Healthcare (Insurance)

in committee · New Hampshire · House Aug 21, 2026

HB 1638: creating a bypass mechanism for health insurer step therapy protocols when medically necessary.

HB 1638 creates a process for healthcare providers to bypass step therapy protocols when a patient's condition requires it, directly affecting patients and providers in insurance plans that use step therapy. Step therapy typically forces patients to try less expensive medications first before coverage is provided for more expensive alternatives. The bill requires step therapy protocols to be based on updated clinical guidelines developed by expert panels and mandates that insurers must grant an override request when providers demonstrate medical necessity, including conditions like advanced cancer or serious mental illness. This establishes a clear, evidence-based pathway to avoid unnecessary treatment delays without altering existing insurance coverage rules.

Topics ✓ HealthcareSupports HealthcareBill mandates insurers to bypass step therapy protocols when medically necessary, improving patient access to required treatments and directly addressing a barrier in healthcare coverage.95% confidence

Sub-Topics Insurance Mental Health Prescription Drugs

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signed · New Hampshire · House Aug 5, 2026

HB 1554: requiring insurance carriers to provide peer-to-peer review at any stage of prior authorization and mandating disclosure of reviewer credentials.

HB 1554 requires health insurance companies to offer peer-to-peer reviews at any stage of the prior authorization process, allowing doctors to discuss medical necessity directly with a qualified medical expert. Insurers must disclose the reviewer’s full name, license details, issuing state, and National Provider Identifier (NPI) to the doctor before the review begins. The bill mandates that reviews be scheduled within 2 business days for initial requests or 5 business days after a denial, with written decisions provided promptly. This applies to all health insurance plans and aims to increase transparency and timely decision-making for doctors and patients seeking coverage.

Topics ✓ HealthcareSupports HealthcareMandates transparent peer-to-peer reviews and timely insurer disclosures, improving patient access to necessary care by reducing arbitrary denials.95% confidence

Sub-Topics Insurance

failed · New Hampshire · Senate May 14, 2026

SB 455: relative to coverage for GLP-1 medication under the state Medicaid plan.

SB 455 requires health insurance plans in New Hampshire to cover GLP-1 medications (used for weight management and diabetes) for people with a BMI of 40 or higher, or a BMI of 35 or higher with at least one qualifying health condition like type 2 diabetes, high blood pressure, or heart disease. This applies to all health benefit plans sold in the state, directly affecting covered individuals who meet these criteria and health insurance companies. The bill mandates coverage without prior authorization for these specific eligibility groups, expanding access beyond current typical commercial coverage standards. It takes effect 60 days after enactment.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for GLP-1 medications under specified BMI criteria, expanding access for weight management/diabetes treatment95% confidence

Sub-Topics Insurance Medicaid

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failed · New Hampshire · House Aug 5, 2026

HB 1656: relative to insurance coverage for pelvic health therapy.

HB 1656 requires all health insurance plans in New Hampshire to cover pelvic-floor physical therapy (PFPT) as a standard benefit for specific conditions, including urinary incontinence, pelvic organ prolapse, postpartum recovery, and pelvic pain. It mandates coverage for up to 12 weeks of supervised therapy, pre-surgery preparation (prehab), and post-surgery rehabilitation without prior authorization for initial evaluations. Insurers must report on this coverage data annually, and the insurance department will publish an annual report on insurer compliance. This directly affects residents with pelvic floor dysfunction, ensuring access to evidence-based treatments currently often excluded from coverage.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for pelvic-floor therapy, expanding access to essential health services without prior authorization for specific conditions.95% confidence

Sub-Topics Insurance Substance Abuse

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in committee · New Hampshire · House Aug 21, 2026

HB 1813: relative to changes to health carrier contracts with providers.

HB 1813 requires health insurance carriers to provide participating healthcare providers and facilities with 60 days' notice before making changes to their contracts, limiting such changes to four times per year on January 1, April 1, July 1, and October 1. The bill mandates that carriers include redlined copies showing changes (with additions underlined/bolded and deletions struck through) and, for changes affecting over $500,000 in total annual reimbursement, provide a financial impact estimate to both providers and the Insurance Department. This directly affects health carriers and their contracted providers by increasing transparency and giving providers more time to review significant contract modifications. Exceptions include mutual agreements between carriers and providers, changes required by government rules, or updates to standard medical coding. The law takes effect 60 days after passage.

Topics ✓ HealthcareSupports HealthcareRequires insurers to provide 60-day notice, redlined contracts, and financial impact estimates for major changes, protecting provider stability and patient access to care.85% confidence

Sub-Topics Insurance

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in committee · New Hampshire · Senate Mar 6, 2026

SB 546: relative to health carrier network access monitoring.

