Bill Text: NH HB1287 | 2020 | Regular Session | Amended
Bill Title: Relative to the duration of antibiotic therapy for tick-borne illness.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Engrossed - Dead) 2020-06-16 - Introduced 06/16/2020, and Laid on Table, Motion Adopted, Voice Vote; 06/16/2020; Senate Journal 8 [HB1287 Detail]
Download: New_Hampshire-2020-HB1287-Amended.html
HB 1287-FN - AS AMENDED BY THE HOUSE
11Mar2020... 0712h
2020 SESSION
20-2074
01/10
HOUSE BILL 1287-FN
AN ACT relative to the duration of antibiotic therapy for tick-borne illness.
SPONSORS: Rep. W. Thomas, Hills. 21; Rep. Stack, Hills. 21
COMMITTEE: Commerce and Consumer Affairs
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ANALYSIS
This bill requires insurance coverage for long-term antibiotic therapy for tick-borne illness.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
11Mar2020... 0712h 20-2074
01/10
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty
AN ACT relative to the duration of antibiotic therapy for tick-borne illness.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; Accident and Health Insurance; Coverage for Long-Term Antibiotic Therapy for Tick-Borne Illness; Individual. Amend RSA 415 by inserting after section 6-x the following new section:
415:6-y 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.
2 New Section; Accident and Health Insurance; Coverage for Long-Term Antibiotic Therapy for Tick-Borne Illness; Group. Amend RSA 415 by inserting after section 18-bb the following new section:
415:18-cc Coverage for Long-Term Antibiotic Therapy Tick-Borne Illness. Each insurer that issues or renews any policy of group or blanket 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.
3 Health Services Corporations; Applicable Statutes. Amend RSA 420-A:2 to read as follows:
420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-t, RSA 415:6-u, RSA 415:6-v, RSA 415:6-w, RSA 415:6-x, RSA 415:6-y, RSA 415:18, V, RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-i, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-y, RSA 415:18-z, RSA 415:18-aa, RSA 415:18-bb, RSA 415:18-cc, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.
4 Health Services Corporations; Applicable Statutes; Effective January 2021. Amend RSA 420-A:2 to read as follows:
420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-u, RSA 415:6-v, RSA 415:6-w, RSA 415:6-x, RSA 415:6-y, RSA 415:18, V, RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-i, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-z, RSA 415:18-aa, RSA 415:18-bb, RSA 415:18-cc, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.
5 Health Maintenance Organizations; Statutory Construction. Amend RSA 420-B:20, III to read as follows:
III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-t, RSA 415:6-u, RSA 415:6-v, RSA 415:6-w, RSA 415:6-x, RSA 415:6-y, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-i, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-y, RSA 415:18-z, RSA 415:18-aa, RSA 415:18-bb, RSA 415:18-cc, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.
6 Health Maintenance Organizations; Statutory Construction; Effective January 1, 2021. Amend RSA 420-B:20, III to read as follows:
III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-u, RSA 415:6-v, RSA 415:6-w, RSA 415:6-x, RSA 415:6-y, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-i, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-z, RSA 415:18-aa, RSA 415:18-bb, RSA 415:18-cc, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.
I. Sections 4 and 6 shall take effect January 1, 2021 at 12:03 p.m.
II. The remainder of this act shall take effect 60 days after its passage.
20-2074
Amended 3/20/20
HB 1287-FN- FISCAL NOTE
AS AMENDED BY THE HOUSE (AMENDMENT #2020-0712h)
AN ACT relative to the duration of antibiotic therapy for tick-borne illness.
FISCAL IMPACT: [ X ] State [ X ] County [ X ] Local [ ] None
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STATE: | FY 2020 | FY 2021 | FY 2022 | FY 2023 |
Appropriation | $0 | $0 | $0 | $0 |
Revenue | $0 | Indeterminable Increase | Indeterminable Increase | Indeterminable Increase |
Expenditures | $0 | Indeterminable Increase | Indeterminable Increase | Indeterminable Increase |
Funding Source: | [ X ] General [ ] Education [ ] Highway [ X ] Other - Health care facility fees | |||
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COUNTY: |
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Revenue | $0 | $0 | $0 | $0 |
Expenditures | $0 | Indeterminable Increase | Indeterminable Increase | Indeterminable Increase |
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LOCAL: |
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Revenue | $0 | $0 | $0 | $0 |
Expenditures | $0 | Indeterminable Increase | Indeterminable Increase | Indeterminable Increase |
METHODOLOGY:
This bill requires insurance coverage for long-term antibiotic therapy for tick-borne illness. The Insurance Department indicates this would be considered a state mandated benefit, and under federal law, the cost of coverage for this benefit for policies sold through the health insurance exchange would have to be borne by the State. The Department states the additional coverage will impact claim costs and may impact premium costs and premium tax revenue collected by the State.
The Department of Health and Human Services indicates tick borne disease are required by law to be reported to the Division of Public Health Services (DPHS). The Department assumes mandated coverage of long-term antibiotic therapy will result in increased utilization of such treatments. The DPHS states such therapy has been associated with serious, sometimes deadly complications, including antimicrobial resistant infections. Many of the adverse outcomes associated with long-term treatment are conditions that are required to be reported by law to DPHS. The Department assumes the proposed legislation would increase resource demands on the DPHS to investigate and prevent the spread of antimicrobial resistant organisms and to track other outcomes of long-term antibiotic treatment. These investigations are resource intensive. The Department indicates about 20% of people on long-term antibiotic treatment for Lyme disease end up with treatment-associated infections, but it is not known how many of the estimated 15,000 people diagnosed with Lyme disease in NH each year would receive longterm antibiotic treatment and what proportion of the 20% who develop treatment-associated infections would have a type of infection that would necessitate DPHS investigation. Because of these variables, any increase in state expenditures cannot be determined. The DPHS is funded with federal funds for tick-borne disease surveillance, prevention, and response activities and funded with federal funds and health care facility fees for performing antimicrobial resistant infection surveillance, prevention and response activities. The Department's Division for Medicaid Services assumes the proposed legislation applies to commercial insurers only and does not pertain to the Medicaid program. Accordingly, there should be no fiscal impact to the Medicaid program.
The Department of Administrative Services indicates the State Health Benefit Plan for employees and retirees is a governmental self-insured plan and is not governed by managed care law. There would be no fiscal impact to the State Health Benefit Plan for employees and retirees.
It is assumed the fiscal impact of the bill would not occur until FY 2021.
AGENCIES CONTACTED:
Departments of Insurance, Health and Human Services and Administrative Services
