reglab/housing_qa huggingface dataset:
NH Rev Stat § 420-A:17 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:17 - Coverage for Nonprescription Enteral Formulas.

    420-A:17 Coverage for Nonprescription Enteral Formulas. –||I. Every health service corporation and every other similar corporation licensed under the laws of another state that issues or renews any policy of individual or group accident or health insurance providing benefits for medical or hospital expenses shall provide to each individual or group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the provision of nonprescription enteral formulas for the treatment of impaired absorption of nutrients caused by disorders affecting the absorptive surface, functional length, or motility of the gastrointestinal tract. Such coverage shall be provided when the prescribing physician has issued a written order stating that the enteral formula is needed to sustain life, is medically necessary, and is the least restrictive and most cost effective means for meeting the needs of the patient.||II. Every health service corporation and every other similar corporation licensed under the laws of another state that issues or renews any policy of individual or group accident or health insurance providing benefits for medical or hospital expenses, shall provide to each individual or group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the provision of nonprescription enteral formulas and food products required for persons with inherited diseases of amino acids and organic acids. Such coverage shall be provided when the prescribing physician has issued a written order stating that the enteral formula or food product is medically necessary and is the least restrictive and most cost effective means for meeting the needs of the patient. Coverage for inherited diseases of amino acids and organic acids shall, in addition to the enteral formula, include food products modified to be low protein in an amount not to exceed $1,800 annually for any insured individual.||III. The benefits included in this section shall not be subject to any greater deductible than any other benefits provided by the insurer. The coinsurance required by the enrolled participant shall not exceed the amount allowed under the contract for the reasonable and customary charge for the service provided.|||Source. 1997, 190:1. 2010, 188:7, eff. Aug. 20, 2010.|
NH Rev Stat § 420-A:17-a (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:17-a - Coverage for Diabetes Services and Supplies.

    420-A:17-a Coverage for Diabetes Services and Supplies. –||Every health service corporation and every similar corporation licensed under the laws of another state that issues or renews any policy, plan, or contract of individual or group accident or health insurance providing benefits for medical or hospital expenses, shall provide to each individual or group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the medically appropriate and necessary outpatient self-management training and educational services, pursuant to a written order of a primary care physician or practitioner, including but not limited to medical nutrition therapy for the treatment of diabetes, provided by a certified, registered, or licensed health care professional with expertise in diabetes, subject to the terms and conditions of the policy. Each health service corporation that issues or renews any individual or group policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses which provides a prescription rider shall cover medically appropriate or necessary insulin, oral agents, and equipment used to treat diabetes subject to the terms and conditions of the policy. Each health service corporation that provides coverage for prescription insulin drugs shall cap the total amount that a covered person is required to pay for each covered insulin drug prescription at an amount not to exceed $30 for each 30-day supply of each insulin prescription. The maximum $30 copayment for each 30-day supply of each covered insulin drug prescription shall apply when an original prescription is dispensed as well as when refills of the prescription are dispensed, including early refills. Coverage for prescription insulin drugs shall not be subject to any deductible. Each health service corporation that issues or renews any individual or group policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses which provides for durable medical equipment coverage shall provide coverage for medically appropriate or necessary equipment used to treat diabetes subject to the terms and conditions of the policy.|||Source. 1997, 258:7. 2010, 188:13, eff. Aug. 20, 2010. 2020, 13:3, eff. Sept. 14, 2020.|
NH Rev Stat § 420-A:17-b (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:17-b - Coverage for Dental Procedures.

    420-A:17-b Coverage for Dental Procedures. –||I. Every health service corporation and every similar corporation licensed under the laws of another state that issues or renews any group policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to each covered individual or certificate holder who is a resident of New Hampshire coverage for the medically necessary hospital or surgical day care facility charges and administration of general anesthesia administered by a licensed anesthesiologist or anesthetist for dental procedures performed on a covered person who:||(a) Is a child under the age of 13 who is determined by a licensed dentist in conjunction with a licensed primary care physician to have a dental condition of significant dental complexity which requires certain dental procedures to be performed in a surgical day care facility or hospital setting; or||(b) Is a person who has exceptional medical circumstances or a developmental disability as determined by a licensed primary care physician which place the person at serious risk.||II. All of the terms and conditions of the covered person's policy shall apply to these services.|||Source. 1998, 280:3. 2003, 278:4. 2010, 188:8, eff. Aug. 20, 2010. 2018, 188:7, eff. Aug. 7, 2018.|
NH Rev Stat § 420-A:17-e (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:17-e - Retroactive Denials Prohibited; Exceptions.

