[{"_1":2,"_100":-5,"_101":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6387741,"mediaKeyId","2115919-f691f9c3369e9eaaa76f792b41098ac5","parentId",2115919,"title","Heated hearing on copay accumulators leaves bill undecided as stakeholders clash over patient access and premiums","audioSeconds",4796,"startMs",2493000,"endMs",7289000,"viewUrl","/Search/View?dp=1&key=2115919-f691f9c3369e9eaaa76f792b41098ac5&start=2493&end=7289","thumbnailUrl","https://assets.pipeline.soar.com/2115919-f691f9c3369e9eaaa76f792b41098ac5/thumbnail_2493000.jpg","articleUrl","/articles/6387741/New-Hampshire/Heated-hearing-on-copay-accumulators-leaves-bill-undecided-as-stakeholders-clash-over-patient-access-and-premiums","mediaUrl","https://secure.pipeline.soar.com/6387741-e9fb85d5bbf8f302c0bd6032e1aa458f/orig.mp4?Expires=1771182368&Signature=W~oWqGBBXW~Y1HXdBD0uMdOtTOrEi2MGnC8-3-Hjx5TLtUrdRy6Tm--VYk5xXsCyDEpXWZFitiWZc9xMKijMx1ok-71voGHTJCzoSj~KX5-FgYGaOVjBHZcYIF8Yp-bZMGrnEXQxrnj9KzyUJZN0JIA9GJcVIgReqs3tnWzjxdyEpOe8VYRFTDDvNkufRQgyR3mD1TIE3f8ym9tFso8aiTmnOC8nOOyDXDmIKDvc2GGWcB4nGAHAaGrpK3yf4mGMCuG~yiEU-FzxsBzDKdIWMth6vfkBxj3VXEyZkBk-vKyCUd8PNPxfIFFGADW6roIu8EPdy5KVdJxKuumprsaLvQ__&Key-Pair-Id=KUT5TJCACFTXG","author","New Hampshire Senate","date","2025-01-15T00:00:00Z","article","The Senate Health and Human Services Committee heard hours of testimony on Senate Bill 17, a proposal to prevent insurers from using copay accumulator and maximizer programs that exclude third‑party copay assistance from a patient’s deductible or out‑of‑pocket maximum.

Sponsor Sen. Dan Innes framed the bill as an affordability measure for patients with high cost specialty drugs, saying copay assistance \"isn't a discount or coupon nor is it a way to steer patients away from or toward branded medications.\" He told the committee an estimated 310,000 New Hampshire patients could be affected if the change is enacted, and said the bill would require that patient assistance count toward cost‑sharing so patients are not exposed to unexpected, large costs.

Patient advocates and disease‑specific groups urged passage. Susanna von Ettingen, the New England Bleeding Disorders Advocacy Coalition state lead and mother of a man with severe hemophilia, described her family’s difficulty in finding a marketplace plan that did not use accumulators and recounted how cost pressures can lead patients to delay or ration lifesaving medicines. \"If he has to decide between rent, electricity, or a monthly co pay of 250 or more for specialty medications, it's highly likely that he will put off his biweekly prophylactic doses,\" she said.

The American Cancer Society Cancer Action Network and other patient groups also supported the bill, arguing that accumulators undermine access to needed therapies and may produce worse outcomes and higher downstream costs. Mike Rollo of ACS CAN told the committee the legislation would not mandate coverage decisions and would leave utilization tools such as prior authorization and step therapy in place.

Insurers, PBMs and the hospital sector strongly opposed the bill as drafted. Paula Rogers of America’s Health Insurance Plans (AHIP) said the bill as written \"is a one‑size‑fits‑all approach\" that could increase premiums and disrupt benefit design, and she urged narrower, targeted changes or means‑tested carve‑outs focused on patients with no clinical alternatives. Anthem, PCMA (the PBM trade association) and others warned the bill could steer patients to more expensive brand drugs and that manufacturers use coupons as a marketing tool; PCMA witnesses said manufacturers sometimes deploy coupons to preserve market share for higher‑priced drugs. PBM testimony cited studies and modeling suggesting broader premium effects if third‑party assistance were treated as plan member payments.

Several witnesses and committee members also noted competing and unresolved evidence: some studies cited by patient advocates found no material premium effects in states that ban accumulators, while industry witnesses pointed to other analyses that project premium increases.

After extended testimony the committee did not take executive session on SB 17; a committee member noted the Insurance Department and other stakeholders were not present and the committee deferred additional action. Committee members and witnesses signaled willingness to continue discussions, including narrower carve‑outs for patients without therapeutic alternatives or options such as extending manufacturer assistance through the full plan year and adding notification requirements so plans can track coupons at point of sale.

