reglab/statecodes huggingface dataset:
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 412-A - Filing of Aircraft Insurance Policies › Section 412-A:3 - Penalties.

412-A:3 Penalties. –
Any insurer willfully violating any of the provisions of this chapter may be fined not more than $500. The commissioner may suspend or revoke the license of any insurer or organization for any violation of this chapter or the failure to comply with an order of the commissioner, issued under this chapter.
Source.
2003, 150:2, eff. Jan. 1, 2004.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 412-A - Filing of Aircraft Insurance Policies › Section 412-A:4 - Hearing and Appeal.

412-A:4 Hearing and Appeal. –
Any insurer or organization aggrieved by any order or decision of the commissioner is entitled to a rehearing and appeal under RSA 541.
Source.
2003, 150:2, eff. Jan. 1, 2004.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:1 - Filing Policies and Rates.

415:1 Filing Policies and Rates. –
No policy of insurance against loss or expense from the sickness, or from the bodily injury or death by accident of the insured shall be issued or delivered to any person in this state nor shall any application, rider or endorsement be used in connection therewith until a copy of the form thereof and of the classification of risks and the premium rates, or, in the case of cooperatives or assessment companies the estimated cost pertaining thereto have been filed with the insurance commissioner nor until the expiration of 30 days thereafter unless the commissioner shall sooner give his written approval thereof.
Source.
1913, 226:1. PL 281:1. RL 331:1. 1947, 162:1, eff. May 28, 1947.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:2 - Disapproval of Forms.

415:2 Disapproval of Forms. –
I. The commissioner may, within 30 days after the filing of any such form, disapprove such form if:
(a) The benefits provided therein are unreasonable in relation to the premium charged;
(b) It contains a provision or provisions which are unjust, unfair, inequitable, misleading, deceptive or encourage misrepresentation of such policy; or
(c) It does not comply with the requirements of law.
II. The 30-day period under paragraph I may be extended by the commissioner if the insurer has not provided all necessary information required to make a determination under paragraph I.
III. If the commissioner shall notify the insurer which has filed any such form that it does not comply with the provisions of this chapter, it shall be unlawful thereafter for such insurer to issue such form or use it in connection with any policy. In such notice the commissioner shall specify the reasons for his disapproval and state that a hearing will be granted within 20 days after request in writing by the insurer.
Source.
1913, 226:1. PL 281:2. RL 331:2. 1947, 162:2. 2008, 212:7, eff. June 16, 2008.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:3 - Subsequent Disapproval.

415:3 Subsequent Disapproval. –
The commissioner may at any time, after a hearing of which not less than 20 days' written notice shall have been given to the insurer, withdraw his approval of any such form on any of the grounds stated in this chapter. It shall be unlawful for the insurer to issue such form or use it in connection with any policy after the effective date of such withdrawal of approval. The notice of any hearing called under this section shall specify the matters to be considered at such hearing and any decision affirming disapproval or directing withdrawal of approval under this chapter shall be in writing and shall specify the reasons therefor.
Source.
1947, 162:3, eff. May 28, 1947.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:4 - Review of Disapproval.

415:4 Review of Disapproval. –
The action of the commissioner in this regard shall be subject to review by the superior court.
Source.
1913, 226:1. PL 281:3. RL 331:3.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-a - Insurance Contracts; Welfare Recipients.

415:6-a Insurance Contracts;  Welfare Recipients. –
No accident or health insurance policy issued, renewed or continued after August 28, 1981 shall contain any provision denying or limiting insurance benefits because services are rendered to an insured or a dependent who is eligible for or who receives medical assistance under RSA 167 or RSA 161.
Source.
1981, 502:2, eff. Aug. 28, 1981.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-aa - 90-Day Supply of Covered Prescription Drugs.

