CHAPTER 252

SB 102-FN – FINAL VERSION

03Jun2009… 1560h

2009 SESSION

09-0896

01/03

SENATE BILL 102-FN

AN ACT relative to managed care and patient choice.

SPONSORS: Sen. Fuller Clark, Dist 24; Sen. Lasky, Dist 13; Sen. DeVries, Dist 18; Sen. Roberge, Dist 9; Rep. Rosenwald, Hills 22

COMMITTEE: Commerce, Labor and Consumer Protection

ANALYSIS

This bill requires provider contracts under managed care to contain a provision that covered persons will have access to any provider in the network.

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

03Jun2009… 1560h

09-0896

01/03

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Nine

AN ACT relative to managed care and patient choice.

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

252:1 New Paragraph; Patients’ Bill of Rights. Amend RSA 151:21 by inserting after paragraph XX the following new paragraph:

XXI. Subject to the terms and conditions of the patient’s insurance plan, the patient shall have access to any provider in his or her insurance plan network and referral to a provider or facility within such network shall not be unreasonably withheld pursuant to RSA 420-J:8, XIV.

252:2 New Subparagraph; Patient Information. Amend RSA 332-I:2, I by inserting after subparagraph (e) the following new subparagraph:

(f) Subject to the terms and conditions of the patient’s insurance plan, the patient shall have access to any provider in his or her insurance plan network and referral to a provider or facility within such network shall not be unreasonably withheld pursuant to RSA 420-J:8, XIV.

252:3 New Paragraph; Managed Care; Provider Contracts. Amend RSA 420-J:8 by inserting after paragraph XIII the following new paragraph:

XIV. Every contract or contract amendment entered into after the effective date of this paragraph between a health care carrier and any provider or facility shall contain a provision stating that no provider employed by a hospital or any affiliate is required or in any way obligated to refer patients to providers also employed or under contract with the hospital or any affiliate. Nothing in this paragraph shall be construed to prohibit health care carriers from providing coverage for only those services which are medically necessary and subject to the terms and conditions of the covered person’s policy.

252:4 Effective Date. This act shall take effect 60 days after its passage.

Approved: July 16, 2009

Effective Date: September 14, 2009