    420-A:17-e Retroactive Denials Prohibited;  Exceptions. –||I. In this section "retroactive denial of a previously paid claim" means any attempt by a health service corporation to retroactively collect payments already made to a health care provider with respect to a claim by requiring repayment of such payments, reducing other payments currently owed to the provider, withholding or setting off against future payments, reducing or affecting the future claim payments to the provider in any other manner.||II. No health service corporation shall impose on any health care provider any retroactive denial of a previously paid claim or any part thereof unless:||(a) The corporation has provided the reason for the retroactive denial in writing to the health care provider; and||(b) The time which has lapsed since the date of payment of the challenged claim does not exceed 18 months. The retroactive denial of a previously paid claim may be permitted beyond 18 months from the date of payment only for the following reasons:||(1) The claim was submitted fraudulently;||(2) The claim payment was incorrect because the physician/provider or the insured was already paid for the health care services identified in the claim;||(3) The health care services identified in the claim were not delivered by the physician/provider;||(4) The claim payment was for services covered by Title XVIII, Title XIX, or Title XXI of the Social Security Act;||(5) The claim payment is the subject of an adjustment with a different insurer, administrator, or payor and such adjustment is not affected by a contractual relationship, association, or affiliation involving claims payment, processing, or pricing; or||(6) The claim payment is the subject of legal action.||III. A health service corporation shall notify a health care provider at least 15 days in advance of the imposition of any retroactive denials of previously paid claims. The health care provider shall have 6 months from the date of notification under this paragraph to determine whether the insured has other appropriate insurance, which was in effect on the date of service. Notwithstanding the contractual terms between the health service corporation and provider, the health service corporation shall allow for the submission of a claim that was previously denied by another insurer due to the insured's transfer or termination of coverage.|||Source. 2002, 143:3. 2006, 104:3, eff. Aug. 7, 2006.|
NH Rev Stat § 420-A:17-f (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:17-f - Coverage for Certified Midwives.

    420-A:17-f Coverage for Certified Midwives. –||Every health service corporation and every other similar corporation licensed under the laws of another state that issues or renews any policy of group accident or health insurance providing maternity benefits shall also provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage consistent with the terms and conditions of the policy for services rendered by a midwife certified under RSA 326-D. Such coverage shall be subject to each insurer's standards and mechanisms for credentialing and contracting pursuant to RSA 420-J:4 and RSA 420-J:8 respectively, where applicable, and contingent upon services being provided in a licensed health care facility or at home and within the scope of practice of a certified midwife. Benefits provided shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.|||Source. 2006, 8:3. 2008, 298:3. 2010, 188:13, eff. Aug. 20, 2010.|
NH Rev Stat § 420-A:17-g (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:17-g - Coverage for Children's Early Intervention Services.

    420-A:17-g Coverage for Children's Early Intervention Services. –||Every health service corporation and every other similar corporation licensed under the laws of another state that issues or renews any policy of group accident or health insurance providing benefits for medical, rehabilitation, or hospital expenses, which provides coverage for outpatient services shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for expenses arising from the services of licensed and credentialed occupational therapists, physical therapists, speech-language pathologists, and clinical social workers working with children from birth to 36 months of age with an identified developmental disability and/or delay as specified in rules adopted pursuant to RSA 171-A:18, IV as long as the providing therapist receives a referral from the child's primary care provider if applicable. The benefits in this section shall not be subject to deductibles, copayments, or coinsurance; provided that the benefits included in this section may have a cap of $3,200 per child per year not to exceed $9,600 by the child's third birthday. For a health care contract that meets the definition of a "high deductible plan" set forth in 26 U.S.C. section 223(c)(2) or a catastrophic health plan, as defined under the Patient Protection and Affordable Care Act of 2009, a carrier shall be exempt from the deductible provisions of this section and may apply a deductible to children's early intervention therapy services until an enrollee's deductible has been satisfied for the year. Notwithstanding any provision of law or rule to the contrary, the coverage under this section shall apply to the medical assistance program, pursuant to RSA 161 and RSA 167.|||Source. 2007, 338:3. 2010, 188:13, eff. Aug. 20, 2010. 2020, 26:41, eff. Sept. 18, 2020. 2021, 56:10, eff. July 24, 2021.|
NH Rev Stat § 420-A:18 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:18 - Investments.