415:6-aa 90-Day Supply of Covered Prescription Drugs. –
An insurer issuing or renewing accident and health insurance policies shall allow its insureds to purchase an up-to-90-day supply of covered prescription drugs on the covered person's health plan formulary at one time at a pharmacy of the insured's choice within the insurer's network, provided that the insured can demonstrate that such drug has been taken by the insured for a continuous period of one year and provided that such drug is not subject to the health plan's utilization management, prior authorization, or pre-certification requirements. Controlled substances as identified by the United States Drug Enforcement Administration are exempt from this section. Nothing in this section shall be construed to limit the health plan's ability to establish co-payments, coinsurance deductibles, or other member cost shares. A retail pharmacy dispensing a 90-day supply of covered prescription drugs under this section shall comply with any specified terms, conditions, and reimbursement rate which the plan may require for mail order pharmacies that fill 90-day prescriptions.
Source.
2007, 73:1. 2014, 120:1, eff. Aug. 15, 2014.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-b - Coverage of Certain Psychiatric and Psychological Services.

415:6-b Coverage of Certain Psychiatric and Psychological Services. –
No accident or health insurance policy issued, renewed or continued on or after January 1, 1993, shall contain any provision denying insurance benefits for psychiatric or psychological services, including psychological examinations, solely because they are rendered to an insured or a dependent in compliance with the lawful order of any court of this state. Benefits for such services shall be at least as favorable as for other psychiatric or psychological services, including psychological examinations, and shall be subject to the same dollar limits, deductibles, co-payments and co-insurance factors and to terms and conditions of the policy or certificate, including any managed care provisions.
Source.
1992, 177:1, eff. Jan. 1, 1993.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-c - Coverage for Nonprescription Enteral Formulas.

415:6-c Coverage for Nonprescription Enteral Formulas. –
I. Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to 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. Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to 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.
1996, 131:1, eff. July 20, 1996.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-d - Maternity Rider.

415:6-d Maternity Rider. –
Upon issuing any individual health insurance policy providing hospital, medical-surgical or major medical benefits, an insurer shall offer the insured the option of including a maternity benefits rider if maternity care is not covered under the policy. Nothing in this section shall be construed to apply to supplemental health insurance and disability insurance policies.
Source.
1996, 188:19, eff. Jan. 1, 1997.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-e - Coverage for Diabetes Services and Supplies.

415:6-e Coverage for Diabetes Services and Supplies. –
Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for 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 insurer that issues or renews any individual 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 insurer 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 insurer that issues or renews any individual 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, 258:1, eff. Jan. 1, 1998. 2020, 13:1, eff. Sept. 14, 2020.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-f - Patients' Bill of Rights.

415:6-f Patients' Bill of Rights. –
Any insurer issuing an individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses under this chapter shall provide to each new policyholder who is a resident of this state a copy of the patients' bill of rights law under RSA 151:21.
Source.
1997, 331:13, eff. Aug. 22, 1997. 2022, 42:7, eff. July 2, 2022.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-g - Off-Label Prescription Drugs.

415:6-g Off-Label Prescription Drugs. –
I. No insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses and providing coverage for prescription drugs shall:
(a) Exclude coverage for any such drug for a particular indication on the ground that the drug has not been approved by the Food and Drug Administration (FDA) for that indication, if such drug is recognized for treatment of such indication in one of the standard reference compendia or in the medical literature; or
(b) As a condition of coverage, impose use of an alternative drug not approved by the FDA for the indication being treated, unless such alternative drug is recognized for treatment of such indication in one of the standard reference compendia or in the medical literature. An override of such condition of coverage shall be expeditiously granted consistent with RSA 420-J:7-b, II whenever the prescriber can demonstrate that the alternative drug:
(1) Has been ineffective in the treatment of the insured's medical condition in the past;
(2) Is expected to be ineffective based on the known relevant physical or mental characteristics of the insured and the known characteristics of the drug regimen;
(3) Will cause or will likely cause an adverse reaction or other physical harm to the insured; or
(4) Is not in the insured's best interest, based on medical necessity consistent with RSA 420-J:7-b, II.
II. Any coverage of a drug required by this section shall also include medically necessary services associated with the administration of the drug.
III. Nothing in this section requires:
(a) Coverage for any drug if the FDA has determined its use to be contraindicated for the treatment of the particular indication for which the drug has been prescribed;
(b) Coverage for experimental or investigational drugs not approved for any indication by the FDA; and
(c) Reimbursement or coverage for any drug not included on the drug formulary or list of covered drugs specified in a health plan, contract, or policy.
Source.
1999, 323:2. 2014, 226:1, eff. Sept. 12, 2014.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-i - Retroactive Denials Prohibited; Exceptions.

