New Hampshire Insurance Department Announces Passage of SB173: The No Surprises Act

CONCORD, NH (July 10, 2024) – The New Hampshire Insurance Department (NHID) is pleased to announce the passage and signing into law of SB173, a pivotal piece of legislation aimed at protecting consumers from unexpected medical bills. This bill, sponsored by Senators Carson, Bradley, and Prentiss, was signed into law by Governor Chris Sununu on July 3, 2024, aligning state law with the federal No Surprises Act (NSA) and providing New Hampshire residents with robust protections against surprise medical bills from out-of-network providers.

SB173 harmonizes New Hampshire's existing Balance Billing law (RSA 420-J: 8-e and RSA 329:31-b) with the federal NSA by enacting the same requirements and prohibitions at the state level. Key provisions include:

• Prohibiting surprise medical bills from out-of-network providers for emergency medical services (excluding ambulance services) and any health care service rendered at an in-network facility.
• Requiring health carriers to cover relevant out-of-network services as if they were provided by in-network providers or facilities.
• Establishing an Independent Dispute Resolution (IDR) process to resolve disputes about the fair value of medical services provided by out-of-network providers. This process will be expedited and less costly compared to the federal IDR process, which has faced litigation and administrative difficulties.

“The enactment of SB173 is a significant milestone in protecting New Hampshire consumers from unexpected medical expenses across a wide range of services,” said NH Insurance Commissioner DJ Bettencourt. “This achievement represents the culmination of a three-year effort by the department and accomplishes one of my top priorities: ensuring that residents can fully focus on receiving the care they need without the concern of surprise bills from out-of-network providers. In keeping with New Hampshire tradition, our Independent Dispute Resolution process will be efficient - providing swift resolutions and ensuring accountability - all at a significantly lower cost to providers and carriers.” 

The bill also expands the definition of emergency services to match the NSA's definition and includes provisions for timely payment by health carriers to out-of-network providers. Importantly, this bill has been reviewed and confirmed by the federal Centers for Medicare and Medicaid Services (CMS) as a “Specified State Law” under the NSA.

“This legislation reflects the hard work and compromise between the Insurance Department and the state's hospitals,” said Deputy Commissioner Keith Nyhan. “By providing a choice between the state and federal IDR processes, we are offering a streamlined and efficient solution for resolving payment disputes, ensuring timely and fair compensation for providers.”

For more information about SB173 and its implications for New Hampshire residents, please contact the New Hampshire Insurance Department.

The New Hampshire Insurance Department Can Help
The New Hampshire Insurance Department’s mission is to promote and protect the public good by ensuring the existence of a safe and competitive insurance marketplace through the development and enforcement of the insurance laws of the State of New Hampshire. Contact us with any questions or concerns you may have regarding your insurance coverage at 1‐800‐ 852‐3416 or (603) 271‐2261, or by email at consumerservices@ins.nh.gov. For more information, visit https://insurance.nh.gov.