reglab/housing_qa huggingface dataset:
NH Rev Stat § 420-E:2 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-E - Licensure of Medical Utilization Review Entities|Section 420-E:2 - Licensure or Registration Required.

    420-E:2 Licensure or Registration Required. –||I. Any person, partnership or corporation, other than an insurer, nonprofit service organization, health maintenance organization, or an employee of those exempt organizations, that performs medical utilization review services on behalf of commercial insurers, nonprofit service organizations, health maintenance organizations, third-party administrators or employers, shall apply for a license to be issued by the department and shall pay an application fee and an annual license fee. No person, partnership or corporation, other than an insurer, nonprofit service organization, health maintenance organization, or the employees of exempt organizations shall perform utilization review services or medical utilization review services unless the person, partnership, or corporation has received a license in accordance with this chapter.||II. [Repealed.]|||Source. 1992, 142:2. 1993, 249:1. 1996, 188:13. 1997, 345:8, III. 1999, 249:4, eff. Sept. 7, 1999.|
NH Rev Stat § 420-E:2-a (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-E - Licensure of Medical Utilization Review Entities|Section 420-E:2-a - Medical Director.

    420-E:2-a Medical Director. –||Every medical utilization review entity licensed by the department under this chapter shall employ a medical director licensed under RSA 329 or, in the case of a dental utilization review entity, a dentist licensed under RSA 317-A.|||Source. 2000, 18:3. 2004, 187:5, eff. July 31, 2004.|
NH Rev Stat § 420-E:3 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-E - Licensure of Medical Utilization Review Entities|Section 420-E:3 - Information Required.

    420-E:3 Information Required. –||I. Each person, partnership or corporation licensed under this chapter shall, at the time of initial licensure and on or before April 1 of each succeeding year, provide the department with the following information:||(a) The process used by the entity to carry out its utilization review services, including the categories of health care personnel that perform utilization review activities and whether or not such individuals are licensed in this state.||(b) The process used by the entity for addressing beneficiary or provider complaints.||(c) The types of utilization review programs offered by the entity, including, but not limited to:||(1) Second opinion programs.||(2) Prehospital admission certification.||(3) Preinpatient service eligibility determination.||(4) Concurrent hospital review to determine appropriate length of stay.||(d) The process used by the entity to preserve beneficiary confidentiality of medical information.||II. Each person, partnership, or corporation licensed under this chapter shall adopt as the minimal acceptable standards for licensure either the Utilization Review Accreditation Commission (URAC) standards, the National Committee for Quality Assurance (NCQA) standards, or other similar standards acceptable to the commissioner, unless rules establishing stricter standards are adopted pursuant to the commissioner's authority under RSA 420-E:7, XII.|||Source. 1992, 142:2. 1993, 249:2. 1999, 249:5, eff. Sept. 7, 1999.|
NH Rev Stat § 420-E:4-a (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-E - Licensure of Medical Utilization Review Entities|Section 420-E:4-a - Uniform Prior Authorization Forms and Electronic Standard for Prescription Drug Benefits.