415:6-i Retroactive Denials Prohibited;  Exceptions. –
I. In this section, "retroactive denial of a previously paid claim" means any attempt by an insurer 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, or reducing or affecting the future claim payments to the provider in any other manner.
II. No insurer shall impose on any health care provider any retroactive denial of a previously paid claim or any part thereof unless:
(a) The insurer has provided the reason for the retroactive denial in writing to the health care provider; and
(b) The time which has elapsed since the date of payment of the challenged claim does not exceed 12 months. The retroactive denial of a previously paid claim may be permitted beyond 12 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 health care 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 health care 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. An insurer 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 insurer and provider, the insurer 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, 143:1. 2006, 104:1, eff. Aug. 7, 2006. 2018, 317:1, eff. Jan. 1, 2019.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-j - Coverage for Certain Prosthetic Devices.

415:6-j Coverage for Certain Prosthetic Devices. –
I. Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance who are residents of this state, coverage for the provision of benefits for prosthetic devices under the same terms and conditions that apply to other durable medical equipment covered under the policy, except as otherwise provided in this section.
II. In this section, "prosthetic device" means an artificial limb device to replace, in whole or in part, an arm or leg.
III. An insurer shall not impose any annual or lifetime dollar maximum on coverage for prosthetic devices other than an annual or lifetime dollar maximum that applies in the aggregate to all items and services covered under the policy.
IV. An insurer shall not apply amounts paid for prosthetic devices to any annual or lifetime dollar maximum applicable to other durable medical equipment covered under the policy other than an annual or lifetime dollar maximum that applies in the aggregate to all items and services covered under the policy.
Source.
2003, 216:2, eff. Jan. 1, 2004.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-k - Individual Policy Prescription Drug Information Cards.

415:6-k Individual Policy Prescription Drug Information Cards. –
I. Each insurer that issues or renews any individual policy of accident or health insurance which provides coverage for prescription drugs or devices or which contracts with an entity providing such prescription drug coverage, including but not limited to pharmacy benefit manager companies, shall issue to certificate holders a card or other technology containing uniform prescription drug information. The uniform prescription drug information card or technology shall include all of the fields required by the health insurance provider for claims processing in a clear, readable, and understandable manner on the card or other technology issued, shall include the information required under RSA 400-A:15-c, and shall include, at a minimum, the following information:
(a) The name or trademark logo of the insurer and, if another company administers the prescription benefit, the name or trademark logo of the benefit administrator.
(b) The certificate holder's name and identification number.
(c) All of the electronic transaction routing information required by the insurer or its benefit administrator in order for the pharmacy to electronically process a prescription claim, including but not limited to the BIN number labeled as such or the Processor Control Number labeled as such, or both.
II. All subscriber health insurance cards issued after January 1, 2004 shall contain the information required under paragraph I.
III. A new uniform prescription drug information card, as required under this section, shall be issued by an insurer upon enrollment of new members and when reissuing a new card to current members when there is a change in the certificate holder's pharmacy coverage that affects data contained on the card.
Source.
2003, 286:2, eff. Sept. 16, 2003. 2016, 111:1, eff. Jan. 1, 2017.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-l - Coverage for Certified Midwives; Individual.

415:6-l Coverage for Certified Midwives;  Individual. –
Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing maternity benefits, shall also provide to 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, 8:1. 2008, 298:1, eff. Aug. 27, 2008.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-m - Coverage for the Cost of Testing for Bone Marrow Donation.

