1 Short Title. This act shall be known as the "Sunshine in Savings Act".

2 New Subdivision; 340B Drug Pricing Program; Reporting and Claims Identification. Amend RSA 126-A by inserting after section 106 the following new subdivision:

340B Drug Pricing Program; Reporting and Claims Identification

126-A:107 Definitions. In this subdivision:

I. "340B covered entity" has the same meaning as in 42 U.S.C. section 256b(a)(4).

II. "340B drug" means a covered outpatient drug as defined under section 1396r-8(k)(2) and (3) of Title 42 of the United States Code.

III. "Net 340B savings" means aggregate third-party reimbursement, plus patient payment, minus the aggregate acquisition cost and any dispensing or administrative fees.

IV. "Other item and service" means any health care item or service that is not a covered drug and that is furnished to a patient of a non-profit hospital by the non-profit hospital, a practice location of the non-profit hospital, or a pharmacy with which the non-profit hospital contracts.

V. "Patient" means an individual who is or has been admitted or registered to receive health care items or services from a non-profit hospital and who, in connection with a hospital visit, is furnished, dispensed, or administered a covered drug or other item and service from the non-profit hospital, a practice location of the non-profit hospital, or a pharmacy with which the non-profit hospital contract.

VI. "Practice location" means any clinic, department, or off-site facility that is an integral part of a non-profit hospital. A clinic, department, or off-site facility is an integral part of a non-profit hospital if it is listed and reimbursable on the non-profit hospital's Medicare cost report.???

126-A:108 Annual Public Report; 340B Covered Entities.

I. By?April 1?each year, each 340B covered entity shall file with the department of health and human services a report for the prior fiscal year in a manner and form as specified by the department:

(a) For the hospital and each practice location of the hospital and pharmacy that the non-profit hospital contracts with, the number of patients who are dispensed or administered covered drugs (and their percentage, out of all patients treated by the hospital, practice location or pharmacy, as the case may be), delineated by form of insurance coverage or payor type, including but not limited to Medicare, Medicaid and other payers.

(b) The following information reported separately for the hospital, each practice location of the hospital and each pharmacy that the hospital contracts with, as applicable:

(1) The total acquisition cost for all covered drugs furnished to patients;

(2) The total reimbursement for all covered drugs furnished to patients;?

(3) The total acquisition cost for other items and services furnished to patients; and?

(4) The total reimbursement for other items and services furnished to patients.?

(c) The total net revenue received by the hospital, each practice location of the hospital, and each pharmacy that the hospital contracts with, for all covered drugs administered or dispensed to patients. For purposes of this report, "total net revenue" means the total revenues received by the hospital, practice location of the hospital, or pharmacy that the hospital contracts with, whether from payers or patients, for covered drugs purchased minus the total acquisition cost of such covered drugs. The hospital shall separately report the net revenues for the hospital, for each practice location of the hospital, and each pharmacy that the hospital contracts with.????

(d) With respect to such hospital, practice location of the hospital, and pharmacy that the hospital contracts with, the total costs of purchasing covered drugs or other items and services to patients at the hospital, each practice location of the hospital, and each pharmacy that the hospital contracts with, and the total costs incurred for charity care furnished to patients at the hospital, each practice location of the hospital, and each pharmacy that the hospital contracts with. For purposes of this report, "charity care" shall have the meaning ascribed to it in line 23 of worksheet S-10 to the Medicare cost report or in any successor form, provided that a children's hospital that does not file a Medicare cost report is exempted from this reporting requirement.?

(e) With respect to such hospital, any contract the hospital has entered into with a state or local government entity with respect to the provision of health care services to lower income individuals who are uninsured or may be under-insured.??

(f) Any other information specified by the department.??

(g) A signed attestation from the chief executive officer or chief financial officer of the hospital, certifying the accurateness and completeness of the report, including there is of no diversion/duplicate discounts identified via audit.

II. The department shall publish? the information under paragraph I in an annual, de-identified statewide dashboard with hospital-level summaries.

126-A:109 Medicaid Claim Identification. The department shall require claim-level 340B identifiers across? fee-for-service and managed care organization claims and implement exclusion rules to prevent duplicate discounts, consistent with GAO/CMS guidance. The department shall publish an annual integrity report regarding such data collection practices on the department's website.

126-A:110 Rural Patient Benefit Plan. Beginning April 1, 2027 and annually thereafter, hospitals that report more than?$2,000,000 in net 340B savings shall file with the department a rural patient benefit plan describing targeted investments in rural services within the hospital service area with measurable metrics.

126-A:111 Patient Transparency. Hospitals shall post a plain-language?340B patient notice and charity-care policy on their websites and at points of service.

126-A:112 Confidentiality.? Reports created pursuant to this subdivision shall be based on aggregated data and shall not include ceiling prices, unit rebate amounts, or drug-specific proprietary pricing.

126-A:113 Rulemaking; Compliance; Enforcement.

I. The department may adopt rules under RSA 541-A regarding the requirements of this subdivision.

II. Material non-filing or false filing constitutes an unfair or deceptive act under RSA 358-A and any right or remedy under RSA 358-A may be used to enforce this subdivision.

126-A:114 Severability. If any section, provision, or portion of this subdivision, including any condition or prerequisite to any action or determination thereunder, is for any reason held to be illegal or invalid, this illegality or invalidity shall not affect the remainder thereof or any other section, provision, or portion of this subdivision, including any condition or prerequisite to any action or determination thereunder, which shall be construed and enforced and applied as if such illegal or invalid portion were not contained therein.?

