Relative to prohibiting insurance companies from conducting an audit of providers services after services have been delivered but before payment has been made to such provider.
Summary
HB 706 would amend New Hampshire’s accident and health insurance law to prohibit insurers from conducting an audit of a provider’s services after the services have been delivered but before the provider has been paid. The bill is aimed at preventing post-service, pre-payment claim audits that could delay reimbursement or be used to deny payment after care has already been provided.
If an insurer violates the prohibition, the bill requires the insurer to promptly pay the provider, hold the patient harmless for any copay or coinsurance tied to the services, pay 15% annual interest from the date of service until payment, and reimburse the provider’s enforcement costs. It also states that an insurer found in violation waives the right to retrospectively review the audited services. The act would take effect 60 days after passage.
Impact
The bill would add a new paragraph to RSA 415:6-i governing accident and health insurance practices, creating a specific restriction on insurer audits in the individual market and related provider payment practices. It would also impose financial penalties and payment obligations on insurers that conduct prohibited audits, while shielding patients from cost-sharing consequences tied to those services. The fiscal note indicates no direct state expenditure impact, but potentially indeterminable increases in General Fund revenue if insurers raise premiums and thereby increase insurance premium tax collections; local and county impacts are also described as indeterminable.
Sentiment
The available materials suggest the bill is generally framed as a provider-protection measure, with the stated purpose of preventing delayed or retroactive insurer audits after care has been delivered. No committee transcript or recorded votes were provided, so there is no direct evidence of formal support or opposition in the record supplied. The fiscal note’s methodology reflects a neutral administrative assessment rather than a policy endorsement, noting possible premium increases and revenue effects if insurers pass costs through to consumers.
Contention
The main point of contention is likely the balance between protecting providers from delayed audits and preserving insurers’ ability to review claims for accuracy and fraud control. Providers would benefit from guaranteed payment, interest, and enforcement-cost reimbursement, while insurers could face higher claims costs and lose retrospective review rights if they violate the new rule. Another potential concern is that insurers may respond by increasing premiums, which could shift costs to policyholders and affect public and private purchasers of health coverage.
Removing fees and charges for governmental records under the right-to-know law and reinstating potential liability for disclosure of information exempt from disclosure.