    420-A:18 Investments. –||No health service corporation shall invest its funds otherwise than as provided in RSA 411-A relating to the investments and holding of real estate by domestic life insurance companies; provided that not exceeding 10 percent of a health service corporation's total admitted assets may be invested in such investments as are prudent for a domestic life insurance company to make, and provided further that, notwithstanding RSA 411-A:12, no such health service corporation may acquire and hold directly or indirectly through its subsidiaries or affiliates more than 10 percent of the outstanding voting stock of any life insurance company formed under the laws of this or another state or any corporation owning or holding the stock of such life insurance company.|||Source. 1997, 190:1, eff. Jan. 1, 1998.|
NH Rev Stat § 420-A:19 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:19 - Prohibiting Limitations on Liability; Disclosure of Information.

    420-A:19 Prohibiting Limitations on Liability;  Disclosure of Information. –||I. No contract between a health service corporation and a physician, for the purpose of delineating the rights and obligations of the parties within the provider network, shall limit the liability of the health service corporation for any actions of the physician for which the health service corporation might otherwise be liable.||II. No contract between a health service corporation and a health care provider shall limit what information such health care provider may disclose to patients or to prospective patients regarding the provisions, terms, or requirements of the health service corporation's products as they relate to the needs of such provider's patients except for trade secrets of significant competitive value.|||Source. 1997, 190:1, eff. Jan. 1, 1998.|
NH Rev Stat § 420-A:20 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:20 - Reports and Examinations.

    420-A:20 Reports and Examinations. –||Every health service corporation shall annually, on or before March 1, file in the office of the commissioner a statement, verified by at least 2 of its principal officers, showing its condition on the preceding December 31, which shall be in such form and contain such matters as the commissioner may prescribe. Examination of the financial condition of each health service corporation by the commissioner shall be made as often as the commissioner deems necessary. The commissioner or designee shall have the power of visitation and examination into the affairs of any health service corporation and free access to all of the books, papers, and documents that relate to the business of the corporation, and may summon and qualify witnesses under oath and examine its officers, agents, or employees or other persons in relation to the affairs, transactions, and condition of the corporation. All costs of such examination shall be paid by the health service corporation.|||Source. 1997, 190:1, eff. Jan. 1, 1998.|
NH Rev Stat § 420-A:21 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:21 - Reserves.

    420-A:21 Reserves. –||Every health service corporation shall collect reasonable rates as described in RSA 420-A:22, designed to permit it to accumulate and maintain a contingency reserve fund.|||Source. 1997, 190:1, eff. Jan. 1, 1998.|
NH Rev Stat § 420-A:22 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:22 - Annual Review.

    420-A:22 Annual Review. –||Annually, in the month of April, the commissioner may review the rates of every health service corporation, and shall, not later than 60 days after April 1 of each year, provided that the corporation has filed all pertinent data, make adjustments thereto, if any, as are just and reasonable. Whenever the contingency reserve fund of a health service corporation shall be less than 8 percent of its annual premium income, the commissioner shall permit the corporation to charge rates designed to enable it to increase its contingency reserve fund by an amount equal to at least 2 percent of the annual premium income of the corporation. If the liabilities of a health service corporation exceed its assets, however, the commissioner shall permit the corporation to charge rates designed to enable the corporation to accumulate such a reserve fund by an amount equal to at least 5 percent of the annual premium income of the corporation until such time as the assets of the corporation equal its liabilities. In no event shall the commissioner permit a health service corporation to charge rates which would result in a reserve fund in excess of 20 percent of the annual premium volume of the corporation. This section shall not preclude the granting of appropriate rate changes at any other times. In connection with a rate decision, the commissioner may also make reasonable supplemental orders to the health service corporation and may attach reasonable conditions and limitations to such orders as the commissioner finds, on the basis of competent and substantial evidence, necessary to insure that benefits and services are provided at minimum cost under efficient and economical management of the corporation.|||Source. 1997, 190:1, eff. Jan. 1, 1998.|
NH Rev Stat § 420-A:23 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:23 - Appeals.

