This bill aims to improve consumer health care cost transparency by aligning state hospital transparency obligations with federal standards and establishing protections for hospitals that provide good-faith estimates. It requires hospitals to maintain public transparency files and patient-friendly estimators for shoppable services, ensuring compliance with federal requirements. Additionally, hospitals will not face penalties for discrepancies between estimates and final bills if these discrepancies arise from clinically necessary changes or factors beyond their control. The Department of Health and Human Services is tasked with publishing an annual dashboard to summarize hospital compliance with these transparency mandates.

Moreover, the bill amends RSA 420-J to enhance consumer protection measures related to health insurance estimates. It mandates that estimates include clear disclosures about potential variances, network status, prior authorization, and differences between facility and professional billing. Providers must also offer relevant CPT/HCPCS codes and service descriptions for scheduled, non-emergency services to facilitate comparison shopping. The bill maintains existing protections against balance billing and surprise medical billing, while granting the insurance commissioner enforcement authority and requiring a notice and cure period for initial violations. An annual public dashboard will track compliance, with certain provisions taking effect 12 months after passage and others 60 days post-passage.

Statutes affected:
Introduced: 151:12-d, 420-G:11-a
SB476 text: 151:12-d, 420-G:11-a