415:6-m Coverage for the Cost of Testing for Bone Marrow Donation. –
I. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state and who meet the criteria for testing as established by the Match Registry (the National Marrow Donor Program), coverage for laboratory fee expenses up to $150 arising from human leukocyte antigen testing, also referred to as histocompatibility locus antigen testing, for utilization in bone marrow transplantation. The testing shall be performed in a facility that is accredited by the American Association of Blood Banks or its successors, or the College of American Pathologists, or its successors, or any other national accrediting body with requirements that are substantially equivalent to or more stringent than those of the College of American Pathologists, and is licensed under the Clinical Laboratory Improvement Act of 1967, 42 U.S.C. section 263a, as amended. At the time of the new testing, the person tested shall complete and sign an informed consent form that also authorizes the results of the test to be used for participation in the National Marrow Donor Program and shall acknowledge a willingness to be a bone marrow donor if a suitable match is found.
II. In addition to paragraph I, the testing facility shall not bill, charge, collect a deposit from, seek payment or reimbursement from, or have recourse against a covered person or a person acting on behalf of the covered person for any portion of the laboratory fee expenses.
Source.
2006, 187:1. 2011, 133:5, eff. Jan. 1, 2012.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-n - Coverage for Children's Early Intervention Therapy Services.

415:6-n Coverage for Children's Early Intervention Therapy Services. –
Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical, rehabilitation, or hospital expenses, shall provide to 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, 338:1, eff. Sept. 14, 2007. 2020, 26:39, eff. Sept. 18, 2020. 2021, 56:8, eff. July 24, 2021.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-o - Coverage for Obesity and Morbid Obesity; Individual.

415:6-o Coverage for Obesity and Morbid Obesity;  Individual. –
Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for the diseases and ailments caused by obesity and morbid obesity and treatment for such, including bariatric surgery, when the prescribing physician has issued a written order stating that treatment is medically necessary and in accordance with the patient qualifications and treatment standards set forth by the American Society for Metabolic and Bariatric Surgery or the American College of Surgeons. Such treatment standards may include, but not be limited to, pre-operative psychological screening and counseling, behavior modification, weight loss, exercise regimens, nutritional counseling, and post-operative follow-up, overview, and counseling of dietary, exercise, and lifestyle changes. The covered insured shall be at least 18 years of age. The benefits included in this section shall be subject to the terms and conditions of the policy and shall be no less extensive than coverage provided for similar conditions or illnesses.
Source.
2008, 389:1, eff. Sept. 14, 2008.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-p - Coverage for Hearing Aids.

415:6-p Coverage for Hearing Aids. –
Each insurer that issues or renews any individual policy or certificate for delivery in this state, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide coverage for the professional services associated with the practice of fitting, dispensing, servicing, or sale of hearing instruments or hearing aids. The benefits included in this section shall not be subject to any greater deductible or coinsurance or copay than any other benefits provided by the insurer. Insurers are required to cover the cost of a hearing aid for each ear, as needed, as well as related services necessary to assess, select, and fit the hearing aid with a maximum for the hearing aid and related services of no less than $1,500 per hearing aid every 60 months. The insured may choose a higher price hearing aid and pay the difference in cost. The hearing aid shall be prescribed and dispensed by a licensed audiologist or hearing instrument specialist. Notwithstanding any provision of law or rule to the contrary, the coverage under this section shall not apply to the medical assistance program, pursuant to RSA 161 and RSA 167. In this section:
I. "Hearing care professional" means a person who is a licensed audiologist, a licensed hearing instrument dispenser, or a licensed physician.
II. "Hearing instrument" or "hearing aid" means any instrument or device designed, intended, or offered for the purpose of improving a person's hearing and any parts, attachments, or accessories, including earmolds. Batteries, cords, and individual or group auditory training devices and any instrument or device used by a public utility in providing telephone or other communication services are excluded.
III. "Hearing instrument dispenser" means a person who is a hearing care professional that engages in the selling, practice of fitting, selecting, recommending, dispensing, or servicing of hearing instruments or the testing for means of hearing instrument selection or who advertises or displays a sign or represents himself or herself as a person who practices the testing, fitting, selecting, servicing, dispensing, or selling of hearing instruments.
IV. "Practice of fitting, dispensing, servicing, or sale of hearing instruments" means the measurement of human hearing with an audiometer, calibrated to the current American National Standard Institute standards, for the purpose of making selections, recommendations, adoptions, services, or sales of hearing instruments including the making of earmolds as a part of the hearing instrument.
Source.
2010, 362:1, eff. Jan. 1, 2011.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-q - Reimbursement for Ambulance Service Providers.