No formal committee vote was recorded on SB 17 during the hearing day.","mediaType","Video","parentTitle","Senate Health and Human Services (01/15/2025)","oneSentenceSummary","Senate Bill 17, which would require insurers to count third‑party copay assistance toward deductibles and out‑of‑pocket maximums, drew extensive testimony from patient advocates, insurers, PBMs and hospitals. The committee did not take executive session on the bill and deferred further action.","taxTitle","Health and Human Services, Senate , Committees\t, Legislative, New Hampshire","taxId",29510,"location","New Hampshire","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6387742,"Committee backs bill requiring residential care facilities to adopt quality oversight, post investigation and life‑safety results",6130,1279000,7409000,"/Search/View?dp=1&key=2115919-f691f9c3369e9eaaa76f792b41098ac5&start=1279&end=7409","https://assets.pipeline.soar.com/2115919-f691f9c3369e9eaaa76f792b41098ac5/thumbnail_1279000.jpg","/articles/6387742/New-Hampshire/Committee-backs-bill-requiring-residential-care-facilities-to-adopt-quality-oversight-post-investigation-and-lifesafety-results","https://secure.pipeline.soar.com/6387742-7b4c55cc6c465fb8eeab4a2147a74868/orig.mp4?Expires=1771182368&Signature=XzDz~4YAVIVmIlj4~a28KDnlVRq3SCttUODkPaE7rWCqPwgISpJoPsiRLowPrNZBYd7~j0STu0KcTnqH~NukbyxSNYdjWIIcW4iXofoUuA7X9bYA8ulYc-dM-X3QspzuunI65YFEVTQd3A54t6fxPzWH6aH2SAwgcJ~YbcPu5Y6LqsLonDuFP3UCF95uHT9ZBWYhS4BSE6UOLurPJzOBZhi9kNesysbZr9j6QQAoMMVUp9Fhg5KGjrvJoTnYmWpvueQaEur-pyra~gwgVAXfqKUl1YLEY9jW95BARQJ0kICGWqmPtitCkAh1-siK0UWbrxcBXHmgFQsOW4hRg8ydrw__&Key-Pair-Id=KUT5TJCACFTXG","The Senate Health and Human Services Committee advanced Senate Bill 37, a department‑requested measure that would make quality assurance programs mandatory at licensed residential care facilities and require that results of certain DHHS investigations and life‑safety surveys be posted publicly at the facility.

Kate Littman, the majority policy director introducing the bill for Sen. Pearl, outlined statutory changes across several RSAs, saying section 1 would revise RSA 151:5‑c to make quality assurance programs mandatory for licensed residential care facilities and that the bill would amend RSA 151:6 and RSA 151:6‑a to expand the types of facilities whose investigations and life‑safety inspection results must be posted. Littman said the change aligns references in the patients’ bill of rights from \"hospital\" to \"facility.\"

Kelly Keith, licensing unit chief at DHHS’s Bureau of Licensing and Certification, said the department supports the bill and described its purpose as increasing transparency and patient safety while preserving confidentiality for quality‑assurance meeting minutes. \"The intent of this bill is to ensure patient safety and well‑being by requiring transparency of healthcare facilities to improve patient care and outcomes and reduce adverse events,\" Keith told the committee.

Several advocacy groups and oversight officials supported the bill. Susan Buxton, the state long‑term care ombudsman, said the change would give consumers better access to inspection and complaint outcomes at assisted living and other residential settings; she highlighted that federal Medicare/Medicaid rules already make nursing home inspections public but that assisted living and similar facilities are currently less transparent.

Hospital and industry representatives sought clarifications and raised implementation concerns. Ben Bradley of the New Hampshire Hospital Association said hospitals already comply with CMS quality and transparency requirements and asked the department to avoid duplication for hospitals that have \"deemed\" CMS status. He and other speakers asked the committee to avoid creating unnecessary regulatory burdens for accredited providers.

A committee amendment was offered to ensure internal wording matched throughout the bill: the word \"hospital\" in one line was replaced with \"facility.\" The amendment was adopted and the committee voted \"ought to pass as amended\" by consent.

