HB470: relative to health insurance providers.

CHAPTER 284

HB 470 - FINAL VERSION

25mar03... 0728h

24jun03... 2224CofC

2003 SESSION

03-0750

01/09

HOUSE BILL 470

AN ACT relative to health insurance providers.

SPONSORS: Rep. Gilman, Graf 9; Rep. Buhlman, Hills 66; Rep. Sorg, Graf 11; Sen. Martel, Dist 18

COMMITTEE: Commerce

AMENDED ANALYSIS

This bill:

I. Requires health insurers to keep a provider's personal information confidential.

II. Ensures continued access to care subsequent to a provider contract termination for a certain period of time.

III. Establishes a committee to study the contracting process between managed care insurers and health care providers in the state.

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

25mar03... 0728h

24jun03... 2224CofC

03-0750

01/09

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Three

AN ACT relative to health insurance providers.

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

284:1 New Section; Health Insurers; Providers. Amend RSA 400-A by inserting after section 15-a the following new section:

400-A:15-b Confidentiality of Provider's Personal Information.

I. Health insurers and other third party payors shall not display a medical provider's home address, date of birth, or social security number on documents provided to subscribers for the purpose of claim payment unless the provider has provided that information for the purposes of claim payment.

II. The provisions of this section shall apply to group hospital and medical expense policies subject to RSA 415, group health service plan contracts issued pursuant to RSA 420-A, and to health maintenance organization policies and plans issued pursuant to RSA 420-B.

284:2 Provider Contract Standards; Continued Access. RSA 420-J:8, XI is repealed and reenacted to read as follows:

XI. Every contract entered into after July 1, 2003 between a health carrier and any physician or facility shall contain a provision that ensures that covered persons will have continued access to the provider in the event that the contract is terminated for any reason other than unprofessional behavior. The continued access to providers shall be made available for 60 days from the date of termination of the contract and shall be provided and paid for in accordance with the terms and conditions of the covered person's health benefit plan and the prior contract between a health carrier and a health care provider. Within 5 business days of the contract termination, the health carrier shall provide written notice to affected covered persons explaining their continued access rights.

284:3 New Section; Continued Access to Care Subsequent to a Provider Contract Termination. Amend RSA 420-J by inserting after section 7-c the following new section:

420-J:7-d Continued Access to Care Subsequent to a Provider Contract Termination. The commissioner may extend the period of continued access to care subsequent to a provider contract termination provided for under RSA 420-J:8, XI for up to an additional 60-day period.

284:4 Committee Established. There is established a committee to study the contracting process between managed care insurers and health care providers in the state.

284:5 Membership and Compensation.

I. The members of the committee shall be as follows:

(a) Three members of the house of representatives, appointed by the speaker of the house.

(b) Three members of the senate, appointed by the president of the senate.

II. Members of the committee shall receive mileage at the legislative rate when attending to the duties of the committee.

284:6 Duties. The committee shall study the contracting process between managed care insurers and health care providers in the state and shall, to the extent practicable:

I. Determine the cause or causes of the recent spate of contracting disputes.

II. Evaluate potential policies to prevent or decrease the incidence of contract disputes and promote a more equitable compensation scheme for health care providers while not adding to the cost of health insurance, including so called "any willing provider" legislation.

III. Evaluate potential policies for protecting covered persons when contract disputes occur while not adding to the cost of health insurance, including the question whether existing laws providing a period of continued access to health care providers for covered persons in the event of a provider contract termination are sufficient to ensure continuity of care for covered persons.

IV. Determine whether any statutory or regulatory changes are needed to achieve a better balance between the interests of increasing competition, controlling health insurance premium increases, promoting choice of health care providers, ensuring quality of care and continuity of care, and achieving a more equitable compensation scheme for health care providers.

284:7 Chairperson; Quorum. The members of the study committee shall elect a chairperson from among the members. The first meeting of the committee shall be called by the first-named house member. The first meeting of the committee shall be held within 45 days of the effective date of this section. Four members of the committee shall constitute a quorum.

284:8 Report. The committee shall report its findings and any recommendations for proposed legislation to the speaker of the house of representatives, the senate president, the house clerk, the senate clerk, the governor, and the state library on or before November 1, 2003.

284:9 Repeal. RSA 420-J:8, XII, relative to certain continued access, is repealed.

284:10 Effective Date.

I. Section 1 of this act shall take effect January 1, 2004.

II. Sections 2, 3, and 9 of this act shall take effect July 1, 2003.

III. The remainder of this act shall take effect upon its passage.

(Approved: July 18, 2003)

(Effective Date: I. Section 1 shall take effect January 1, 2004.

II. Sections 2, 3 and 9 shall take effect July 1, 2003.

III. Remainder shall take effect July 18, 2003)