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.

In 2024, the state passed legislation to create a committee to study the impact of pharmacy benefit manager operations on the cost, administration, and distribution of prescription drugs.  The state also enacted a law establishing criteria for prior authorization required by insurers offering managed care health benefit plans.

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).