[{"_1":2,"_123":-5,"_124":-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",[32,76,88,100,112],{"_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",6577745,"mediaKeyId","3101945-5d692a25d1038abe168bfd9a62621219","parentId",3101945,"title","Insurance department, providers back overhaul of continuing care retirement community rules","audioSeconds",1944,"startMs",12392000,"endMs",14336000,"viewUrl","/Search/View?dp=1&key=3101945-5d692a25d1038abe168bfd9a62621219&start=12392&end=14336","thumbnailUrl","https://assets.pipeline.soar.com/3101945-5d692a25d1038abe168bfd9a62621219/thumbnail_12392000.jpg","articleUrl","/articles/6577745/New-Hampshire/Insurance-department-providers-back-overhaul-of-continuing-care-retirement-community-rules","mediaUrl","https://secure.pipeline.soar.com/6577745-ab64dd12a5bf9b94681d128c33eaef1d/orig.mp4?Expires=1771176136&Signature=RQCUpPynVSIyQrDf-IULGyabxI0Sxtpg34Dk0tKTeUOXWG64JG6s4W4wYWVde3Oo1xyB5m2WTR4QAp~BujF4Z-GznizaYVn82Beaf1cD8c~TZvRYMAzueCz71d2HoBnOTbNUUlxISmqJUFukIT7kKnO7qj5ZYbmoBl3EVMKnB1PhO-8crSNB2Q1CnI36qwixmQsFE9wWzJqPuAFuEudA0Ev010RSg7FfLA7O00r2OoGyIPvUPq-C6W08PartwpBZEWrqcyCP1gHyUW9qfmKJ~bkGIKXvchlfFt~hbfD7To3RRwaDWdafJ5ijZ9clT8Pz5zUahZQS7ByXESmEAtl3Ig__&Key-Pair-Id=KUT5TJCACFTXG","author","New Hampshire Legislature","date","2025-04-23T21:27:18.987Z","article","Lawmakers heard testimony on Senate Bill 124 FN, a comprehensive overhaul of New Hampshire’s regulatory framework for continuing care retirement communities (CCRCs).

The bill, introduced on behalf of Senator Ricciardi, would modernize a statute more than 30 years old and give the New Hampshire Insurance Department new tools to monitor financial health, the department said. “When you are talking about an entity who is in that degree of crisis, the options and the opportunities available to you to rectify that situation are greatly narrowed,” DJ Betancourt, commissioner of the Insurance Department, told the committee. The department said it had responded to three CCRCs facing major financial distress in the past decade, including one that had about 10 days of cash on hand.

Key proposed changes include quarterly financial reporting rather than annual filings, an early warning system that triggers review and a required financial solvency plan, escrow protections for substantial entrance fees, and a statutorily enumerated residents’ bill of rights. The draft also allows the department to give greater autonomy to high-performing CCRCs (for example, not requiring escrow when an operator meets occupancy and cash-on-hand benchmarks) while imposing additional oversight for facilities that fail benchmarks.

Steve Nottinger, an attorney in the Insurance Department, said the “most important thing” is quarterly reporting to create time for intervention. The department’s proposal would require CCRCs in distress to submit a financial plan within 60 days for the department to approve or reject; the department said that requirement is intended to compel timely action and avoid the “reactive” posture that followed past crises.

LeadingAge New Hampshire, which represents nonprofit CCRCs, testified that members participated in the drafting process and generally support the bill’s approach, though the association noted smaller or independent-living-only operators could face heavier compliance demands. LeadingAge said it appreciated language that allows operators meeting occupancy and solvency benchmarks to avoid escrowing entrance fees, because banks are sometimes reluctant to accept escrow arrangements.

The measure’s supporters said the overhaul balances increased oversight for troubled facilities with flexibility for healthy operators. No formal committee vote occurred at the hearing; the department and providers said they would continue to negotiate technical refinements.

Why it matters: CCRCs accept substantial entrance fees and promise long-term care. Financial failure at a CCRC can jeopardize residents’ housing and large amounts of personal wealth; department officials said federal and state tools have been insufficiently proactive in recent cases.

