1 New Section; Managed Care Law; Mental Health Coverage Reporting and Oversight. Amend RSA 420-J by inserting after section 6-e the following new section:

420-J:6-e Mental Health Coverage Reporting and Oversight.

I. Each health insurance carrier offering health benefit plans in this state shall submit an annual report to the insurance department, no later than March 1 of each year, detailing the carrier's policies, procedures, and data regarding mental health and substance use disorder coverage, including but not limited to:

(a) Utilization management practices, including prior authorization, step therapy, and medical necessity criteria.

(b) Claims denial rates for mental health and substance use disorder services compared to medical/surgical services.

(c) Average wait times for in-network mental health provider appointments.

(d) Provider network adequacy specific to mental health and substance use disorder care.

(e) Efforts to ensure compliance with federal mental health parity laws.

II. Reports shall be submitted in a form prescribed by the insurance commissioner and made publicly available, with de-identified aggregate data to protect patient privacy.

III. The insurance commissioner shall review reports annually to ensure compliance with state and federal requirements.

IV. The commissioner may adopt rules under RSA 541-A to enforce this section, including establishing penalties for failure to submit complete or timely reports.

V. The commissioner shall prepare a biennial report to the general court summarizing trends, compliance status, and recommendations for legislative action.

VI. This section shall apply to health carriers providing coverage under the New Hampshire granite advantage health care program pursuant to RSA 126-AA.

2 New Paragraph; Department of Health and Human Services; Mental Health Coverage Reporting and Oversight. Amend RSA 126-A:3 by inserting after paragraph X the following new paragraph:

XI. Beginning March 1, 2027 and annually thereafter, the commissioner of the department of health and human services shall prepare a detailed report regarding the scope and adequacy of mental health coverage and substance use disorder treatment available under the state Medicaid plan, Medicaid managed care waivers and 1115 demonstrations. The commissioner shall submit the report to the speaker of the house of representatives, the senate president, and the governor and shall make the report available on the department's website. The report shall include the data and information regarding:

(a) Utilization management practices, including prior authorization, step therapy, and medical necessity criteria.

(b) Claims denial rates for mental health and substance use disorder services compared to medical/surgical services.

(c) Average wait times for in-network mental health provider appointments.

(d) Provider network adequacy specific to mental health and substance use disorder care.

(e) Efforts to ensure compliance with federal mental health parity laws.

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

1 New Section; Managed Care Law; Mental Health Coverage Reporting and Oversight. Amend RSA 420-J by inserting after section 6-e the following new section:

420-J:6-e Mental Health Coverage Reporting and Oversight.

I. Each health insurance carrier offering health benefit plans in this state shall submit an annual report to the insurance department, no later than March 1 of each year, detailing the carrier's policies, procedures, and data regarding mental health and substance use disorder coverage, including but not limited to:

(a) Utilization management practices, including prior authorization, step therapy, and medical necessity criteria.

(b) Claims denial rates for mental health and substance use disorder services compared to medical/surgical services.

(c) Average wait times for in-network mental health provider appointments.

(d) Provider network adequacy specific to mental health and substance use disorder care.

(e) Efforts to ensure compliance with federal mental health parity laws.

II. Reports shall be submitted in a form prescribed by the insurance commissioner and made publicly available, with de-identified aggregate data to protect patient privacy.

III. The insurance commissioner shall review reports annually to ensure compliance with state and federal requirements.

IV. The commissioner may adopt rules under RSA 541-A to enforce this section, including establishing penalties for failure to submit complete or timely reports.

V. The commissioner shall prepare a biennial report to the general court summarizing trends, compliance status, and recommendations for legislative action.

VI. This section shall apply to health carriers providing coverage under the New Hampshire granite advantage health care program pursuant to RSA 126-AA.

2 New Paragraph; Department of Health and Human Services; Mental Health Coverage Reporting and Oversight. Amend RSA 126-A:3 by inserting after paragraph X the following new paragraph:

XI. Beginning March 1, 2027 and annually thereafter, the commissioner of the department of health and human services shall prepare a detailed report regarding the scope and adequacy of mental health coverage and substance use disorder treatment available under the state Medicaid plan, Medicaid managed care waivers and 1115 demonstrations. The commissioner shall submit the report to the speaker of the house of representatives, the senate president, and the governor and shall make the report available on the department's website. The report shall include the data and information regarding:

(a) Utilization management practices, including prior authorization, step therapy, and medical necessity criteria.

(b) Claims denial rates for mental health and substance use disorder services compared to medical/surgical services.

(c) Average wait times for in-network mental health provider appointments.

(d) Provider network adequacy specific to mental health and substance use disorder care.

(e) Efforts to ensure compliance with federal mental health parity laws.

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