Current through the 2024 Legislative Session
Section 420-J:8-g - [Effective 1/1/2025] Coverage And Payment For Emergency Services Provided By Nonparticipating Providers Or Nonparticipating Emergency FacilitiesI. Each insurer that issues or renews any policy of health insurance providing benefits for emergency services shall cover emergency services provided by a nonparticipating provider or nonparticipating emergency facility in the same manner and without imposing any additional requirements as if the services were provided by a participating provider or participating emergency facility.II. The patient's cost-sharing for items or emergency services provided by a nonparticipating provider or nonparticipating emergency facility shall be calculated by the health carrier based on the qualifying payment amount.III. The insurer shall pay the nonparticipating provider of emergency services or nonparticipating emergency facility an amount based on the fair value considerations set out in RSA 420-J:8-e, IV, less any cost-sharing for the services provided.IV. In the event of a dispute between a nonparticipating provider or facility and an insurer relative to the fair value of an item or service under this section, the commissioner shall make available, as provided in RSA 420-J:8-e, an independent dispute resolution process to determine the fair value payment amount.Added by 2024, 143:10, eff. 1/1/2025.