415:6-q Reimbursement for Ambulance Service Providers. –
Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance that constitutes health coverage under RSA 420-G:2, IX, and that provides benefits for medically necessary ambulance services shall reimburse the ambulance service provider directly or by a check payable to the insured and the ambulance service provider subject to the terms and conditions of the policy, plan, or contract. Nothing in this section shall preclude an insurer from negotiating with and subsequently entering into a contract with a non-participating ambulance provider that establishes rates of reimbursement for emergency medical services.
Source.
2011, 133:1, eff. Jan. 1, 2012.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-r - Naturopathy Providers; Payment for Equivalent Types of Service; Individual.

415:6-r Naturopathy Providers;  Payment for Equivalent Types of Service;  Individual. –
Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses shall provide to persons covered by such insurance who are residents of this state coverage for expenses arising from a health service performed by a doctor of naturopathic medicine licensed under RSA 328-E if that particular type of service is within the scope of practice of such doctor and if the insurer would reimburse for that type of service when performed by any other type of health care provider. Such coverage shall be subject to each insurer's standards and mechanisms for determining medical necessity, for credentialing pursuant to RSA 420-J:4, and for contracting pursuant to RSA 420-J:8. Benefits provided shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.
Source.
2012, 278:1, eff. Jan. 1, 2013.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-t - Oral Anti-Cancer Therapies.

415:6-t Oral Anti-Cancer Therapies. –
I. No insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for anti-cancer medications that are injected or intravenously administered by a health care provider and patient administered anti-cancer medications, including but not limited to those orally administered or self-injected, shall require a higher copayment, deductible, or coinsurance amount for patient administered anti-cancer medication than it requires for injected or intravenously administered anti-cancer medications, regardless of the formulation or benefit category determination by the policy or plan.
II. An insurer shall not comply with paragraph I by:
(a) Increasing the copayment, deductible, or coinsurance amount required for injected or intravenously administered anti-cancer medication that are covered under the policy or plan.
(b) Reclassifying benefits with respect to anti-cancer medications.
III. In this section, "anti-cancer medication" means drugs and biologics that are used to kill, slow, or prevent the growth of cancerous cells.
IV. If the cost-sharing requirements for orally administered anti-cancer medications do not exceed $200 per prescription fill, the health plan shall be deemed in compliance with this section.
V. 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), a carrier shall be exempt from the provisions of paragraphs I-IV until an enrollee's deductible has been satisfied for the year.
VI. This section shall apply only to oral anti-cancer medications where an intravenously administered or injected anti-cancer medication is not medically appropriate.
VII. This section shall not apply to policies which are solely to replace income or pay a predetermined fixed amount based on the occurrence of a specified medical or health event.
Source.
2015, 263:6, eff. Jan. 1, 2017.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-u - Coverage for Early Refills of Prescription Eye Drops.

415:6-u Coverage for Early Refills of Prescription Eye Drops. –
I. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for one early refill of a prescription for eye drops if the following criteria are met:
(a) For prescription eye drops dispensed as a 30-day supply, the enrollee requests the refill no earlier than 21 days after the later of the following dates:
(1) The date the original prescription was dispensed to the enrollee; or
(2) The date that the most recent refill of the prescription was dispensed to the enrollee;
(b) For prescription eye drops dispensed as a 90-day supply, the enrollee requests the refill no earlier than 63 days after the later of the following dates:
(1) The date the original prescription was dispensed to the enrollee; or
(2) The date that the most recent refill of the prescription was dispensed to the enrollee;
(c) The prescribing health care provider indicated on the original prescription that a specific number of refills are authorized;
(d) The refill requested by the enrollee does not exceed the number of refills indicated on the original prescription;
(e) The prescription has not been refilled more than once during the 30-day or 90-day period prior to the request for an early refill; and
(f) The prescription eye drops are a covered benefit under the enrollee's health plan.
II. Benefits provided under this section shall not be subject to any greater copayment, deductible, or coinsurance than any other similar benefits provided by the insurer.
Source.
2016, 326:1, eff. Aug. 23, 2016.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-v - Coverage for Blood Lead Testing.

