SB389: (New Title) relative to certain insurance contracts.

SB 389 - AS AMENDED BY THE SENATE

03/17/04 0811s

2004 SESSION

04-3103

01/09

SENATE BILL 389

AN ACT relative to certain insurance contracts.

SPONSORS: Sen. Flanders, Dist 7; Sen. Estabrook, Dist 21; Sen. Johnson, Dist 2

COMMITTEE: Insurance

AMENDED ANALYSIS

This bill clarifies that covered persons shall have continued access to their physicians in the event of a termination of a contract between a facility or facilities and a health carrier.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

03/17/04 0811s

04-3103

01/09

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Four

AN ACT relative to certain insurance contracts.

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

1 Provider Contract Standards; Continued Access. Amend RSA 420-J:8, XI to read as follows:

XI.(a) 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.

(b) Notwithstanding subparagraph (a) or any provision conforming with subparagraph (a) contained in the contract, if a contract between a health carrier and a health care facility is terminated, the health carrier shall not, for a period of 120 days from the termination of the contract, terminate its network affiliation with physicians having admitting privileges at the facility or otherwise disrupt or interfere with continued access to health care services for covered persons provided by such physicians for any reason other than unprofessional behavior. This prohibition against disrupting or interfering with continued access to health care services for covered persons shall include all services provided to covered persons at the terminated facility when such persons have been admitted by a physician who is a participating provider. The continued access to such facility 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 the health carrier and the health care facility; provided, that the continued access required by this subparagraph shall no longer be required upon the effective date of a new contract between such health carrier and such health care facility.

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