Committee Summary for House Commerce and Consumer Affairs (04/07/2026)

Member	Member	Member
Hunt, John(Chairman)(R)[B+]2025	Post, Lisa(Clerk)(R)[A]2025	Potucek, John(V Chairman)(R)[A-]2025
Butler, Billie(D)	Salvi, Santosh(D)[CT]2025	Chourasia, Manoj(D)[F]2025
Ammon, Keith(R)[A]2025	Herbert, Christopher(D)[D-]2025	Osborne, Jason(R)[A+]2025
Thackston, Dick(R)[B+]2025	Walsh, Lilli(R)[B]2025	Porcelli, Susan(R)[B]2025
Spier, Carry(D)[D-]2025	Burroughs, Anita(D)[F]2025	McAleer, Chris(D)[D-]2025
Sullivan, Jared(D)[D]2025	Miles, Julie(R)[A-]2025	Presa, Adam(R)[B]2025

Bill/Time	Type	Title	Sponsor
SB657	Public Hearing	(New Title) creating a study commission to oversee the use of artificial intelligence in the state.	Perkins Kwoka, Rebecca(D)[F]2025
SB639	Public Hearing	establishing a committee to study the health and safety impacts of Red Dye 40 and other food additives in food and beverages sold in New Hampshire.	Fenton, Donovan(D)[F]2025
SB648	Public Hearing	(New Title) requiring age verification by commercial entities to allow access to pornographic material.	Reardon, Tara(D)[F]2025
SB482	Public Hearing	establishing consumer protections for digital access transaction kiosks.	McGough, Tim(R)[B+]2025
SB496	Public Hearing	relative to supervision and registration requirements for associates of broker-dealers.	McGough, Tim(R)[B+]2025
SB256	Public Hearing	(New Title) establishing safety and care requirements for clinician-administered drugs.	McGough, Tim(R)[B+]2025

SB657: Information Only 00:05:48.966 - 10:05:14 AM; Rep. Speier introduced SB 657 on behalf of Sen. Rebecca Perkins-Carker, explaining that the original bill involved a commission and Justice Department collaboration on AI investigations and consumer protection, but the Senate Judiciary Committee removed the Justice Department aspects, leaving only a study committee. She noted the fiscal note of nearly a million dollars no longer applies and the bill should not be treated as an early bill. The study would examine AI's use in the state, including in health insurance, without focusing solely on problems but on development and implementation impacts. The committee includes two Senators, two House members, and others like a governor-appointed AI expert.
SB639: Support 00:34:48.678 - 10:34:14 AM; Sen. Fenton introduced SB 639, a bipartisan bill creating a study committee to review scientific evidence on Red Dye 40 and other food additives, assess policies in other states, examine impacts on schools, consumers, and businesses, and consider future legislation. She highlighted federal interest in regulating these additives and the need for New Hampshire to prepare, especially for small businesses like grocers and bakeries that could be harmed by sudden changes. Other countries like the EU, UK, and Norway have banned Red Dye 40 or require warning labels. The bill serves as a placeholder for proactive planning. During questioning, she clarified it's a study first, not an outright ban, and addressed concerns about enforcement, fiscal impacts, and comparisons to California's actions. She emphasized protecting children from harmful effects like hyperactivity and the importance of data-driven decisions.
SB648: Support 01:01:39.251 - 11:01:05 AM; Sen. Reardon introduced SB 648, which requires age verification on websites where over half the content is pornographic, targeting online access rather than stores. It includes privacy provisions to delete verification data immediately. Motivated by a constituent noting increased domestic and sexual violence among youth linked to porn exposure, similar laws exist in Texas, Arkansas, and Utah, with Texas upheld by the Supreme Court. The bill was modified to protect platforms like Apple, Google, and ISPs from liability for user-generated content, removing a private right of action. She provided an amendment to restore a paragraph exempting providers. Verification uses methods like government ID or reasonable alternatives, similar to lottery or betting sites, though reliant on user honesty.
