Commerce and Consumer Affairs

SB 247 allows community pharmacies to decline filling prescriptions when a pharmacy benefits manager (PBM) offers reimbursement below the pharmacy’s actual drug cost, without facing network exclusion. Pharmacies must inform patients to contact their insurer for alternative pharmacy options. The bill also requires pharmacy administrative organizations (PSAOs) to share PBM contracts and payment details with pharmacies within 3 days and prohibits PSAOs from forcing pharmacies to buy drugs from specific suppliers. This applies to independent pharmacies and takes effect January 1, 2026.

SB 256 requires health maintenance organizations (HMOs) to cover clinician-administered drugs (CADs) - outpatient medications that patients cannot safely self-administer and are typically given by healthcare professionals in clinics or hospitals - without requiring prior authorization. It prohibits HMOs from mandating that pharmacies dispense CADs directly to patients for them to transport to a healthcare setting for administration. The bill mandates HMOs to use the lowest-cost reimbursement method for covered CADs and ensures coverage aligns with medical standards of care. This directly affects patients needing CADs (like IV therapies) and HMOs operating in New Hampshire, effective January 1, 2026.

SB 498 creates the New Hampshire Children's Behavioral Health Association to fund mental health services for children under 18. The association will collect mandatory assessments (fees) from insurance companies, stop-loss carriers, and third-party administrators covering children in the state, excluding Medicaid recipients. Funds gathered will be deposited into a dedicated fund managed by the insurance commissioner and used to pay care management entities providing specific services like intensive in-home therapy, structured outpatient programs, and care coordination. This directly affects insurers (who pay assessments), care management organizations (who receive payments), and children under 18 with covered health plans (who gain access to funded services).

SB 647 authorizes New Hampshire's Department of Insurance to join a cooperative group with other states to secure lower prices on prescription drugs through a discount program. The bill enables the department to form an intergovernmental agreement for this purpose, requiring approval from the governor and executive council. This would directly affect the Department of Insurance's operations and potentially reduce prescription drug costs for state residents. The program would take effect on July 1, 2026.

HB 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.