Parents can direct home education with limited state oversight

Parents can direct their own child's home education on their own schedule. These rules cover New Hampshire children ages 6 through 17 educated by a parent, guardian, or legal custodian. Students in the education freedom account program are excluded. A signed declaration identifying the child is required when withdrawing from public school or seeking access to public school programs. District superintendents must work with parents upon request. Officials cannot govern home education except through policies for public school courses and programs. Parents may certify completion. If they submit a certificate to the education commissioner, the commissioner must issue a completion certificate within 30 days of receipt. Full-time school enrollment or entry into the education freedom account program ends the home education program. Families using public school programs must tell their district when entering that account program. The home education provisions took effect July 1, 2026.

Government agencies must keep home education information confidential unless a parent gives written consent to share it. Privacy protections cover home education families. The protection against a neglect finding based only on program participation also covers education freedom account students. State student tracking and information collection are barred unless the child counts toward district attendance totals or participates in statewide testing. In child protection cases, the state cannot treat home education participation as inadequate education or use missing notices, records, evaluations, or assessments against a program run under these rules. Participation in home education or an education freedom account program alone cannot establish child neglect. Other grounds for neglect still apply. These protections took effect July 1, 2026.

Starting January 1, 2027, companies managing insurers' prescription drug benefits must have written agreements and follow reporting and examination rules. Covered managers include insurer-owned businesses. The insurance commissioner may examine or investigate managers and charge examination costs. Managers must provide records. Administrative fines can reach $5,000 per violation. Agreements must describe duties, instructions, and access to transaction records. Both parties must keep them during the agreement and for five years afterward. Annual reports cover drug spending, fees, and manufacturer rebates, including amounts kept. Reports remain confidential; the insurance commissioner must publish combined rebate totals without identifying insurers or managers. Reporting excludes Medicaid, Medicaid managed care, the Ryan White HIV/AIDS program, self-funded plans, the state employee health plan, and other plans outside the insurance commissioner's authority. Insurers may conduct on-site or virtual audits at least twice yearly when a manager serves more than 100 covered people in New Hampshire on their behalf. These drug benefit manager rules take effect January 1, 2027.

Pharmacy contracts must explain drug payment limits and appeals. Insurers must delay recovering previously paid claims when providers appeal within the required time. These rules cover contracted pharmacies and providers facing recovery of paid claims. Providers have six months after notice to identify insurance held on the service date. Insurers must accept claims another insurer denied because coverage ended or changed. Pharmacies get at least 30 business days after the initial claim to appeal a payment limit. Insurers or managers must resolve appeals within 30 business days. Denied appeals must explain why and identify a drug available at or below the payment limit. Successful appeals require a price correction and permission to rebill within 30 business days. Contracts must identify drug price sources. Payment limits must be available to pharmacies and reviewed and adjusted for price changes at least every 14 days. Initial on-site audits require seven days' notice, plus another seven days if requested. Insurers must give providers at least 15 days' notice before denying previously paid claims. Appeals filed within 15 days of notice delay recovery until the appeal and outside review finish. These contract and claim recovery rules take effect January 1, 2027.

Insurers selling group health coverage must explain rebate treatment and disclose whether a drug benefit manager is paid through differences in drug prices. The disclosure duty covers insurers selling group health coverage. Disclosure of spread pricing applies when a drug benefit manager handles prescription coverage. The disclosure is due when the group plan is sold. Spread pricing means the manager charges the plan a different amount from what it pays the pharmacy. The law permits this practice. Violations of the section governing excess patient cost sharing may carry a civil fine up to $5,000 each. The disclosure requirement and civil fine ceiling take effect January 1, 2027.