    420-A:23 Appeals. –||All orders and decisions of the commissioner concerning matters within the commissioner's jurisdiction under this chapter shall be subject to rehearing and appeal as provided in RSA 541. RSA 541:18 and RSA 541:19 shall apply to orders and decisions of the insurance commissioner affecting the rates of health service corporations.|||Source. 1997, 190:1, eff. Jan. 1, 1998.|
NH Rev Stat § 420-A:24 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:24 - Agreements With Providers.

    420-A:24 Agreements With Providers. –||Any health service corporation may enter into agreements with eligible persons whereby such persons become providers of a plan operated by the corporation. Any health service corporation may enter into contracts for the payment of health services to the subscribers or members of similar nonprofit health service corporations of other states subject to the supervision of such other states, or of counties of this state in which the corporation does not transact business. The corporation shall maintain in its office complete records of all health services rendered to subscribers and covered dependents in such form as will include the kind of services rendered, the amounts claimed for such services by the providers and the amount paid by the corporation.|||Source. 1997, 190:1, eff. Jan. 1, 1998.|
NH Rev Stat § 420-A:25 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:25 - Administrative Services.

    420-A:25 Administrative Services. –||Any health service corporation may contract to furnish administrative services to any health-related organization, agency, entity, or plan.|||Source. 1997, 190:1, eff. Jan. 1, 1998.|
NH Rev Stat § 420-A:26 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:26 - Nonliability of Corporation.

    420-A:26 Nonliability of Corporation. –||No health service corporation holding a license under this chapter shall be liable for injuries resulting from negligence, malfeasance, nonfeasance, or malpractice on the part of any officer or employee or on the part of any provider in the course of rendering health care service or supplies to subscribers.|||Source. 1997, 190:1, eff. Jan. 1, 1998.|
NH Rev Stat § 420-A:27 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:27 - Taxation.

    420-A:27 Taxation. –||Except as otherwise expressly provided for by law, every health service corporation doing business pursuant to this chapter is hereby declared to be a nonprofit and benevolent organization and to be exempt from all taxes, other than taxes on real property situated within this state, fees on motor vehicles registered in this state, fees prescribed by this chapter, and the premium tax under RSA 400-A:32. Except for payments made by the state of New Hampshire no tax shall be levied on any premiums, fees-for-service and other payments for health, dental, and employee benefit coverages from political subdivisions of the state of New Hampshire, or from employees or retirees of such political subdivisions, either directly or indirectly. Nor shall any tax be levied on any revenues of such a health service corporation that are derived from any business of the corporation where the corporation has assumed no insurance risk and is providing administrative services only.|||Source. 1997, 190:1, eff. Jan. 1, 1998.|
NH Rev Stat § 420-A:28 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:28 - Relationship of Provider and Patient.

    420-A:28 Relationship of Provider and Patient. –||Nothing in this chapter shall be deemed to alter the relationship of physician and patient. No health service corporation shall in any way influence the subscriber in the free choice of hospital or physician or other provider. Nothing in this chapter shall be deemed to abridge the right of any hospital, physician or other provider to decline patients in accordance with lawful standards and practices of such provider.|||Source. 1997, 190:1, eff. Jan. 1, 1998.|
NH Rev Stat § 420-A:29 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:29 - Foreign Corporations; Reciprocity.

    420-A:29 Foreign Corporations;  Reciprocity. –||Any corporation organized under the laws of another state or country which except as to state of organization is a health service corporation and which the commissioner finds has fully complied with the laws of such other state or country, shall be entitled to do business within this state subject to this chapter after obtaining a license as provided in RSA 420-A:4; provided, however, that no such corporation organized under the laws of another state or country shall be entitled to such license, or to do business in this state, unless such other state or country grants substantially similar rights and privileges to health service corporations organized under the laws of this state. The commissioner shall determine whether rights and privileges granted by other states or countries are substantially similar to those granted by this state, and the commissioner's determination shall be final.|||Source. 1997, 190:1, eff. Jan. 1, 1998.|
NH Rev Stat § 420-A:30 (2021)
2021 New Hampshire Revised Statutes|Title XXXVII - Insurance|Title 420-A - Health Service Corporations|Section 420-A:30 - Exceptions.

    420-A:30 Exceptions. –||Fraternal benefit societies and life or accident insurance companies are not affected by this chapter.|||Source. 1997, 190:1, eff. Jan. 1, 1998.|