415:6-v Coverage for Blood Lead Testing. –
Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses shall provide to persons covered by such insurance who are residents of this state coverage for the costs of blood lead testing conducted pursuant to RSA 130-A:5-a. Benefits provided under this section shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.
Source.
2018, 4:11, eff. Feb. 8, 2018.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-w - Coverage for Prescription Contraceptive Drugs and Prescription Contraceptive Devices and for Contraceptive Services.

415:6-w Coverage for Prescription Contraceptive Drugs and Prescription Contraceptive Devices and for Contraceptive Services. –
Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for outpatient contraceptive services under the same terms and conditions as for other outpatient services. "Outpatient contraceptive services" means consultations, examinations, and medical services, provided on an outpatient basis, including the initial screening provided through a pharmacy pursuant to RSA 318:47-l at a rate established by contract between the pharmacy and the insurer or its pharmacy benefits manager, and related to the use of contraceptive methods to prevent pregnancy which have been approved by the U.S. Food and Drug Administration. Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses shall cover all prescription contraceptive drugs and contraceptive devices approved by the U.S. Food and Drug Administration. Coverage shall include contraceptives dispensed in a quantity intended to last for a 12-month period if prescribed in that quantity. An insurer shall not impose utilization review requirements or other limitations to control the prescribing or dispensing of contraceptives to an amount that is less than a 12-month supply, if that quantity is prescribed. An insurer shall not be required to cover more than one 12-month contraceptive prescription in a single dispensing per plan year. A deductible, copayment, coinsurance, or other cost-sharing requirement shall not be imposed on the coverage of prescription contraceptive drugs and contraceptive devices approved by the FDA under this section. Notwithstanding any other provision of law, if there is a therapeutic equivalent of a drug or device for an FDA-approved contraceptive method, an insurer may impose cost-sharing requirements as long as at least one drug or device for that method is available without cost-sharing; provided that if an individual's provider recommends a particular FDA-approved contraceptive drug or device based on a medical determination, the insurer shall provide coverage for the prescribed contraceptive drug or device without cost-sharing. Nothing in this section shall be construed as altering the terms and conditions of a contract relating to prescription drugs and outpatient services. 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.
2018, 205:7, eff. Jan. 1, 2019; 361:8, eff. Jan. 1, 2019 at 12:01 a.m.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-x - Coverage for Medically Necessary Dental Services.

415:6-x Coverage for Medically Necessary Dental Services. –
Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for medically necessary dental services resulting from an accidental injury to sound natural teeth and gums when the course of treatment for the accidental injury is received or authorized within 3 months of the date of the injury. Treatment made necessary due to injury to the jaw and oral structures other than teeth shall be covered without time limit. Coverage under this section shall be subject to such other terms and conditions of the policy that may apply.
Source.
2019, 113:1, eff. Aug. 20, 2019.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-y - Coverage for Perfluoroalkyls (PFAS) and Perfluorinated Compound (PFC) Blood Testing.

415:6-y Coverage for Perfluoroalkyls (PFAS) and Perfluorinated Compound (PFC) Blood Testing. –
Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for perfluoroalkyls (PFAS) and perfluorinated compound (PFC) blood testing. Benefits provided under this section shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.
Source.
2020, 30:9, eff. Sept. 21, 2020.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-z - Coverage for Epinephrine Auto-Injectors.

415:6-z Coverage for Epinephrine Auto-Injectors. –
Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for the cost of epinephrine auto-injectors. Benefits provided under this section shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer and shall be subject to the terms and conditions of the policy. In this section, "epinephrine auto-injector" means a single-use device used for the automatic injection of a pre-measured dosage of epinephrine into the human body.
Source.
2020, 13:9, eff. Jan. 1, 2021.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:6-a1 - Coverage for Long-Term Antibiotic Therapy for Tick-Borne Illness.

