Health carriers would give providers 60 days' contract-change notice

Health carriers would give participating providers and facilities 60 days' notice before proposing covered contract changes. The rule covers changes to provider contracts, attachments, exhibits, and provider manuals. Carriers could send these notices only four times each calendar year, effective January 1, April 1, July 1, and October 1. The carrier and provider or facility could jointly waive the 60-day notice period. A carrier could send a notice at another time when required by state or federal government action or because of changes to American Medical Association procedure codes. The act would take effect 60 days after passage, and the four notice dates would apply each calendar year after that effective date.

Health carriers would provide both the current and revised versions of each affected contract document. The documents would include contracts, attachments, exhibits, and provider manuals sent to participating providers or facilities. Carriers would provide the documents in print or electronically. The revised version would show added language in bold and underlined text and deleted language with a visible strikeout. The document copies would be provided as part of the required notice after the act takes effect.

Health carriers would estimate and report the statewide financial effect of covered contract changes that alter provider payments by more than $500,000 per year. The estimate would cover the combined effect across all participating providers and facilities in New Hampshire that have a provider contract with the carrier. The carrier would give each affected provider or facility a good-faith estimate of the total yearly financial effect. The carrier would send the estimate and an explanation of all financial effects to the insurance commissioner. The information would be published on the Insurance Department's website or made available when the department requests it. The carrier would submit this information annually for each covered change after the act takes effect.