SB648: Support 01:07:06.800 - 11:06:32 AM; Responds to questions about the history of a paragraph mistakenly left out via a Senate floor amendment, emphasizing the need for complete amendments by a certain date. Discusses enforcement of data privacy provisions prohibiting retention of personal information, with penalties enforced by the Attorney General's office. Notes removal of private right of action and lack of fiscal note for enforcement, suggesting discovery might occur in larger suits rather than audits. Addresses concerns about potential damage from data breaches before detection and the invasive nature of verification processes like facial scans outsourced to third parties.
SB648: Oppose 01:12:26.840 - 11:11:52 AM; Opposes SB 648, arguing age verification laws are ineffective as they redirect users to noncompliant foreign websites with less regulation. Warns that such laws normalize broader internet censorship, mass surveillance, data farming, breaches, and security leaks. Emphasizes protecting children but views the bill as overreaching and counterproductive with implications beyond pornography.
SB648: Oppose 01:14:41.923 - 11:14:07 AM; Reads testimony from Tricia Nualo, a certified sex educator, intimacy coordinator, and adult industry veteran who ran a studio in New Hampshire. Highlights legality of producing adult entertainment per 2008 NH Supreme Court ruling. Argues no hack-proof way to collect IDs, creating false security; minors can bypass via VPNs. Advocates parental controls over state intervention, citing existing website verifications and nonprofits like Electronic Frontier Foundation and Free Speech Coalition for alternatives. Warns of slippery slope to government interference in free speech, art, writing, and employment. Personally notes invasive ID and facial scan requirements on platforms like OnlyFans with no retention limits, viewing it as surveillance. Elaborates on broader implications as 'canaries in the coal mine' for restricting other content and social media verifications leading to data selling.
SB648: Support 01:21:13.267 - 11:20:39 AM; Testifies on behalf of NECTA, representing ISPs like Breeze Line, Comcast, and Charter serving 485,000 customers. Supports bill's intent to protect minors online but seeks clarification that ISPs transmitting content are not targeted. Notes sponsor's amendment for clarifying language and offers to work with committee.
SB482: Support 03:21:43.355 - 1:21:09 PM; Sponsors SB 482 to protect vulnerable citizens, especially seniors, from scams via crypto/Bitcoin ATMs sending money offshore. Bill, passed unanimously by Senate as amended, mandates identity verification, transaction holds with cooling-off refunds, daily limits, fee transparency, and suspicious activity reporting. Balances industry needs with safeguards; discusses Vermont's $1,000 limit causing industry exit. Suggests debating limits (e.g., $2,000 compromise) and cooling periods (10-90 days). Emphasizes preventing pressure scams, supporting investigators, and avoiding counterproductive policies. Notes retailer benefits and scam videos; urges against interim study to prevent status quo of scamming. Responds to questions affirming legitimacy of business, avoiding bans or monopoly, and $2,000 as Senate compromise after Vermont's failure.
SB482: Oppose 03:32:29.923 - 1:31:55 PM; Representative Bullion, who previously owned and operated a Bitcoin ATM business in New Hampshire, testified that while SB 482 has good intentions to combat fraud, its execution is flawed and may not reduce scams effectively but instead target an innovative financial tool that New Hampshire has pioneered. He shared experiences from his business where a small number of transactions were fraudulent, including filing suspicious activity reports that received no follow-up from law enforcement. He emphasized that fraud losses have risen 430% nationwide since 2020, with over 3 million reports to the FTC last year, and argued that resources should target scammers directly rather than tools like Bitcoin ATMs, comparing it to not banning matches to stop arson. He noted scammers use various methods beyond ATMs, such as bank wires and mailing cash, and cited examples like an elderly woman in Nebraska scammed into mailing cash. Bullion advocated for better law enforcement resources, fraud task forces, dedicated reporting lines, and innovative measures like bounties for scam baiting. He highlighted the importance of digital asset kiosks for cash-to-cryptocurrency exchanges, especially for unbanked individuals, and suggested adjustments like first-time user limits or self-exclusion lists similar to gambling blacklists, rather than broad restrictions that might not address the root causes.
