The bill SB 173-FN seeks to align state law with the federal No Surprises Act, addressing the coverage and payment for emergency and certain non-emergency services provided by out-of-network providers at in-network facilities. It prohibits balance billing for these services and establishes a payment rate determined through negotiation or an independent dispute resolution (IDR) process. The bill introduces new definitions, such as "Nonparticipating provider" and "Qualifying payment amount," and amends the Consumer Protection Act to make balance billing an unlawful act. Additionally, it updates the Managed Care Law to ensure consistency with federal law.

The bill details the IDR process for resolving payment disputes between health carriers and providers, including a 30-day negotiation period, a 4-day window to initiate IDR, and a 30-day deadline for the IDR entity to make a binding fair value determination. Health carriers must pay the determined amount within 30 days or face interest charges and potential attorney’s fees. The bill also specifies the certification and fee schedule for IDR entities, and it amends the Unfair Insurance Trade Practices Act to include timely payment to nonparticipating providers as a requirement. The bill repeals RSA 329:31-b, which previously addressed balance billing, and is set to take effect on January 1, 2025.

Statutes affected:
Introduced: 420-J:3, 420-J:8, 420-J:8-e, 420-J:12, 329:31-b, 151:21, 153-A:2
As Amended by the Senate: 420-J:3, 417:4, 329:31-b
Version adopted by both bodies: 420-J:3, 417:4, 329:31-b
CHAPTERED FINAL VERSION: 420-J:3, 417:4, 329:31-b