What’s next: The committee will consider the bill in subcommittee and work sessions. Department staff signaled willingness to refine technical provisions; providers asked for continued collaboration on bank, escrow and actuarial details.","mediaType","Video","parentTitle","House Commerce and Consumer Affairs (04/23/2025)","oneSentenceSummary","The House Commerce Committee took testimony on Senate Bill 124 FN, a comprehensive update to New Hampshire’s regulation of continuing care retirement communities intended to strengthen financial oversight and resident protections.","taxTitle","Commerce and Consumer Affairs, House of Representatives, Committees\t, Legislative, New Hampshire","taxId",17743,"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},6577750,"Lawmakers consider bill to let pharmacies refuse fills when PBM reimbursement is below acquisition cost",3789,3872000,7661000,"/Search/View?dp=1&key=3101945-5d692a25d1038abe168bfd9a62621219&start=3872&end=7661","https://assets.pipeline.soar.com/3101945-5d692a25d1038abe168bfd9a62621219/thumbnail_3872000.jpg","/articles/6577750/New-Hampshire/Lawmakers-consider-bill-to-let-pharmacies-refuse-fills-when-PBM-reimbursement-is-below-acquisition-cost","https://secure.pipeline.soar.com/6577750-4f36ce813e3cf0b1d320512b0d7ea398/orig.mp4?Expires=1771176136&Signature=Nq33TVTjvBV2MyFQc9c~E~CIqzfvEgL3APsZ-wQ1T0aqqHciIMLoZYyyhl1zPs4Wldd8VUv1gB0U~iaO6cIgKvnBOovDdne07msmRojCNyuf6E8QIqxxQvcwLAmY1tMvYzq4Bvzgm2OWzQMin8xE55X93Myg~PI4kupwA7DVP6KiQU6FaQ8Muyl70xL5J6ip2jVvPfih2EHu3T~F30fDv8PalbvaIB-2JjW~kEAd~gSiSTT5pwX8lYPAQluN0u1AiQZtMls04jr3RRDA1EQjquUdCYEWRsh~Ul3Qt6JdMf~SXvHwYbIlg9GbYVscbMnHk-LPUgnsEZuRIkMp-rGw6g__&Key-Pair-Id=KUT5TJCACFTXG","The committee heard long, sometimes heated testimony on Senate Bill 247, which would prohibit network exclusion for pharmacies that refuse to dispense a prescription when the PBM reimbursement is below the pharmacy’s acquisition cost.

Representative Brian Cole introduced the measure, saying the bill addresses practices by pharmacy benefit managers that leave some independent pharmacists forced to dispense medications at a loss. \"Pharmacists don't have to sell a prescription below their cost,\" Cole told the committee, offering the bill as a compromise to protect local pharmacies.

Independent pharmacists and owners described examples where PBM-set reimbursement could be below the wholesale or acquisition cost for a drug. “We’re talking prescriptions that cost anywhere from $1,000 to $1,500 that we're being underpaid anywhere from $50 to $200 on,” said Glenn Peralta, owner of Colonial Pharmacy, who urged reinstating language the Senate removed that would have allowed pharmacists to charge the patient the difference between acquisition cost and PBM reimbursement.

The legislation as amended on the Senate floor removed language that would have expressly allowed pharmacists to collect the delta from patients. Multiple independent pharmacists testified they want that provision restored to preserve at-the-counter access and avoid forcing many patients to use mail-order or travel to distant pharmacies.

Opponents, including the Health Care Distribution Alliance (HDA) and industry witnesses, urged narrower drafting or removal of certain provisions on pharmacy services administrative organizations (PSAOs); they said the bill conflates different PSAO roles and could cause PSAOs to exit the state, reducing choices for independent pharmacies. AHIP indicated it could support the bill if the notice period was aligned with federal requirements; AHIP’s representative said a 90‑day state notice would resolve concerns in Sen. Raybards’s amendment discussions.

Committee members pressed on practical effects for patients. Representative Sullivan asked whether a patient could pay the difference at point of sale to keep buying locally; witnesses said the bill as currently drafted (without the Senate’s deleted language) does not create a mechanism for a customer to pay a premium at the register — instead, the pharmacy could decline to fill and direct the patient to the insurer or PBM for alternatives.

Pharmacy supporters argued independent pharmacies cannot match the mail-order volume discounts PBMs secure and that current PBM contracting practices give few alternatives for independents; pharmacy supporters said the bill balances consumer access and pharmacy viability. Industry witnesses and some legislators said the removed “delta” language would defeat the purpose of contracted network pricing and could drive up costs by eroding negotiated rates.

Key technical issues raised in testimony included: whether the bill should restore language allowing a pharmacist to collect the acquisition-cost delta from patients; whether Medicare and Medicaid lines should be excluded from the measure; how PSAOs should be defined and regulated; and whether the Senate’s removal of the delta provision was intentional and why it was dropped.

What happened at the hearing: Stakeholders on both sides said they wanted more negotiation. Pharmacy owners asked the committee to reinstate the deleted language so they can continue to serve patients without heavy financial loss. The department and industry witnesses urged careful drafting to avoid unintended consequences. The committee did not vote at the hearing; members signaled follow-up work sessions would be needed to reconcile competing concerns.

