1 New Section; Managed Care Law; Public Hearing Regarding Termination of Provider Contract; When Required. Amend RSA 420-J by inserting after section 7-e the following new section:

420-J:7-f Public Hearing Regarding Termination of Provider Contract; When Authorized.

I. The commissioner may, in the commissioner's discretion, hold a public hearing within 15 business days after receiving notice that a health carrier intends to terminate a contract with a provider when such termination will affect 1,000 or more covered persons. Any hearing held pursuant to this section shall be informational in nature and shall not constitute approval, disapproval, or review of the contract termination. The purpose of the hearing shall be limited to receiving information and testimony regarding the potential effect of the contract termination on access to care in the affected community, including access to quality and affordable physical and mental health care services.

II. Nothing in this section shall be construed to authorize the commissioner to require continuation, modification, or renegotiation of a provider contract.

III. For purposes of this section, a health carrier's obligation to notify the commissioner of a provider contract termination shall be satisfied in accordance with existing notice requirements under this chapter.

2 Managed Care Law; Provider Contract Standards. RSA 420-J:8, XI is repealed and reenacted to read as follows:

XI.(a) Every contract entered into after July 1, 2003, between a health carrier and any physician or facility shall include a provision ensuring that covered persons have continued access to the provider in the event the contract is terminated for any reason other than unprofessional conduct.

(b) Such continued access shall be provided for a period of 60 days from the effective date of contract termination and shall be furnished and reimbursed in accordance with the terms and conditions of the covered person's health benefit plan and the prior contract between the health carrier and the provider.

(c) Within 5 business days of the contract termination, the health carrier shall provide written notice to affected covered persons explaining their continued access rights and stating whether the commissioner has elected to hold a public hearing pursuant to RSA 420-J:7-f.

(d) The commissioner may adopt rules under RSA 541-A to further specify the content of and process for providing notice to consumers when a contract is terminated.

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

1 New Section; Managed Care Law; Public Hearing Regarding Termination of Provider Contract; When Required. Amend RSA 420-J by inserting after section 7-e the following new section:

420-J:7-f Public Hearing Regarding Termination of Provider Contract; When Authorized.

I. The commissioner may, in the commissioner's discretion, hold a public hearing within 15 business days after receiving notice that a health carrier intends to terminate a contract with a provider when such termination will affect 1,000 or more covered persons. Any hearing held pursuant to this section shall be informational in nature and shall not constitute approval, disapproval, or review of the contract termination. The purpose of the hearing shall be limited to receiving information and testimony regarding the potential effect of the contract termination on access to care in the affected community, including access to quality and affordable physical and mental health care services.

II. Nothing in this section shall be construed to authorize the commissioner to require continuation, modification, or renegotiation of a provider contract.

III. For purposes of this section, a health carrier's obligation to notify the commissioner of a provider contract termination shall be satisfied in accordance with existing notice requirements under this chapter.

2 Managed Care Law; Provider Contract Standards. RSA 420-J:8, XI is repealed and reenacted to read as follows:

XI.(a) Every contract entered into after July 1, 2003, between a health carrier and any physician or facility shall include a provision ensuring that covered persons have continued access to the provider in the event the contract is terminated for any reason other than unprofessional conduct.

(b) Such continued access shall be provided for a period of 60 days from the effective date of contract termination and shall be furnished and reimbursed in accordance with the terms and conditions of the covered person's health benefit plan and the prior contract between the health carrier and the provider.

(c) Within 5 business days of the contract termination, the health carrier shall provide written notice to affected covered persons explaining their continued access rights and stating whether the commissioner has elected to hold a public hearing pursuant to RSA 420-J:7-f.

(d) The commissioner may adopt rules under RSA 541-A to further specify the content of and process for providing notice to consumers when a contract is terminated.

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