twenty Five

 

AN ACT relative to health carrier credentialing requirements.

 

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

 

1  Managed Care Law; Credentialing Verification Procedures; Health Carrier Responsibility.  Amend RSA 420-J:4, VI to read as follows:

VI. Nothing in this section shall be construed to require a health carrier to select a health care professional as a participating provider solely because the health care professional meets the health carrier's credentialing verification standards, or to prevent a health carrier from utilizing separate or additional criteria in selecting the health care professionals with whom it contracts; provided that the cost of any additional program or certification required by the health carrier as part of its credentialing procedure or provider eligibility determination shall be the responsibility of the health carrier.

2  Effective Date.  This act shall take effect 60 days after its passage.

 

LBA

25-0551

12/27/24

 

HB 275-FN- FISCAL NOTE

AS INTRODUCED

 

AN ACT relative to health carrier credentialing requirements.

 

FISCAL IMPACT:   This bill does not provide funding, nor does it authorize new positions.

 

 

Estimated State Impact

 

FY 2025

FY 2026

FY 2027

FY 2028

Revenue

$0

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

Revenue Fund(s)

General Fund

Expenditures*

$0

$0

$0

$0

Funding Source(s)

None

Appropriations*

$0

$0

$0

$0

Funding Source(s)

None

*Expenditure = Cost of bill                *Appropriation = Authorized funding to cover cost of bill

 

Estimated Political Subdivision Impact

 

FY 2025

FY 2026

FY 2027

FY 2028

County Revenue

$0

$0

$0

$0

County Expenditures

$0

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

Local Revenue

$0

$0

$0

$0

Local Expenditures

$0

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

 

METHODOLOGY:

This bill require health carriers to cover the costs of any additional programming or certification they mandate for provider credentialing.

 

The Insurance Department states since health carriers establish credentialing standards, the bill does not clearly define what is meant by “any additional program or certification.”  However, the Department assumes the bill aims to ensure health carriers reimburse providers for expenses related to obtaining professional certifications.  While these costs are difficult to quantify, they could be significant and may contribute to higher insurance premiums, ultimately leading to increased Insurance Premium Tax revenues.

 

To the extent counties and municipalities purchase health insurance, they could see an increase in their health insurance premiums.

 

AGENCIES CONTACTED:

Insurance Department

 

Links


Action Dates

Date Body Type
Jan. 23, 2025 House Hearing

Bill Text Revisions

HB275 Revision: 46098 Date: Jan. 6, 2025, 10:24 p.m.

Docket


Jan. 15, 2025: Public Hearing: 01/23/2025 01:15 pm LOB 302-304


Jan. 7, 2025: Introduced 01/08/2025 and referred to Commerce and Consumer Affairs HJ 2