    420-E:4-a Uniform Prior Authorization Forms and Electronic Standard for Prescription Drug Benefits. –||I. Beginning July 1, 2017, all health insurers, health maintenance organizations, health services corporations, medical services corporations, and preferred provider programs may, when requiring prior authorization for a prescription drug, use and accept the prior authorization paper forms or electronic standard described in this section.||II. Beginning December 31, 2017, all health insurers, health maintenance organizations, health services corporations, medical services corporations, and preferred provider programs shall, when requiring prior authorization for a prescription drug, use and accept only the prior authorization paper forms or electronic standard described in this section.||III. On or before March 1, 2017, the commissioner shall adopt rules, pursuant to RSA 541-A, specifying the contents and format of the uniform prior authorization paper forms and the electronic prior authorization standard, consistent with the requirements of this section. In developing the paper forms and the electronic standard, the commissioner shall seek input from interested stakeholders, including but not limited to prescribers, pharmacists, carriers, and prescription benefits managers, and shall support adoption of nationally recognized standards for electronic prior authorization of prescription drugs, including those provided by the National Council for Prescription Drug Programs or an equivalent organization as available.||IV. The prior authorization paper forms adopted under this section shall not exceed 2 pages in length.||V. Nothing in this section shall require a carrier or pharmacy benefits manager to use electronic prior authorization. A carrier or pharmacy benefits manager shall not require use of electronic prior authorization when:||(a) A pharmacist or prescriber lacks broadband Internet access;||(b) A pharmacist or prescriber has low patient volume;||(c) A pharmacist or prescriber has opted-out for a certain medical condition or for a patient request;||(d) A pharmacist or prescriber lacks an electronic medical record system;||(e) The electronic prior authorization interface does not provide for the pre-population of prescriber and patient information; or||(f) The electronic prior authorization interface requires an additional cost to the prescriber.||VI. Nothing in this section shall prohibit the use of prior authorization for prescription drug benefits.||VII. This section shall apply to RSA 420-J and shall not apply to the Medicaid managed care program under RSA 126-A:5, XIX.|||Source. 2016, 228:3, eff. June 9, 2016.|
NH Rev Stat § 420-E:5 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-E - Licensure of Medical Utilization Review Entities|Section 420-E:5 - Listing.

    420-E:5 Listing. –||The commissioner shall compile and maintain a current listing of persons, partnerships or corporations licensed pursuant to this chapter. The list shall be available to the public.|||Source. 1992, 142:2, eff. July 5, 1992.|
NH Rev Stat § 420-E:6 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-E - Licensure of Medical Utilization Review Entities|Section 420-E:6 - Periodic Reviews.

    420-E:6 Periodic Reviews. –||The commissioner or designee may conduct periodic reviews of the operations of the entities licensed under this chapter to ensure that they continue to meet the minimum standards set in RSA 420-E:4 and any applicable rules adopted by the commissioner. The commissioner may perform periodic telephone audits of licensees to determine if representatives of the licensee are reasonably accessible, as required in RSA 420-E:4, I.|||Source. 1992, 142:2. 2001, 207:7, eff. Jan. 1, 2002.|
NH Rev Stat § 420-E:7 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-E - Licensure of Medical Utilization Review Entities|Section 420-E:7 - Rulemaking.

    420-E:7 Rulemaking. –||The commissioner shall adopt rules, under RSA 541-A and after public hearing, relative to:||I. Procedures for application for license under RSA 420-E:2.||II. Initial application fees and annual license fees.||III. The time period for notification of determination as required under RSA 420-E:4, IV.||IV. Standards for telephone accessibility as required under RSA 420-E:4, I.||V. Manner for filing and other information for minimum standards as required under RSA 420-E:4.||VI. Manner and content of all forms required under this chapter.||VII. What shall constitute cause to take actions under RSA 420-E:6 and RSA 420-E:8.||VIII. Confidentiality of records and access to records of the provider and reviewer, as required under RSA 420-E:4.||IX. The scope of the review and the information which the reviewer is entitled to review and have access to from the provider.||X. Qualification of the reviewer, as required under RSA 420-E:4, II.||XI. Procedures for registration.||XII. Additional standards for licensure of medical utilization review entities under RSA 420-E:3, II.|||Source. 1992, 142:2. 1993, 249:4. 2001, 207:8, 9. 2012, 171:24, eff. Aug. 10, 2012.|
NH Rev Stat § 420-E:8 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-E - Licensure of Medical Utilization Review Entities|Section 420-E:8 - Enforcement; Administrative Fine; Hearings.

