NH SB476

Aligns New Hampshire hospital price transparency requirements with federal rules and provides a safe harbor protecting hospitals from penalties when good-faith cost estimates differ from final bills due to clinical changes, factors outside facility control, or changes in patient benefits

Requires health insurers to provide free, member-specific out-of-pocket cost estimates for shoppable services through existing online tools and secure APIs accessible via the state's HealthCost portal or enrollee-authorized third-party applications

Expands the All-Payer Claims Database (APCD) to support consumer price comparisons, display de-identified benchmark ranges for uninsured patients, and allow voluntary data contributions from self-funded ERISA plans

Prohibits the state from building new IT systems, instead requiring use of existing HealthCost infrastructure with costs borne by carriers and hospitals through vendor contracts or in-kind integration work

Establishes a 60-day cure period for first-time or technical violations before administrative penalties and requires annual public dashboards on hospital and carrier compliance; most provisions take effect 12 months after passage