Why it matters: The bill touches pharmacies’ financial survival, patient convenience and access, and PBM contracting practices that affect drug distribution and retail pharmacy networks. Independent pharmacies told the committee the stakes are high for small-town access to routine medications.

What’s next: Committee work sessions and potential subcommittee amendment are likely to address whether pharmacies can collect a “delta” from patients, how PSAOs are treated in statute, and carve-outs for federal programs. Testimony indicated the Senate already removed the delta language and some witnesses want it restored.","The House Commerce Committee heard extended testimony on Senate Bill 247, which would bar network exclusion for pharmacies that refuse to dispense a prescription when PBM reimbursement is below the pharmacy’s acquisition cost.",{"_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},6577740,"Secretary of State and actuaries push solvency guardrails for pooled risk programs; stakeholders debate model",9415,14735000,24150000,"/Search/View?dp=1&key=3101945-5d692a25d1038abe168bfd9a62621219&start=14735&end=24150","https://assets.pipeline.soar.com/3101945-5d692a25d1038abe168bfd9a62621219/thumbnail_14735000.jpg","/articles/6577740/New-Hampshire/Secretary-of-State-and-actuaries-push-solvency-guardrails-for-pooled-risk-programs-stakeholders-debate-model","https://secure.pipeline.soar.com/6577740-3978f3115ecf8e9bc0a5da197acbd2b8/orig.mp4?Expires=1771176136&Signature=Lx7cPx7CDMvoeeZzdaHnFXPLPfxDK6n768zhoj3hEfJGg2cUdiSsjH0nbGDoZ9vn0l9RAOBuMKv7wAjK~xIumvJGT69uqdUzkzOuJtdTljWXgVZ8N3dd0nEILKopzggjT-946Yc8HlJVAlakTRVTpXXA64C3jxt7ZW55P3EL6KY~DMV~A-imkSUTZP9v9~VXh7JfXg-uHowGhHOMPmncS2~zTw7tJM82LpcJDxSu~a8x5pTHyUNo1foUafOAB~NCCKF8AcqNbu3WYI3xVTesYA81r561bzPg-Be4BjtKa6os3EsAeMPfL2Ku-IkV3WMML8AWHIDcJA0HVuJt0BxhIw__&Key-Pair-Id=KUT5TJCACFTXG","The House Commerce Committee held a lengthy hearing on Senate Bill 297, a proposal to add solvency guardrails, reporting requirements and emergency assessment mechanisms for public entity pooled risk management programs governed by RSA 5‑B.

Secretary of State David Scanlon said the bill responds to a two-year sequence of financial stress in pooled public risk programs, including the unexpected closure announcement this month by one pool, New Hampshire Interlocal Trust (NHIT). \"Back in 2023, HealthTrust came into my office and self-reported that there were financial concerns about the level of reserves they had on hand to be able to pay their claims,\" Scanlon said. The secretary’s office commissioned actuarial analyses and worked with stakeholders to craft the bill.

The measure would establish a contingency-reserve target range for health lines (12%–16% of expected claims and administration costs, with a constrained option to request up to 18%) and a higher range for property and casualty lines (30%–40%). If reserves drop to warning levels (8%) the bill would trigger heightened review, and a lower trigger (4%) would authorize emergency assessment processes and allow the secretary to seek court-ordered receivership in extreme cases. The bill also proposes a restricted “break-glass” fund — up to 4% of previous-year contributions, sourced from earnings and surplus — that pools could elect to hold to smooth potential assessments.

Secretary Scanlon and the bill’s outside counsel, Christina Ferrari, described the provisions as narrowly tailored guardrails that preserve member ownership and local control while introducing early-warning tools and defined remediation steps. Actuaries who worked for the secretary’s office said modeling shows the contingency ranges would substantially reduce insolvency risk.

Risk-pool representatives, notably HealthTrust, urged a different approach. HealthTrust’s executive director Scott Duroch said the proposed 12%–16% health contingency range and the bill’s emphasis on assessments would undercapitalise some pool models and leave members exposed to mid-year rate shocks and benefit disruptions. HealthTrust cited prior experience in which its contingency reserve fell sharply after a surge in claims; the trust said it has implemented a multi-year rebuild plan and argued that a risk‑based capital model tied to actuarial measures like IBNR and loss development would be a more defensible approach.

Local government groups and municipal officials urged caution and asked for more analysis. The New Hampshire Municipal Association opposed the bill as drafted and supported an amendment to move regulation to the Insurance Department; municipal officials warned that forced assessments or surprise replenishments would be difficult for town budgets to absorb. Several municipal and county officials described urgent, near-term budget impacts as pools reprice coverage.