The bill would make several targeted statutory changes (as presented at the hearing) including mandatory quality assurance committees, required posting of investigation results and life‑safety notices to correct, and uniform language in the patients’ bill of rights. The department said meeting minutes and other privileged quality‑assurance materials would remain confidential; posted items would be the publicly releasable results of investigations and inspections.","Senate Bill 37, a DHHS‑requested bill to mandate quality assurance committees and require public posting of investigation and life‑safety inspection results at certain residential care and health facilities, moved out of committee with a committee amendment.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6387747,"Senate committee advances bill letting DHHS assess need for extra pediatric beds at Cedar Crest",1059,181000,1240000,"/Search/View?dp=1&key=2115919-f691f9c3369e9eaaa76f792b41098ac5&start=181&end=1240","https://assets.pipeline.soar.com/2115919-f691f9c3369e9eaaa76f792b41098ac5/thumbnail_181000.jpg","/articles/6387747/New-Hampshire/Senate-committee-advances-bill-letting-DHHS-assess-need-for-extra-pediatric-beds-at-Cedar-Crest","https://secure.pipeline.soar.com/6387747-c0e56bde589369af9bac9abd6a1d2dd8/orig.mp4?Expires=1771182368&Signature=UMm-q3sZDbLl2pySUxlOqCnHnbhOM14mqGwVXAFDxmm6MtdduWHOgwKnciKakjUBboIScZQmUbMwxTPBd8ucUPyY7vcf8DwVoL2juZUxEZVUtE85pCyRDJdbZ-UAoznIR7aG2VXctjLlD0cdH~~Ug71m6H7s7Wf-uFlCBi8jGTEECyDX0j9acC8UDtxTIgo~S20EbQGlwMxuwW1q3kcKk~3Vm2eP7zUb96Lvw-8xyUhTkrzjvm15PUy8De~8Lv0LqdQpbALCBeOuZnOVsYlDCH3ZCOBCWR9NgSRWRxVYxbK16xcJi3g-S8oy0nxK3lRAM4SrXGQUjEYUNx49iG9S0A__&Key-Pair-Id=KUT5TJCACFTXG","Senate Health and Human Services members voted by consent to advance Senate Bill 18, a measure that would let the Department of Health and Human Services (DHHS) commissioner evaluate whether New Hampshire’s only pediatric intermediate care facility needs more beds and, if so, seek fiscal‑committee approval to add them.

The bill’s prime sponsor, Sen. Cindy Rosenwald, told the committee the proposal creates a process for the commissioner to \"assess the need for serving New Hampshire's children with complex developmental and medical needs\" without dismantling the long‑term care bed moratorium that has been in place since 1995. Rosenwald said the fiscal committee would vet any recommendation because expansions could raise Medicaid costs.

Supporters described Cedar Crest Center for Children with Disabilities in Keene as unique in the state’s care continuum for medically complex children. Dr. Jay Hasten, president and CEO of Cedar Crest, told the committee that the facility provides post‑acute care, special education and respite services and serves infants through age 22. He said the center currently had 25 occupied beds and had been temporarily authorized for 28 beds last year. Hasten provided clinical detail on the population the facility serves, saying, \"40% of the children that we serve are on ventilators, for all or part of the day,\" and that many rely on feeding tubes.

Hasten said Cedar Crest handles both long‑term placements and a high volume of respite stays — 62 respite stays last year and roughly 100 inquiries, about 60 of which he said may be appropriate for one or more of the center’s services. He and Rosenwald emphasized the bill’s intent to allow the commissioner to examine census data and other factors and to avoid repeated legislative fixes for temporary expansions.

During questioning, senators pressed on decision criteria and workforce issues for community‑based alternatives. Rosenwald and speakers said the commissioner would consider how many eligible New Hampshire children exist, bed occupancy and whether community services are available; any recommendation would also require fiscal‑committee approval because of Medicaid cost implications.

In executive session the committee received a motion to \"ought to pass\" from Sen. Abarth, seconded by Sen. Prentiss. The voice vote was taken by consent and the motion advanced out of committee.

The bill does not itself add beds; it creates an administrative pathway for the DHHS commissioner to evaluate and, with fiscal‑committee approval, authorize additional pediatric intermediate care beds at Cedar Crest under specified circumstances. Further details about any recommended expansion — including exact bed counts, cost estimates and the fiscal committee’s subsequent action — were not specified during the hearing.","The Senate Health and Human Services Committee voted by consent to advance Senate Bill 18, which would allow the Department of Health and Human Services commissioner to evaluate and request additional pediatric intermediate care beds at Cedar Crest without lifting the long‑term care bed moratorium.","actionData","errors"]

Article not found

Heated hearing on copay accumulators leaves bill undecided as stakeholders clash over patient access and premiums

Committee backs bill requiring residential care facilities to adopt quality oversight, post investigation and life‑safety results

Senate committee advances bill letting DHHS assess need for extra pediatric beds at Cedar Crest