New HampshireHealth plans would change how clinician-administered drugs are provided
If enacted, health plans would cover certain faster clinic-dispensed drugs and could not require patients to carry them to health professionals for treatment.
What it does
Health maintenance organizations would have to cover certain clinician-administered drugs dispensed by in-network hospitals or clinics when that route is medically faster and follows plan terms.
Health plans and pharmacy benefit managers could not require patients to pick up certain clinician-administered drugs and carry them to a clinic, unless the patient or prescriber makes a written request.
Argument forPatients may face fewer safety and handling concerns because clinics, rather than patients, would arrange delivery of drugs meant for professional administration.
Argument againstInsurers may face higher costs when pharmacies cannot use patient transport, which could put upward pressure on premiums for some policyholders.
More detail
A health maintenance organization or its representative would have to authorize, approve, and pay for a covered clinician-administered drug dispensed by an in-network hospital or clinic. This applies to outpatient prescription drugs, other than vaccines, that patients or helpers cannot reasonably give themselves and that health professionals usually give in a clinical setting. The drug must be provided faster through the hospital or clinic than through any other insurer-covered method, based on medical standards for the patient's condition. The dispensing, approval, authorization, and payment must follow the health plan's benefit and the same terms used for similar network providers. This rule would apply beginning January 1, 2026, if the bill is enacted.
A health maintenance organization, pharmacy benefits manager, or representative would be barred from requiring a pharmacy to give the drug directly to a patient for transport to a health care setting. The rule covers clinician-administered outpatient drugs that generally must be given by a health professional in a clinical setting. The restriction would not apply if the patient or prescriber asks for this arrangement in writing. This rule would apply beginning January 1, 2026, if the bill is enacted.
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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 19Interim 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
- Sep 17Subcommittee Work Session: 10/07/2026 10:00 am GP 229
- Aug 21Subcommittee Work Session: 09/09/2026 10:00 am GP 229
- May 14Refer for Interim Study: MA VV 05/14/2026 HJ 13 P. 2
- May 1Committee Report: Refer for Interim Study 04/29/2026 (Vote 15-0; CC) HC 19 P. 6
- Apr 22Executive Session: 04/29/2026 10:00 am GP 229
- Apr 16Subcommittee Work Session: 04/22/2026 10:00 am GP 229
- Apr 2Public Hearing: 04/07/2026 02:15 pm GP 159
- Apr 1Subcommittee Work Session: 04/08/2026 10:00 am GP 229
- Mar 2Vacated and Referred to Commerce and Consumer Affairs (Rep. Kofalt): MA VV (in recess of) 02/19/2026 HJ 5 P. 127Minor
- Feb 26Introduced (in recess of) 02/19/2026 and referred to Health, Human Services and Elderly Affairs HJ 5 P. 124Minor
- Jan 7Ought to Pass with Amendment #2025-3029s, MA, VV; OT3rdg; 01/07/2026; SJ 1Passed Senate
- Jan 7Committee Amendment # 2025-3029s, AA, VV; 01/07/2026; SJ 1
- 2025
- Oct 22Committee Report: Ought to Pass with Amendment # 2025-3029s, 01/07/2026; Vote 5-0; CC; SC 46Minor
- Mar 6Rereferred to Committee, MA, VV; 03/06/2025; SJ 6Minor
- Feb 21Committee Report: Rereferred to Committee, 03/06/2025; Vote 5-0; CC; SC 11
- Feb 5Hearing: 02/12/2025, Room 101, LOB, 09:15 am; SC 9
- Jan 23Introduced 01/09/2025 and Referred to Health and Human Services; SJ 3Introduced
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