SB482: Support 03:45:49.290 - 1:45:15 PM; Brandon Garraud, chief of the Consumer Protection and Antitrust Bureau, strongly supported SB 482, stating it would make a significant difference in combating crypto kiosk fraud despite no bill being perfect. He described the hotline receiving frequent calls about scam victims using kiosks and the Elder Abuse and Financial Exploitation Unit seeing substantial losses from elderly victims directed to these machines without warnings or limits. Garraud explained that while pursuing overseas scammers is nearly impossible due to jurisdictional barriers, the bill's provisions—like 14-day refunds upon reporting to law enforcement, transaction limits, and mandatory disclosures—would prevent scams upfront by educating users, limiting losses, and enabling recovery. He shared an anecdote of an AG staffer intervening mid-scam at a Cumberland Farms kiosk, but the victim still lost money despite warnings, underscoring the need for built-in protections. Garraud noted the AG's office is directly involved and views this as a no-brainer, emphasizing education and prevention as key defenses against scams, particularly for vulnerable elderly populations. He clarified that the bill focuses on state-based kiosk regulations, not overseas enforcement, and affirmed the office has resources to implement it.
SB482: Support 04:08:10.950 - 2:07:36 PM; Lily Wellington testified in support of SB 482, focusing on its impact on older adults who are particularly vulnerable to scams due to social engineering tactics that create panic and hasty decisions. She explained that scammers rely on repeatable methods, but victims often experience shame and embarrassment, leading to underreporting, especially among seniors who fear losing their independence if they disclose being scammed to family or authorities. Wellington highlighted that for older adults, maintaining financial independence is crucial, and unreported fraud exacerbates risks to their autonomy. The Commission on Aging prioritizes policies that protect Granite Staters' long-term independence, urging the committee to support the bill to address this underreported issue and safeguard seniors from financial exploitation.
SB482: Support 04:10:16.957 - 2:09:42 PM; Cheryl Steinberg supported SB 482, emphasizing the growing problem of financial exploitation, particularly scams targeting seniors through crypto ATMs, which make recovery nearly impossible as funds vanish into untraceable cryptocurrency. She noted the Justice in Aging Project assists those 60+ with civil legal issues, focusing on basic needs and financial exploitation, which has worsened exponentially with sophisticated scammers preying on even savvy individuals. Steinberg cited a 2023 Iowa investigation finding 95-98% of transactions at major crypto ATM companies fraudulent, with victims over 60 losing over $20 million, paying 20%+ fees, leading to lawsuits and limits like $1,000 daily caps and 5% max fees. She mentioned at least 17 states, including Maine ($1,000 daily limit) and Vermont (outright ban on new machines), have enacted protections, warning that without action, New Hampshire becomes a target for scammers directing victims across borders. Steinberg argued the high fees suggest limited legitimate use and urged weighing victim harm over business benefits, strongly recommending an ought-to-pass vote.
SB482: Support 04:17:12.253 - 2:16:38 PM; Ray Lamby, with 16 years in law enforcement and prior banking experience, supported a statewide ban on crypto ATMs but endorsed SB 482 as amended if banning is not feasible, advocating further restrictions like surrounding states. He countered arguments of unfair targeting by noting other money transmitters self-regulate effectively, while crypto ATMs enable anonymous overseas transfers. Lamby reported 24 states plus D.C. regulate them, with Indiana banning and New England neighbors imposing limits (e.g., $1,000 daily, 3% fees, refunds), nearly eliminating fraud there, making New Hampshire a target. In Manchester, with 22 deposit-only machines, he handled 70 cases over four years totaling $1.2 million loss, average victim age 73, versus $1 million recovered in non-crypto fraud. Vendors were unresponsive to law enforcement inquiries, and blockchain tracing showed funds quickly moved offshore. Lamby recommended $1,000 daily limits and 90-day refunds, noting seniors' trust in authority figures makes them prime targets for lengthy scam processes impersonating officials. Store owners reported rare use, mostly seniors feeding cash, questioning legitimate utility.