3 Effective Date.? This act shall take effect January 1, 2027.

1 Short Title. This act shall be known as the "Sunshine in Savings Act".

2 New Subdivision; 340B Drug Pricing Program; Reporting and Claims Identification. Amend RSA 126-A by inserting after section 106 the following new subdivision:

340B Drug Pricing Program; Reporting and Claims Identification

126-A:107 Definitions. In this subdivision:

I. "340B covered entity" has the same meaning as in 42 U.S.C. section 256b(a)(4).

II. "340B drug" means a covered outpatient drug as defined under section 1396r-8(k)(2) and (3) of Title 42 of the United States Code.

III. "Net 340B savings" means aggregate third-party reimbursement, plus patient payment, minus the aggregate acquisition cost and any dispensing or administrative fees.

IV. "Other item and service" means any health care item or service that is not a covered drug and that is furnished to a patient of a non-profit hospital by the non-profit hospital, a practice location of the non-profit hospital, or a pharmacy with which the non-profit hospital contracts.

V. "Patient" means an individual who is or has been admitted or registered to receive health care items or services from a non-profit hospital and who, in connection with a hospital visit, is furnished, dispensed, or administered a covered drug or other item and service from the non-profit hospital, a practice location of the non-profit hospital, or a pharmacy with which the non-profit hospital contract.

VI. "Practice location" means any clinic, department, or off-site facility that is an integral part of a non-profit hospital. A clinic, department, or off-site facility is an integral part of a non-profit hospital if it is listed and reimbursable on the non-profit hospital's Medicare cost report.???

126-A:108 Annual Public Report; 340B Covered Entities.

I. By?April 1?each year, each 340B covered entity shall file with the department of health and human services a report for the prior fiscal year in a manner and form as specified by the department:

(a) For the hospital and each practice location of the hospital and pharmacy that the non-profit hospital contracts with, the number of patients who are dispensed or administered covered drugs (and their percentage, out of all patients treated by the hospital, practice location or pharmacy, as the case may be), delineated by form of insurance coverage or payor type, including but not limited to Medicare, Medicaid and other payers.

(b) The following information reported separately for the hospital, each practice location of the hospital and each pharmacy that the hospital contracts with, as applicable:

(1) The total acquisition cost for all covered drugs furnished to patients;

(2) The total reimbursement for all covered drugs furnished to patients;?

(3) The total acquisition cost for other items and services furnished to patients; and?

(4) The total reimbursement for other items and services furnished to patients.?

(c) The total net revenue received by the hospital, each practice location of the hospital, and each pharmacy that the hospital contracts with, for all covered drugs administered or dispensed to patients. For purposes of this report, "total net revenue" means the total revenues received by the hospital, practice location of the hospital, or pharmacy that the hospital contracts with, whether from payers or patients, for covered drugs purchased minus the total acquisition cost of such covered drugs. The hospital shall separately report the net revenues for the hospital, for each practice location of the hospital, and each pharmacy that the hospital contracts with.????

(d) With respect to such hospital, practice location of the hospital, and pharmacy that the hospital contracts with, the total costs of purchasing covered drugs or other items and services to patients at the hospital, each practice location of the hospital, and each pharmacy that the hospital contracts with, and the total costs incurred for charity care furnished to patients at the hospital, each practice location of the hospital, and each pharmacy that the hospital contracts with. For purposes of this report, "charity care" shall have the meaning ascribed to it in line 23 of worksheet S-10 to the Medicare cost report or in any successor form, provided that a children's hospital that does not file a Medicare cost report is exempted from this reporting requirement.?

(e) With respect to such hospital, any contract the hospital has entered into with a state or local government entity with respect to the provision of health care services to lower income individuals who are uninsured or may be under-insured.??

(f) Any other information specified by the department.??

(g) A signed attestation from the chief executive officer or chief financial officer of the hospital, certifying the accurateness and completeness of the report, including there is of no diversion/duplicate discounts identified via audit.

II. The department shall publish? the information under paragraph I in an annual, de-identified statewide dashboard with hospital-level summaries.

126-A:109 Medicaid Claim Identification. The department shall require claim-level 340B identifiers across? fee-for-service and managed care organization claims and implement exclusion rules to prevent duplicate discounts, consistent with GAO/CMS guidance. The department shall publish an annual integrity report regarding such data collection practices on the department's website.

126-A:110 Rural Patient Benefit Plan. Beginning April 1, 2027 and annually thereafter, hospitals that report more than?$2,000,000 in net 340B savings shall file with the department a rural patient benefit plan describing targeted investments in rural services within the hospital service area with measurable metrics.

126-A:111 Patient Transparency. Hospitals shall post a plain-language?340B patient notice and charity-care policy on their websites and at points of service.

126-A:112 Confidentiality.? Reports created pursuant to this subdivision shall be based on aggregated data and shall not include ceiling prices, unit rebate amounts, or drug-specific proprietary pricing.

126-A:113 Rulemaking; Compliance; Enforcement.

I. The department may adopt rules under RSA 541-A regarding the requirements of this subdivision.

II. Material non-filing or false filing constitutes an unfair or deceptive act under RSA 358-A and any right or remedy under RSA 358-A may be used to enforce this subdivision.

126-A:114 Severability. If any section, provision, or portion of this subdivision, including any condition or prerequisite to any action or determination thereunder, is for any reason held to be illegal or invalid, this illegality or invalidity shall not affect the remainder thereof or any other section, provision, or portion of this subdivision, including any condition or prerequisite to any action or determination thereunder, which shall be construed and enforced and applied as if such illegal or invalid portion were not contained therein.?

3 Effective Date.? This act shall take effect January 1, 2027.