Bill > SB17

This bill requires health insurance providers to apply any third-party payments (such as those from independent charities) towards an enrollee's cost-sharing requirements for prescription drugs, with some important exceptions. Specifically, the bill defines "cost-sharing" as any coinsurance, copayment, deductible, or out-of-pocket maximum, and mandates that insurers count third-party assistance payments towards these requirements when processing insurance claims. The key exception is for prescription drugs that have a generic alternative or an interchangeable biological product available. If a third-party payment is not processed at the point of sale, pharmacies may be required to disclose details about the payment to the insurer, including the enrollee's name, the drug name, and the payment amount. The bill also provides an exemption for high-deductible health plans and catastrophic health plans until the enrollee meets their minimum deductible. This legislation aims to help patients reduce their out-of-pocket prescription drug costs by ensuring that charitable or other third-party assistance can be applied to their insurance cost-sharing requirements. The bill is set to take effect on January 1, 2026, and could potentially lead to increased insurance premium costs due to the new calculation method.

Health and Social Services

https://gc.nh.gov/bill_status/legacy/bs2016/bill_docket.aspx?lsr=269&sy=2025&sortoption=&txtsessionyear=2025&txtbillnumber=SB17