Bill > HB705

This bill, titled "Relative to health care cost transparency," mandates that health plans, which include health carriers and third-party administrators subject to claims data submission, must publicly disclose specific pricing information for covered healthcare items and services. This disclosure will be made through three separate machine-readable files available on an internet website, updated monthly, and accessible to anyone for free. These files will detail in-network rates, including negotiated rates and derived amounts (prices used for internal accounting), out-of-network allowed amounts (the maximum a plan will pay for out-of-network care), and for prescription drugs, negotiated rates and historical net prices (average amounts paid after rebates and discounts). The bill defines various terms like "billed charge" (total charges from a provider), "billing code" (codes like CPT or NDC used for claims), "negotiated rate" (contractual payment amount to in-network providers), and "historical net price" for prescription drugs. The implementation of this bill is contingent upon the finalization of federal guidance related to Presidential Executive Order 14221, which aims to empower patients with clear healthcare pricing information, and it will take effect six months after that federal guidance is finalized, with the insurance commissioner responsible for notifying relevant state officials of the finalization date.

Business and Industry, Health and Social Services

https://gc.nh.gov/bill_Status/billinfo.aspx?id=583&inflect=2