NH SB546

Health insurance carriers offering commercial coverage in New Hampshire must implement network access compliance protocols consistent with CMS "secret shopper" audit requirements, effective January 1, 2027

Carriers must contract with independent third parties to conduct annual secret shopper surveys of behavioral health and primary care providers, with results due to the Insurance Department by May 31 each year

Carriers face civil monetary penalties if they fail to submit complete audit reports, if fewer than 80% of contacted provider listings are confirmed in-network and accepting appointments, or if they violate network adequacy standards

Noncompliant carriers must reimburse all out-of-network claims incurred by enrollees for provider types where the carrier failed to meet audit or network adequacy requirements, and must enter corrective action plans

The fiscal note indicates potential indeterminable increases to state General Fund revenue from insurance premium taxes, as carriers may pass administrative costs to policyholders through higher premiums