    420-E:8 Enforcement;  Administrative Fine;  Hearings. –||I. The commissioner may take appropriate action against a licensee which fails to meet the standards under this chapter or any rules adopted by the commissioner, or who fails to respond in a timely manner to corrective actions ordered by the commissioner. The commissioner may impose an administrative fine not to exceed $1,000 for each violation or may deny, suspend or revoke the license.||II. Before taking the actions authorized by this section to deny, suspend or revoke the license, the commissioner shall provide the licensee with reasonable time to supply additional information demonstrating compliance with the requirements of this chapter and the opportunity to request a hearing under RSA 541-A. Rehearings and appeals shall be conducted in accordance with RSA 541.|||Source. 1992, 142:2, eff. July 5, 1992.|
NH Rev Stat § 420-E:9 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-E - Licensure of Medical Utilization Review Entities|Section 420-E:9 - Rulings on Appropriateness of Medical Judgments Not Authorized.

    420-E:9 Rulings on Appropriateness of Medical Judgments Not Authorized. –||Nothing in this chapter requires or authorizes the commissioner to rule on the appropriateness of medical decisions or judgments rendered by review entities and their agents.|||Source. 1992, 142:2, eff. July 5, 1992.|
NH Rev Stat § 420-F:2 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-F - Delta Dental Plan of New Hampshire, Inc.|Section 420-F:2 - Directors.

    420-F:2 Directors. –||I. The board of directors who shall manage the business and affairs of Delta shall be composed of 7 participating dentists, 4 public members, and 4 purchaser members.||II. A nominating committee composed of 2 participating dentists, one member of the general public, and 2 purchasers, none of whom are members of the board, selected by a majority vote of the entire board, shall develop recommendations for board nominees, as board vacancies occur, which nominees shall be approved to serve on the board by a majority vote of the entire board. The nominating committee may use an outside consultant in selecting new board members as vacancies occur.|||Source. 1992, 252:1. 1998, 180:3, eff. July 1, 1998.|
NH Rev Stat § 420-F:2-a (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-F - Delta Dental Plan of New Hampshire, Inc.|Section 420-F:2-a - Bylaws.

    420-F:2-a Bylaws. –||Any bylaw developed by the board of directors or developed by the members shall require approval of both 2/3 of the members of the board and a simple majority of all the members of Delta.|||Source. 1998, 180:4, eff. July 1, 1998.|
NH Rev Stat § 420-F:3 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-F - Delta Dental Plan of New Hampshire, Inc.|Section 420-F:3 - Agent License.

    420-F:3 Agent License. –||I. No person, for himself or in behalf of any person, shall sell or offer to sell any Delta benefit plan, as is provided for in this chapter, without being licensed by the commissioner pursuant to the provisions of RSA 402-J.||II. Upon written notice by Delta of its appointment of a person to act as its agent, the commissioner shall issue, if he is first satisfied that the appointee is a suitable person and intends to hold himself out in good faith as an agent and upon payment of the proper fee by the applicant, to the appointee a license to act as such agent.||III. A license previously issued may be renewed upon the application of Delta upon payment of the proper fee.||IV. The commissioner, at any time after granting such license, for cause shown and after notice and hearing, may determine such licensee to be unsuitable to act as such agent, and shall thereupon revoke such license and notify both Delta and the agent of such revocation.||V. Unless revoked by the commissioner, or unless Delta by written notice to the commissioner cancels the agent's authority to act for it, such license issued to an agent, or any renewal thereof, shall expire on June 14 of the second year after its issue.||VI. If a person acts or aids in any manner in the negotiation of Delta contracts, or solicits or receives any application for such contracts, without a license from the commissioner, or if the license granted to him or her or Delta for whom he or she acts as agent has been revoked, he or she shall be guilty of a class A misdemeanor if a natural person, or guilty of a felony if any other person; but any contract issued on an application thus procured shall bind Delta if otherwise valid. This paragraph shall not apply to any clerical employee of Delta, or to any persons rendering their services without compensation.|||Source. 1992, 252:1. 2000, 315:24. 2005, 206:9, eff. Jan. 1, 2006.|
NH Rev Stat § 420-F:4 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-F - Delta Dental Plan of New Hampshire, Inc.|Section 420-F:4 - Filing and Approval of Contracts.

