Overview
The state of New Hampshire is a trailblazer that is highly active in considering innovative cost containment solutions and expanding price transparency initiatives. New Hampshire created one of the nation’s first all-payer claims databases (“APCD”) in 2003 to collect and disseminate healthcare price information, leading the way for many other states. In 2007, price transparency leader New Hampshire took its APCD one step further and launched NHHealthCost.org, a website that provides the median bundled prices for the thirty most common healthcare services. Continuing the trend, the state was the first state to use health insurance claims to rate networks and also the first state to implement right-to-shop or shared incentive policies. In 2015, The state commissioned Anthem Blue Cross and Blue Shield to develop a right-to-shop pilot program for state employees. Powered by Sapphire Digital’s SmartShopper program, the initiative resulted in $12 million in savings with $1 million paid out to patients as rewards in just the first three years.
New Hampshire’s antitrust legislation bans most-favored nation clauses in provider contracts and prohibits exclusive contracting for managed care plans. New Hampshire also prohibits most non-compete agreements for physicians. In merger review authority, New Hampshire law requires healthcare-specific notice of transactions involving nonprofit hospitals to the attorney general and a broad public interest criterion that includes consideration of competition concerns. As a result, the AG is active in antitrust enforcement of provider mergers in the state, blocking the proposed merger of Exeter Health Resources and Wentworth-Douglass Hospital in 2019 due to concerns that it would adversely impact competition for certain health care services in the Seacoast region of New Hampshire.
Additionally, New Hampshire established a work requirement for those seeking Medicaid who are part of the Expansion population and received CMS approval in 2020 for its Section 1332 waiver for state-based reinsurance program to reduce premium rates. The legislature has also proposed several bills to implement single payer in the state and continues to push for parity in telehealth reimbursement to supplement its existing coverage parity law.
See below for an overview of existing New Hampshire state mandates. Click on citation tab for detailed information of specific statutes (click link to download statute text).
State Action
Latest Legislative Session: 1/4/2023 - 1/3/2024 (2023-2024 term). *Current session bill updates are ongoing. Check back weekly for updates.
HB 1044 – New Hampshire
Introduced: 2022 Status: Inactive / Dead
Relative to direct payment and membership-based health care facilities. This bill exempts facilities operating with membership-based or direct payment business models from certain special licensing provisions.
HB 1140 – New Hampshire
Introduced: 2020 Status: Inactive / Dead
An Act establishing a hospital merger advisory commission. This bill establishes a commission to monitor the merger of hospitals. The commission shall monitor proposals to merge, and the mergers of, hospitals and other health care …
HB 1241 – New Hampshire
Introduced: 2018 Status: Inactive / Dead
AN ACT ESTABLISHING A COMMISSION TO ASSESS BENEFITS AND COSTS OF A “HEALTH CARE FOR ALL” PROGRAM FOR NEW HAMPSHIRE: This bill establishes a commission to study the benefits and cost of a “health care …
HB 1280 – New Hampshire
Introduced: 2019 Status: Enacted
Relative to copayments for insulin, establishing a wholesale prescription drug importation program, establishing a New Hampshire prescription drug affordability board, establishing the prescription drug competitive marketplace, relative to the pricing of generic prescription drugs, relative …
HB 1362 – New Hampshire
Introduced: 2018 Status: Inactive / Dead
AUTHORIZING INDIVIDUALS AND CERTAIN BUSINESSES TO PURCHASE HEALTH INSURANCE FROM OUT-OF-STATE COMPANIES: This bill authorizes individuals and certain businesses to purchase health insurance from out-of-state companies.
N.H. Rev. Stat. Ann. §§ 417-F:1 through 3: Coverage for Emergency Services – New Hampshire
Introduced: Status: Enacted
A participating provider or other authorized representative of the plan that gives prior authorization shall not rescind or modify the authorization after the health care provider has rendered the authorized emergency services care in good …
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N.H. Rev. Stat. Ann. §§ 417:1 through 417:17: Unfair Insurance Trade Practices — General Provisions – New Hampshire
Introduced: Status: Enacted
The purpose of this chapter is to regulate trade practices in the business of insurance, in accordance with the intent of Congress as expressed in the Act of Congress of March 9, 1945 (Public Law …
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N.H. Rev. Stat. Ann. §§ 420-C:1 through 420-C:8: Preferred Provider Agreements – New Hampshire
Introduced: Status: Enacted
The purpose of this chapter is to assure that health benefit plans encourage covered persons to seek health care services from preferred providers and that contracts or agreements between preferred providers and health care insurers …
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N.H. Rev. Stat. Ann. §§ 420-E:1, 420-E:4-a, 420-E:5, & 420-E:6: Licensure of Medical Utilization Review Entities – New Hampshire
Introduced: Status: Enacted
Beginning July 1, 2017, all health insurers, health maintenance organizations, health services corporations, medical services corporations, and preferred provider programs may, when requiring prior authorization for a prescription drug, use and accept the prior authorization …
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N.H. Rev. Stat. Ann. §§ 420-G:1 through 420-G:16: Portability, Availability, and Renewability of Health Coverage – New Hampshire
Introduced: Status: Enacted
The department and the department of health and human services shall enter into a memorandum of understanding for collaboration in the development of a comprehensive health care information system. The department shall make available to …
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United States et al. v. Anthem, Inc., and Cigna Corp. – California, Colorado, Connecticut, District of Columbia, Federal, Georgia, Iowa, Maine, Maryland, New Hampshire, New York, Tennessee, Virginia
District Court: District of Columbia Status: Decided
On April 28, 2017, the D.C. Circuit Court of Appeals affirmed the District Court’s decision to block the proposed $54 billion merger between Anthem and …
In re: Suboxone Antitrust Litigation (State of Wisconsin, et al. v. Indivior Inc, et al.) – Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Utah, Virginia, Washington, West Virginia, Wisconsin
District Court: E.D. Pennsylvania Status: Pending
In September 2016, 35 state attorneys general and the District of Columbia brought a multi-district case against pharmaceutical manufacturer Indivior, MonoSol RX et al., alleging …
In Re: Generic Pharmaceuticals Pricing Antitrust Litigation – Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin
District Court: Eastern District of Pennsylvania Status: Pending
Plaintiffs are attorney generals from 48 states, Puerto Rico, and the District of Columbia, as well as classes of private plaintiffs that filed an antitrust …
Additional Resources
STATE BUDGET
New Hampshire enacts budgets on a two-year cycle. The fiscal year begins July 1 of each odd-numbered year and ends on June 30 of the next odd-numbered year.
REGULATION & ENFORCEMENT
- The New Hampshire Attorney General is conducted a review on the proposed affiliation of The Memorial Hospital at North Conway (“Memorial Hospital”) and MaineHealth pursuant to RSA 7:19-b. The Attorney general approved the merger in June 2016. The transaction made MaineHealth the sole corporate member of Memorial Hospital with certain reserved powers over Memorial Hospital’s governance and operations.
- Additional enforcement actions by the Department of Insurance can be found on the Department’s website.