New HampshireNew Hampshire bill would let pharmacies decline prescriptions when insurer managers pay below their cost
As introduced, this New Hampshire bill would let a network pharmacy decline to fill a drug, supply, or service when the benefit manager's payment is less than the pharmacy's cost, and would add contract rules for pharmacy purchasing groups.
What it does
Network pharmacies could decline a drug, supply, or service when the benefit manager's payment is below their cost, and would have to point patients to their insurer or manager for where to fill it.
Pharmacy purchasing and negotiating groups would have to give pharmacies copies of benefit manager contracts within 3 days and could not require purchases from a specific supplier.
Argument forPharmacies, especially small independent ones, could avoid filling prescriptions at a loss when reimbursement falls below what they paid.
Argument againstPatients could be turned away and have to find another pharmacy or pay the difference themselves if their pharmacy declines.
More detail
A pharmacist or pharmacy in a health carrier or benefit manager network may decline to provide a drug, supply, or service if the reimbursement is less than the acquisition cost. It covers brand-name drugs, multi-source generic drugs, supplies, and services. A pharmacy that declines must tell the patient to contact their insurance carrier or pharmacy benefits manager to find where to get it filled. A customer may pay the difference between the acquisition cost and the reimbursement to have the pharmacy fill it. As introduced, the act would take effect January 1, 2026.
Contracts between a pharmacy and a pharmacy services administrative organization must require the organization to give the pharmacy copies of its benefit manager contracts and payment details within 3 calendar days. It covers groups that provide administrative services to independent pharmacies and negotiate with benefit managers for them. These contracts may not require a pharmacy to buy drugs or medical devices from a specific entity. A pharmacy that believes its contract has an unlawful reimbursement or purchasing term may file a complaint with the department. The copies are due within 3 calendar days after a contract or amendment is executed.
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Where it stands
- Introduced
- Passed Senate
- Passed House
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- Oct 21Interim Study Report: Not Recommended for Future Legislation 10/16/2026 (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
- May 28Retained in Committee
- May 21Executive Session: 05/27/2025 01:15 pm LOB 302-304
- Apr 30Subcommittee Work Session: 05/07/2025 10:00 am LOB 302-304
- Apr 16Public Hearing: 04/23/2025 11:00 am LOB 302-304
- Mar 28Introduced (in recess of) 03/27/2025 and referred to Commerce and Consumer Affairs HJ 11 P. 113Minor
- Mar 27Sen. Birdsell Floor Amendment # 2025-1401s, AA, VV; 03/27/2025; SJ 9
- Mar 27Committee Amendment # 2025-1173s, AF, VV; 03/27/2025; SJ 9
- Mar 27Ought to Pass with Amendment #2025-1401s, MA, VV; OT3rdg; 03/27/2025; SJ 9Passed Senate
- Mar 27SB 247 was Removed from the Consent Calendar; 03/27/2025; SJ 9
- Mar 20Committee Report: Ought to Pass with Amendment # 2025-1173s, 03/27/2025; Vote 5-0; CC; SC 14Minor
- Mar 5Hearing: 03/12/2025, Room 101, LOB, 10:30 am; SC 12
- Jan 23Introduced 01/09/2025 and Referred to Health and Human Services; SJ 3Introduced
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