    420-F:4 Filing and Approval of Contracts. –||Delta shall not revise or modify any contract or issue a new contract to a contract holder until it shall have filed with the commissioner a copy of the form of such amendment, modification or contract, including all riders and endorsements, and until the commissioner's approval shall have been obtained. Any form of amendment, modification or contract not disapproved by the commissioner within 90 days after the filing, shall be deemed to have been approved as filed.|||Source. 1992, 252:1, eff. Jan. 1, 1993.|
NH Rev Stat § 420-F:5 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-F - Delta Dental Plan of New Hampshire, Inc.|Section 420-F:5 - Contracts With Contract Holders.

    420-F:5 Contracts With Contract Holders. –||Every contract between Delta and a contract holder shall be in writing, a copy of which shall be furnished to the contract holder and shall contain the following provisions:||I. A statement of the amount payable to Delta by the contract holder and the manner in which such amount is payable.||II. A statement of the nature and extent of the benefits to be provided, and if any benefits are to be limited or excepted, an enumeration of such limitations or exceptions shall be printed with the same prominence as the statement of benefits conferred.||III. A statement of the terms and conditions upon which the contract may be cancelled or otherwise terminated at the option of either party.||IV. A statement that the contract includes endorsements and attached papers, if any, and that it comprises the entire contract.||V. A provision that no statement by the contract holder in its application for a contract shall void the contract or be used in any legal proceeding on the contract unless an exact copy of the application is included or attached to the contract.||VI. A statement of the grace period which will be allowed the contract holder for making any payment due under the contract. Such period shall be not less than 10 days.||VII. If the coverage for dependent children includes coverage for dependent children who are full-time students, as defined by the appropriate educational institution, beyond the age of 18, such dependent coverage shall include coverage for a dependent's medically necessary leave of absence from school for a period not to exceed 12 months or the date on which coverage would otherwise end pursuant to the terms and conditions of the policy, whichever comes first. Any breaks in the school semester shall not disqualify the dependent child from coverage under this paragraph. Documentation and certification of the medical necessity of a leave of absence shall be submitted to the insurer by the student's attending physician and shall be considered prima facie evidence of entitlement to coverage under this paragraph. The date of the documentation and certification of the medical necessity of a leave of absence shall be the date the insurance coverage under this paragraph commences.|||Source. 1992, 252:1. 2007, 289:20, eff. Jan. 1, 2008.|
NH Rev Stat § 420-F:5-a (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-F - Delta Dental Plan of New Hampshire, Inc.|Section 420-F:5-a - Dependent Coverage.

    420-F:5-a Dependent Coverage. –||I. A policy may, at the election of the carrier, insure, originally or by subsequent amendment, upon application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children, or any other person dependent upon the policyholder. In the event a carrier elects to provide coverage for dependent children, the term "dependent child" shall include a subscriber's child by blood or by law, who is under age 26.||I-a. The coverage of any family member insured by such policy, pursuant to paragraph I, who is mentally or physically incapable of earning his or her own living as of the date on which such dependent's status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another policy as long as such incapacity continues and as long as such dependent remains chiefly financially dependent on the policyholder or the employee or his or her estate is chargeable for the care of such dependent; provided, that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this paragraph, such dependent shall be entitled upon the termination of such incapacity to coverage offered by the New Hampshire high risk pool under RSA 404-G.||II. Nothing in this section shall be construed to require:||(a) Coverage for services provided to a dependent before the effective date of this section; or||(b) That an employer pay all or part of the cost of family coverage that includes a dependent as provided pursuant to this section.||III. A subscriber that elects family coverage during any applicable open enrollment period may enroll any dependent eligible pursuant to this section.||IV. Coverage for a dependent provided pursuant to this section shall be provided until the earlier of the following:||(a) The dependent is disqualified for dependent status as set forth in paragraph I of this section; or||(b) The date upon which the employer under whose contract coverage is provided to a dependent ceases to provide coverage to the subscriber.||V. Nothing in this section shall be construed to permit a health insurance carrier to refuse an election for coverage by a dependent pursuant to paragraph III, based upon the dependent's prior disqualification pursuant to subparagraph IV(a).||VI. (a) Notice regarding coverage for a dependent as provided pursuant to this section shall be provided to a subscriber:||(1) In the certificate of coverage prepared for subscribers on or about the date of commencement of coverage; and||(2) Within 30 days following the effective date of this section.||(b) Such notice shall include information regarding the required special open enrollment period.|||Source. 2007, 352:5. 2009, 235:14. 2010, 243:12, eff. Sept. 23, 2010.|
NH Rev Stat § 420-F:6 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-F - Delta Dental Plan of New Hampshire, Inc.|Section 420-F:6 - Rates and Contracts to be Approved.

