Rep. Dave Nagel

Maddy summaryHB 1347 prevents health care facilities (like hospitals and clinics) from blocking referrals from outside primary care doctors when both the facility and specialist accept the patient's insurance. It directly affects patients seeking specialist care and health care facilities that previously restricted such referrals. The bill requires facilities to accept these referrals if insurance is accepted, and violations can result in $100,000 fines per incident or loss of nonprofit status. Enforcement is handled by the attorney general, with the law taking effect 60 days after passage.

Maddy summaryHB 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.

Maddy summaryHB 1752 requires commercial timber harvesters and mills to use a standardized tracking ticket that follows forest products (like logs, chips, or biomass) from the harvest site through processing. This ticket system establishes a verifiable chain of custody for all timber sold or processed, directly affecting harvesters, landowners, and forest product mills. Key provisions include mandating the ticket’s use for all commercial harvesting, requiring signatures on notices of intent to cut, and posting approved notices at harvest sites. The bill updates existing forestry regulations to create uniform tracking, replacing previous inconsistent documentation methods.

Maddy summaryHB 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.

Maddy summaryHB 1406 prohibits health insurance companies (health carriers) from using artificial intelligence to override doctors' clinical decisions. Specifically, it bans AI from auditing or adjusting provider codes based on AI recommendations that would change a physician's professional judgment about patient care. Health carriers must document all AI use in claims processing and provide these records to regulators. Violations are considered unfair insurance practices, potentially resulting in fines or restitution for denied care. The law directly affects healthcare providers and insurers, taking effect January 1, 2027.

Maddy summarySB 663 creates a working group within New Hampshire's Department of Health and Human Services to study Medicaid reimbursement rates for nursing homes. The group, including state officials and healthcare associations, will examine issues like access to care, staffing needs, infrastructure costs, and fair rate adjustments during ownership changes. It also allocates $5 million for a one-time payment to licensed nursing facilities serving Medicaid patients that saw their daily reimbursement rates drop below 95% of 2025 rates as of January 1, 2026. The working group must submit recommendations by December 2026, with the department having sole discretion over distributing the funds.

Maddy summaryThis bill repeals a 2025 law requiring New Hampshire to sell the Anna Philbrook Center property in Concord by June 2027. The state currently uses the property for adult transitional housing and office space for about 40 state staff. By removing the sales mandate, the bill prevents the state from collecting an expected $5 million in revenue from the sale while avoiding $75,000-$90,000 in costs related to preparing the property for sale and relocating equipment. The repeal keeps the property under state management without changing its current operational use.

Maddy summarySB 548 requires health insurance companies in New Hampshire to hold a public hearing with the insurance commissioner within 15 business days if they terminate a contract with a healthcare provider that would affect 1,000 or more patients. It also mandates that all health insurance provider contracts include a 60-day provision ensuring patients maintain access to their provider after termination (except for unprofessional conduct), and requires insurers and providers to jointly notify affected patients about this access and the hearing. The bill directly affects health insurers, healthcare providers, and patients covered by these contracts. These provisions aim to ensure transparency and continuity of care during contract terminations that impact large groups of patients.

Maddy summaryHB 1318 renews a state committee studying non-drug treatment options for chronic pain patients, extending its work through 2027. The bill requires the committee to submit annual interim reports to legislative leaders and the governor by November 1 each year, with a final report due by November 1, 2027. It focuses on developing payment models to support patient-centered, integrated care for chronic pain management. The committee’s prior work established a foundation for a pilot program, and this renewal aims to explore practical implementation strategies.

Maddy summarySB 422 expands the governor's commission on addiction, treatment, and prevention by adding two new public members: one with expertise in gaming addiction and one representing long-term recovery. It also changes the status of the faith-based community representative from non-voting to a voting member. The bill modifies the commission's membership structure under state law to include these additions, increasing the total public members from seven to nine. These changes directly affect the commission's composition and decision-making process for addressing addiction-related policies. The bill takes effect 60 days after enactment.