Supporters said the bill is intended to stop a cycle of underpricing and surprise deficits that have left political subdivisions exposed; opponents said the drafting risks unintended consequences and that an insurance‑department regulatory model (using NAIC risk‑based capital principles) might be preferable. The committee did not vote; testimony indicated ongoing negotiations and a draft Secretary of State amendment that would let pools keep a restricted assessment fund at the pool level rather than forcing every member to hold separate municipal funds.

Why it matters: Pooled risk programs cover millions of dollars in municipal assets and tens of thousands of lives; insolvency or disorderly wind‑up can create serious coverage gaps and unanticipated costs for towns, schools and taxpayers.

What’s next: Committee work sessions to consider revisions; stakeholders signaled interest in exploring an alternative model using industry-standard risk-based capital methods or moving oversight to the Department of Insurance, though several panelists said a statutory interim solution is needed quickly for orderly wind‑ups.","The House Commerce Committee heard hours of testimony on Senate Bill 297, which would set contingency reserve ranges, reporting requirements and emergency assessment powers for public entity pooled risk programs under RSA 5‑B following recent losses and an NHIT closure announcement.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6577755,"Insurance department seeks notice when carriers stop writing lines, citing Medicare Advantage disruption",772,1779000,2551000,"/Search/View?dp=1&key=3101945-5d692a25d1038abe168bfd9a62621219&start=1779&end=2551","https://assets.pipeline.soar.com/3101945-5d692a25d1038abe168bfd9a62621219/thumbnail_1779000.jpg","/articles/6577755/New-Hampshire/Insurance-department-seeks-notice-when-carriers-stop-writing-lines-citing-Medicare-Advantage-disruption","https://secure.pipeline.soar.com/6577755-4076d1f7c6688aa88705b23b441e8551/orig.mp4?Expires=1771176136&Signature=XyMZkqz-O1puBasu9qZt9q707~lIQCPtmXDIdARDbK68W0zrUNh0OQZY16hepHLLT19ap-PZ1Q1voyjJiSQptzBqpC-c9DJAVSxaXrcZc3ybZLu6ztSKebiE619Mr3WOsjtPxlSTvGItK0XniH3h-VOAy-IAZeNkBKPRFdcMTK6rUONVA9CPsqp0UmqqmhvpGR62hi0ObGXMkJ9g2GPPWarcJ1~IyJilWchWF6t9tTGHqPNaeoYN6lwFc1YslrSm5Rx5ZZVq8A9LfpCxhiA-FDoeow7OuMAlvROZ-63gz5AEMsHHsOhw1wAPcfb~YVEtlyxhBtvk1MTH2HRFj5YEMA__&Key-Pair-Id=KUT5TJCACFTXG","The House Commerce Committee took testimony on Senate Bill 121, a Department of Insurance–backed bill requiring insurers to notify the department when they plan to stop writing a full line of business or substantially change their offerings.

Grant Bosse introduced the bill on behalf of the prime sponsor, Senator Kevin Avard, saying the measure was filed at the department’s request. DJ Betancourt, commissioner of the New Hampshire Insurance Department, told the committee that the bill stems from “a significant degree of disruption” in the Medicare Advantage market this past year, when several carriers narrowed or withdrew product offerings.

“We were inundated with calls from seniors and brokers asking what’s going on,” Betancourt said. The department does not regulate Medicare Advantage itself, he noted, but it licenses companies that sell Medicare Advantage plans. Betancourt said the department’s staff spent a day in phone calls to carriers to learn which plans would continue and which would disappear, a time-consuming effort that the bill’s notice requirement would obviate.

The bill would make notice a licensing condition: carriers would be required to inform the department when they cease writing an entire product line or substantially change their offerings. Betancourt said the intent is to keep the department informed so it can give better consumer guidance.

Several legislators and witnesses discussed the notice period. The federal notice period for Medicare Advantage is 120 days; department rules typically use 90 days. Industry groups said they were working with the department to align state and federal timing, and representatives said an amendment to the bill would change the notice to 90 days to match typical state practice.

Representative Rose asked about enforcement. Betancourt said the requirement would be part of a carrier’s license condition; “if they choose not to comply in a flagrant way, then, yeah, their license would be at risk,” and fines could be imposed.

Supporters including AHIP said they would accept a 90-day amendment; AHIP’s Paula Rogers told the committee that aligning state notice timing with federal rules would alleviate concerns about preemption. The hearing closed with staff and stakeholders signaling ongoing negotiation on the notice period and related technical language.

