relative to insurance coverage for glucose monitoring.
HB 648 would expand New Hampshire health insurance coverage for diabetes care by requiring individual, group, health service corporation, and HMO policies to cover glucose monitoring devices and related supplies for people with diabetes. The bill specifically adds traditional blood glucose monitors and continuous glucose monitoring systems (CGMS), along with sensors, transmitters, receivers, lancets, and test strips, to the list of covered diabetes equipment. It also requires coverage for outpatient diabetes self-management training, medical nutrition therapy, insulin, oral agents, and other diabetes treatment equipment where a prescription rider or pharmacy/durable medical equipment coverage exists.
The bill places limits on cost-sharing for insulin and glucose-monitoring equipment. Insulin prescriptions would be capped at $30 per 30-day supply and would not be subject to deductibles. Glucose monitoring devices and supplies would also be covered without a deductible, and insurers could not require prior authorization, an endocrinology referral, insulin use, or a minimum testing frequency as a condition of coverage. The bill does, however, require periodic follow-up care with a treating practitioner to maintain continued coverage: every six months during the first 18 months of use, then at least annually afterward.
HB 648 would amend four insurance statutes—RSA 415:6-e, RSA 415:18-f, RSA 420-A:17-a, and RSA 420-B:8-k—thereby extending the same diabetes coverage requirements across individual policies, group policies, health service corporations, and health maintenance organizations. It would create a new mandated benefit for continuous glucose monitoring and associated supplies for people with Type 2 diabetes or gestational diabetes, while also reinforcing existing diabetes coverage rules and insulin cost caps. The fiscal note indicates the bill could increase claims costs and premiums, with possible indirect effects on state, county, and local health insurance spending, and it may trigger potential state cost-defrayal obligations under federal exchange rules.
The available materials suggest generally favorable support for the bill’s goal of improving access to diabetes monitoring and treatment. The bill is framed as a consumer and health coverage expansion, and the fiscal note reflects the Insurance Department’s view that it would broaden access to medically necessary monitoring supplies and equipment. No committee transcript or vote record is provided, so there is no documented opposition or recorded floor sentiment in the supplied materials.
The main policy tension is cost versus access. Supporters appear to favor broader, easier access to glucose monitoring devices and supplies, while the fiscal note highlights insurer concerns about higher claim frequency, higher unit costs, and resulting premium increases. Another point of potential contention is the scope of the mandate: the bill requires coverage without prior authorization, endocrinology referral, or insulin-use thresholds, which reduces administrative barriers but may be viewed by insurers as limiting utilization controls. The bill also raises a possible federal exchange cost-defrayal issue, which could create a state fiscal obligation if the mandate is treated as an additional essential health benefit.