    420-F:6 Rates and Contracts to be Approved. –||Delta shall file with the insurance commissioner a full schedule of the rates to be paid by contract holders and shall obtain the commissioner's approval prior to implementing any rate changes. The commissioner may refuse such approval if he finds the rates are excessive, inadequate, or discriminatory.|||Source. 1992, 252:1, eff. Jan. 1, 1993.|
NH Rev Stat § 420-F:7 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-F - Delta Dental Plan of New Hampshire, Inc.|Section 420-F:7 - Cancellation or Nonrenewal.

    420-F:7 Cancellation or Nonrenewal. –||I. No contract with a contract holder authorized under this chapter shall be cancelled by Delta, except for nonpayment of premium, unless the contract holder receives a notice of cancellation in accordance with this section. Notice of cancellation for breach of the contract by the contract holder shall be delivered to the contract holder or mailed to the contract holder's last address as shown in the records of Delta at least 10 days prior to the effective date of the cancellation. Notice of cancellation for lack of participation shall be delivered to the contract holder or mailed to the contract holder's last address as shown in the records of Delta, at least 30 days prior to the effective date of the cancellation.||II. No contract with a contract holder authorized under this chapter shall be nonrenewed by Delta, except for nonpayment of premium, unless the contract holder receives either a notice of nonrenewal or an offer of renewal in accordance with this section. The notice of nonrenewal or offer of renewal shall be delivered to the contract holder or mailed to the contract holder's last address as shown in the records of Delta at least 30 days prior to the renewal date of the contract.|||Source. 1992, 252:1, eff. Jan. 1, 1993.|
NH Rev Stat § 420-F:8 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-F - Delta Dental Plan of New Hampshire, Inc.|Section 420-F:8 - Investments.

    420-F:8 Investments. –||Delta shall invest its funds as provided for in RSA 411-A.|||Source. 1992, 252:1, eff. Jan. 1, 1993.|
NH Rev Stat § 420-F:9 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-F - Delta Dental Plan of New Hampshire, Inc.|Section 420-F:9 - Financial Report and Examination.

    420-F:9 Financial Report and Examination. –||I. Delta shall file with the commissioner, on March 1, a report verified by an appropriate official of Delta, showing its financial condition on the last day of the preceding fiscal year.||II. Such report shall include:||(a) Delta's financial statements, including its balance sheet and statement of income and expenditures for the preceding year, certified by an independent public accountant;||(b) Such other financial information relating to Delta's performance as the commissioner may require.|||Source. 1992, 252:1. 2001, 224:9, eff. Jan. 1, 2002.|
NH Rev Stat § 420-F:10 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-F - Delta Dental Plan of New Hampshire, Inc.|Section 420-F:10 - Contingency Reserve Fund.

    420-F:10 Contingency Reserve Fund. –||Delta shall collect reasonable rates as described in RSA 420-F:6, designed to permit it to accumulate and maintain a contingency reserve fund which shall not be less than 8 percent of Delta's annual premium risk income.|||Source. 1992, 252:1, eff. Jan. 1, 1993.|