Why it matters: Department officials described the bill as a transparency measure designed to reduce consumer confusion when carriers make sudden market exits or large plan changes. It arose from real complaints from Medicare beneficiaries and brokers who received notices that carriers were leaving or narrowing offerings.

What’s next: Committee work sessions were expected to consider technical amendments, including language to align the notice period with federal timing and to tailor reporting requirements for property-and-casualty lines that raised carrier concerns.","Senate Bill 121 would require carriers to notify the New Hampshire Insurance Department if they cease writing an entire line of business or significantly change offerings — a measure prompted by recent disruption in the Medicare Advantage market and by consumer confusion, department officials said.",{"_33":113,"_35":36,"_37":38,"_39":114,"_41":115,"_43":116,"_45":104,"_47":117,"_49":118,"_51":119,"_53":120,"_55":56,"_57":58,"_59":121,"_61":62,"_63":64,"_65":122,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6577759,"Committee hears bill to make birth mother’s policy primary for newborn care",1407,372000,"/Search/View?dp=1&key=3101945-5d692a25d1038abe168bfd9a62621219&start=372&end=1779","https://assets.pipeline.soar.com/3101945-5d692a25d1038abe168bfd9a62621219/thumbnail_372000.jpg","/articles/6577759/New-Hampshire/Committee-hears-bill-to-make-birth-mothers-policy-primary-for-newborn-care","https://secure.pipeline.soar.com/6577759-911b4911e88cc71c79a5f724c713f2d8/orig.mp4?Expires=1771176136&Signature=FvvsWJSNb6UXBLB-SBNZ4bNsMLgVMvpcneZUMHKbZPMY6PDUGffilhQSn83zfX5gHfowCGAUSRm~i5HzwFxeZAlNWBzoTsrKfKBIhio~g~lXPEhfPhMIAsM8wcrrXkRVGJsYl6QzF542Mm7NL6ysUPiA08fCqfoSihD-oM0ersvwqw6xGMtoKJkc5OcGnvpWOKzYbHTS~9AQ~0-i82399VCmD~6N4bd6DLhpSAaR5EJKrn3LavHq7qamykoMmpX82ye0onqT54b0q-JFPYoIf3b7SBkopU7GkZVvgT6zMSnWSj9ZfSOfEGJ2TzKYHKy6dqXAghaSGVGUuxbOgB4wKw__&Key-Pair-Id=KUT5TJCACFTXG","Senators opened a public hearing on Senate Bill 47 Tuesday, a bill carried by Senator Regina Birdsall that would codify the New Hampshire Insurance Department’s interpretation that a birth mother’s health insurance policy be treated as the primary policy for a newborn’s care when that policy is available.

The bill “is a request from the Department of Insurance,” Senator Regina Birdsall said, telling the committee the legislation “makes a birth mother’s health insurance policy the primary policy for a newborn child’s health care unless the mother has no insurance or coverage under an employer-sponsored health plan.”

The measure does not change the department’s guidance, department officials said; it formalizes the department’s longstanding reading of the law. “It is purely a clarification of how we have always interpreted the statute,” DJ Betancourt, commissioner of the New Hampshire Insurance Department, told the committee, adding the department brought the bill to ensure the practice and the statute are aligned.

Representative Miles asked whether a young woman covered as a dependent on her parents’ plan who becomes a parent would trigger the parents’ coverage for the newborn. Senator Birdsall and department staff confirmed that in the example given the parents’ coverage would continue to be available for the child if the young mother remained on the parents’ policy.

The hearing closed without a committee vote. No formal amendments or votes were recorded during the public hearing; department staff were available to answer technical questions.

Why it matters: Supporters framed the bill as a consumer-protection clarification for vulnerable newborns and families, and the department described it as bringing statute into alignment with its enforcement practice. Lawmakers asked clarifying implementation questions about dependent coverage and interactions with employer-sponsored plans.

What’s next: The bill will proceed through the committee process; department staff said they will be available to draft any technical language and to answer follow-up questions requested by the committee.","Lawmakers heard testimony on Senate Bill 47, which would codify the New Hampshire Insurance Department’s long-standing interpretation that a newborn’s health care should be covered first by the birth mother’s policy when available; department officials said the measure clarifies existing practice and provided staff to answer questions.","actionData","errors"]

Article not found

Insurance department, providers back overhaul of continuing care retirement community rules

Lawmakers consider bill to let pharmacies refuse fills when PBM reimbursement is below acquisition cost

Secretary of State and actuaries push solvency guardrails for pooled risk programs; stakeholders debate model

Insurance department seeks notice when carriers stop writing lines, citing Medicare Advantage disruption

Committee hears bill to make birth mother’s policy primary for newborn care