SB 546 requires health insurance carriers offering commercial plans in New Hampshire to implement annual secret shopper audits starting January 2027. These audits, conducted by independent third parties, assess whether providers in carriers' networks are accessible and accepting new patients, following federal CMS guidelines for health benefit exchanges. Carriers must submit results by May 31 each year, with penalties for failing to report, confirming fewer than 80% of providers as in-network, or not meeting network access standards. Noncompliant carriers face fines, must reimburse enrollees for out-of-network claims, and may be required to create corrective action plans. The law directly affects all health insurers selling commercial coverage in New Hampshire.

Topics ✓ HealthcareSupports HealthcareRequires annual audits to ensure health carriers maintain accessible provider networks (80% in-network), directly improving patient access to care per CMS guidelines.95% confidence

Sub-Topics Insurance

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passed · New Hampshire · Senate Aug 21, 2026

SB 606: relative to insurance coverage for biomarker testing.

SB 606 requires health insurance plans and Medicaid to cover biomarker testing for diagnosis, treatment, or monitoring of diseases when the test has clinical utility and is supported by evidence like FDA approvals, drug labels, or medical guidelines. It applies to all health benefit plans issued on or after January 1, 2027, and mandates Medicaid coverage under similar standards. The bill limits disruptions in care (e.g., requiring multiple biopsies) and sets strict timelines for prior authorization decisions - 72 hours for urgent cases and 14 days for non-urgent requests. It also ensures patients and providers have a clear, accessible process to appeal coverage denials through health insurers' websites.

Topics ✓ HealthcareSupports HealthcareMandates insurance/Medicaid coverage for biomarker testing, expanding patient access to evidence-based diagnostics without prior authorization barriers.95% confidence

Sub-Topics Insurance Medicaid

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failed · New Hampshire · House Mar 13, 2026

HCR 12: calling upon the federal delegation from New Hampshire to support Medicare for All, a universal health insurance program that guarantees all people the health care they need.

HCR 12 is a New Hampshire legislative resolution urging the state's federal congressional delegation to support Medicare for All. It requests federal lawmakers pursue legislation establishing universal health coverage through Medicare, including comprehensive benefits like dental, vision, and prescription drugs without deductibles, and transitioning current Medicaid recipients into the program. The resolution outlines six key provisions for such a system, emphasizing preventive care, provider choice, cost controls, and quality oversight. As a non-binding resolution, it does not change federal law but expresses the legislature's position on health care policy.

Topics ✓ HealthcareSupports HealthcareCalls for universal Medicare coverage including dental/vision without deductibles, expanding access and comprehensive benefits beyond current Medicaid.95% confidence

Sub-Topics Insurance Medicare Primary Care

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in committee · New Hampshire · House Feb 11, 2026

HB 1232: relative to insurance coverage for telemedicine services.

HB 1232 requires New Hampshire health insurers to reimburse telemedicine services at the same rate as in-person services when the telemedicine code is substantially equivalent to an in-person code. Insurers that fail to comply face administrative fines of up to $2,500 per violation, and repeated violations (three or more in five years) could trigger license suspension. Affected individuals may also sue for court costs and attorney fees if an insurer violates the law repeatedly. The bill applies to all health insurers offering plans in New Hampshire and takes effect January 1, 2027.

Topics ✓ HealthcareSupports HealthcareRequires equal insurance reimbursement for telemedicine, expanding access to healthcare services and protecting patient rights under coverage.95% confidence ✓ TechnologySupports TechnologyRequires equal insurance reimbursement for telemedicine, promoting adoption of digital healthcare technology and ensuring equitable access to tech-enabled services.95% confidence

Sub-Topics Insurance Telehealth

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in committee · New Hampshire · Senate Mar 6, 2026

SB 547: relative to regulation and transparency of pharmacy benefit manager practices.

SB 547 regulates pharmacy benefit managers (PBMs) in New Hampshire to increase transparency and fairness in drug pricing. The bill requires PBMs to act in the best interest of health insurance companies (their clients) and bans them from keeping profits from "spread pricing" - where PBMs charge health plans more than they pay pharmacies for drugs. It defines key terms like "affiliate" and "revenue," and mandates that PBMs pass all rebates from drug manufacturers to health plans rather than retaining them. This directly affects PBMs, health insurers, and pharmacies, aiming to address high drug costs (23% of healthcare spending) and patient cost concerns (25% skip doses due to expense).

Topics ✓ HealthcareSupports HealthcareRegulates PBMs to prevent spread pricing and mandate rebate passing to insurers, lowering drug costs and increasing transparency in healthcare pricing systems.95% confidence

Sub-Topics Insurance Prescription Drugs

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