SB 256-FN - AS INTRODUCED
2025 SESSION
25-1003
05/11
SENATE BILL256-FN
AN ACTrelative to the affordability and safety of clinician administered drugs.
SPONSORS:Sen. McGough, Dist 11; Sen. Gannon, Dist 23; Sen. Rochefort, Dist 1; Rep. Potucek, Rock. 13; Rep. Miles, Hills. 12
COMMITTEE:Health and Human Services
-----------------------------------------------------------------
ANALYSIS
This bill requires a health plan to utilize the lowest cost method of reimbursement for clinician administered drugs and requires a health maintenance organization to cover clinician-administered drugs if the drug cannot reasonably be self-administered and is typically administered by a health care professional. The bill also prohibits a health maintenance organization from requiring that a pharmacy dispense a medication to a patient with the expectation that the patient will transport it to a health care setting for administration by a health care professional.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Explanation:Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
25-1003
05/11
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Five
AN ACTrelative to the affordability and safety of clinician administered drugs.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; Health Maintenance Organizations; Dispensing of Clinician-Administered Drugs. Amend RSA 420-B by inserting after section 26 the following new section:
420-B:27 Dispensing of Clinician-Administered Drugs.
I. As used in this section, “clinician-administered drug” means an outpatient prescription drug other than a vaccine that:
(a) Cannot reasonably be self-administered by the patient to whom the drug is prescribed or by a non-clinician individual assisting the patient with the self-administration; and
(b) Is typically administered:
(1) By a health care professional authorized under the laws of this state to administer the drug, including when acting under a physician’s delegation and supervision; and
(2) In a physician’s office, hospital outpatient infusion center, or other clinical setting.
II. A health maintenance organization or a third party acting on its behalf shall not refuse to authorize, approve, or pay a provider for a covered clinician-administered drug that was dispensed by any in-network hospital or clinic, provided that:
(a) According to medical standards of care for the patient’s condition, the medication must be provided to the patient more expeditiously than the medication could be provided via any other channel covered by the insurer; and
(b) The dispensing and any associated authorization, approval, or payment occurs consistent with the terms and conditions of similarly situated network participants and according to the benefit offered by the health maintenance organization.
III. Unless otherwise requested in writing by the patient or prescriber, a health maintenance organization, pharmacy benefits manager, or other third party acting on behalf of the health maintenance organization, shall not, by contract, written policy, or written procedure, require that a pharmacy dispense a clinician-administered drug directly to a patient with the expectation or intention that the patient will transport the medication to a health care setting for administration by a health care professional.
2 Effective Date. This act shall take effect January 1, 2026.
LBA
25-1003
1/21/25
SB 256-FN- FISCAL NOTE
AS INTRODUCED
AN ACTrelative to the affordability and safety of clinician administered drugs.
FISCAL IMPACT: This bill does not provide funding, nor does it authorize new positions.
Estimated State Impact
FY 2025 FY 2026 FY 2027 FY 2028
Revenue $0 Indeterminable Indeterminable Indeterminable
Revenue Fund(s) Insurance premium tax revenue
Expenditures* $0 $0 $0 $0
Funding Source(s) None
Appropriations* $0 $0 $0 $0
Funding Source(s) None
*Expenditure = Cost of bill *Appropriation = Authorized funding to cover cost of bill
Estimated State Impact
FY 2025
FY 2026
FY 2027
FY 2028
Revenue
$0
Indeterminable
Indeterminable
Indeterminable
Revenue Fund(s)
Insurance premium tax revenue
Expenditures*
$0
$0
$0
$0
Funding Source(s)
None
Appropriations*
$0
$0
$0
$0
Funding Source(s)
None
*Expenditure = Cost of bill *Appropriation = Authorized funding to cover cost of bill
METHODOLOGY:
This bill adds a new section to RSA 420-B relative to dispensation of clinician-administered drugs. Among other things, the new section prohibits health maintenance organizations (HMO) from requiring pharmacies to dispense clinician-administered drugs directly to patients for patients to then bring to their health care professional. The Insurance Department notes that this practice, known as "brown-bagging," is thought to reduce costs to patients and/or insurers. The Department states that prohibiting brown-bagging may therefore cause insurers to raise premiums to offset these increased costs, resulting in an increase in insurance premium tax revenue collected by the state. The Department cautions that the extent of any such impact is indeterminable, and that the bill would apply only to HMOs and not to other types of insurers.
AGENCIES CONTACTED:
Insurance Department