415:6-a1 Coverage for Long-Term Antibiotic Therapy for Tick-Borne Illness. –
Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for long-term antibiotic therapy for tick-borne illness when determined to be medically necessary and ordered by a licensed infectious disease physician after making a thorough evaluation of the patient's symptoms, diagnostic test results or response to treatment. Benefits provided under this section shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer. In this section, "long-term antibiotic therapy" means the administration of oral, intramuscular, or intravenous antibiotics singly or in combination, for periods of time in excess of 4 weeks.
Source.
2020, 39:20, eff. June 30, 2021.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:7 - Conforming to Statute.

415:7 Conforming to Statute. –
I.
Other Policy Provisions. No policy provision which is not subject to RSA 415:6 shall make a policy, or any portion thereof, less favorable in any respect to the insured or the beneficiary than the provisions thereof which are subject to this chapter.
II.
Policy Conflicting With This Chapter. A policy delivered or issued for delivery to any person in this state in violation of this chapter shall be held valid but shall be construed as provided in this chapter. When any provision in a policy subject to this chapter is in conflict with any provision of this chapter, the rights, duties and obligations of the insurer, the insured and the beneficiary shall be governed by the provisions of this chapter.
Source.
1913, 226:5, 9. PL 281:13, 19. RL 331:13, 19. 1951, 207:1, par. 6, eff. July 1, 1951.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:8 - Exceptions.

415:8 Exceptions. –
A policy, rider or endorsement, which could have been lawfully used or delivered or issued for delivery to any person in this state immediately before July 1, 1951, may be used or delivered or issued for delivery to any such person during 5 years after July 1, 1951, without being subject to the provisions of RSA 415:5-415:7, 415:13, 415:14 and 415:16.
Source.
1951, 207:5, eff. July 1, 1951.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:9 - Falsity in Application.

415:9 Falsity in Application. –
The falsity of any statement in the application for any policy covered by this chapter shall not bar the right to recovery thereunder, unless such false statement was made with actual intent to deceive, or unless it materially affected either the acceptance of the risk or the hazard assumed by the insurer.
Source.
1913, 226:6. PL 281:15. RL 331:15.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:10 - Acknowledgment of Notice.

415:10 Acknowledgment of Notice. –
The acknowledgment by any insurer of the receipt of notice given under any policy covered by this chapter, or the furnishing of forms for filing proofs of loss, or the acceptance of such proofs, or the investigation of any claim thereunder, shall not operate as a waiver of any of the rights of the insurer in defense of any claim arising under such policy.
Source.
1913, 226:7. PL 281:16. RL 331:16.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:11 - Alteration of Application.

415:11 Alteration of Application. –
No alteration of any written application for insurance, by erasure, insertion or otherwise, shall be made by any person other than the applicant without his written consent, and the making of any such alteration without the consent of the applicant shall be a misdemeanor.
Source.
1913, 226:8. PL 281:17. RL 331:17.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:12 - By Insurer.

415:12 By Insurer. –
If such alteration shall be made by any officer of the insurer, or by any employee of the insurer with the insurer's knowledge or consent, such act shall be deemed to have been performed by the insurer thereafter issuing the policy upon such altered application.
Source.
1913, 226:8. PL 281:18. RL 331:18.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:13 - Age Limit.

415:13 Age Limit. –
If any such policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if such date falls within a period for which premium is accepted by the insurer or if the insurer accepts a premium after such date, the coverage provided by the policy will continue in force subject to any right of cancellation until the end of the period for which premium has been accepted. In the event the age of the insured has been misstated and if, according to the correct age of the insured, the coverage provided by the policy would not have become effective, or would have ceased prior to the acceptance of such premium or premiums, then the liability of the insurer shall be limited to the refund, upon request, of all premiums paid for the period not covered by the policy.
Source.
1951, 207:2, par. 19, eff. July 1, 1951.