New HampshireInsurers could not audit delivered care before paying providers
If passed, the measure would bar insurers from auditing delivered services before payment and require them to pay providers if they break the rule.
What it does
Insurers could not audit a provider's services after delivery but before payment. If an insurer breaks the rule, it must pay the provider, protect the patient from cost-sharing, and cover interest and enforcement costs.
Argument forProviders could get paid sooner after an improper audit, while patients would not owe copays or coinsurance for those services.
Argument againstInsurers could face more claim payments and enforcement costs, and they may raise premiums to offset those costs.
More detail
The proposal would bar insurers from auditing delivered services before paying providers. The rule covers audits of provider services after delivery but before the insurer has paid for them. If an insurer violates the rule, it must pay the provider's charge and the provider's costs to enforce the rule. The insurer must also pay 15% annual interest from the service date until payment and cover the patient's copay or coinsurance. The insurer would give up its right to review those services later. The proposal would take effect 60 days after passage.
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Where it stands
- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- Oct 15Interim Study Report: Not Recommended for Future Legislation 10/15/2026 (Vote 11-0; )Latest
- Oct 1Executive Session: 10/14/2026 10:00 am GP 229
- Aug 21Subcommittee Work Session: 09/09/2026 10:00 am GP 229
- Jan 7Refer for Interim Study: MA VV 01/07/2026 HJ 1 P. 46
- 2025
- Nov 13Committee Report: Refer for Interim Study 10/28/2025 (Vote 17-0; CC) HC 51 P. 5
- Oct 8Executive Session: 10/28/2025 11:00 am GP 229
- Aug 27Full Committee Work Session: 09/10/2025 10:00 am GP 229
- Mar 19Retained in Committee
- Mar 13Executive Session: 03/19/2025 10:00 am LOB 302-304
- Mar 7Subcommittee Work Session: 03/12/2025 01:15 pm LOB 302-304
- Feb 13Public Hearing: 02/19/2025 01:45 pm LOB 302-304
- Jan 22Introduced (in recess of) 01/09/2025 and referred to Commerce and Consumer Affairs HJ 3 P. 24Introduced
Healthcare