SB482: Support 04:24:16.727 - 2:23:42 PM; Judith Jones testified in support of SB 482, emphasizing the vulnerability of older adults to fraud, citing FTC statistics showing $65 million in losses over six months in 2024, with those over 60 three times more likely to be victimized. She highlighted the economic impact on New Hampshire if life savings are lost, affecting community living. She applauded the bill's daily and 14-day transaction limits, dedicated law enforcement line, but suggested considering a longer hold period beyond 48 hours and a transaction fee up to 25% to promote better business practices and reduce windfall profits.
SB482: Support 04:26:54.043 - 2:26:20 PM; Mike Padmore expressed strong support for SB 482 as amended by the Senate, noting AARP's focus on combating fraud. He referenced a prior bill on unfair service agreements and highlighted the skyrocketing fraud associated with crypto ATMs in the last five years. He mentioned that 24 states, including all New England neighbors (Maine, Vermont, Rhode Island, Connecticut), have enacted protections, making New Hampshire a target. He deferred to colleagues for further perspectives.
SB482: Support 04:28:11.850 - 2:27:37 PM; Pat McDermott, representing AARP with 200,000 members and 160 volunteers (12 present), testified in support of SB 482, focusing on the caregiver perspective. As a caregiver for his mother, he explained how caregivers monitor bank statements but delays in access can hinder timely intervention. He shared how his mother's non-driving status acted as a safeguard against scams. He stressed the importance of the $2,000 daily limit to prevent total loss of savings and the refund window for reaction time. He noted many elderly lack caregivers and urged protections to avoid New Hampshire becoming a fraud target, as surrounding states have acted.
SB482: Support 04:30:49.116 - 2:30:15 PM; Ken Heideman shared a personal scam experience in fall 2022, where a fake website led him to call scammers posing as Microsoft and bank support, resulting in withdrawing large cash amounts deposited into two crypto ATMs. He explained how scams exploit fear, urgency, and speed, with crypto ATMs lacking oversight and limits. He supported SB 482's limits to disincentivize criminals, making fraud harder and less profitable, thus protecting communities. He noted attempted refunds were denied after 15 minutes. While acknowledging elderly vulnerability, he emphasized scams affect all ages, citing a 40-year-old cousin's experience, and called for broad education efforts. He became more aware of scam information only after victimization.
SB482: Support 04:36:40.947 - 2:36:06 PM; Mary Robers, an AARP volunteer and fraud fighter from Manchester, reiterated support for SB 482's $2,000 daily limit and refund period, applicable across all ages. She noted under-reporting due to victims' fear of judgment, especially seniors fearing perceptions of incapacity. She compared scams to wallet theft as crimes, explaining victims act under heightened emotional states from urgent calls about family emergencies or arrest warrants. Scammers are intelligent, targeting vulnerabilities, placing victims 'under the ether,' making self-protection difficult.
SB482: Support 04:39:14.867 - 2:38:40 PM; Kristen Evans, Director of Policy for ABLE New Hampshire, a disability justice organization, testified in support of Senate Bill 482. She highlighted that digital asset kiosks are increasingly used to facilitate scams targeting older adults and people with disabilities, who are disproportionately vulnerable due to communication barriers, isolation, and reliance on others. The amended bill provides practical consumer protections without banning access, creating guardrails to prevent harm by placing responsibility on systems rather than assuming individuals should be more careful. This approach balances access with safety, responds to documented risks, and centers on real impacts for vulnerable populations.
SB482: Support 04:41:35.987 - 2:41:01 PM; Eric Baker, representing the nonprofit Satoshi Action Fund, which advances digital asset policy, supported SB 482 for addressing kiosk fraud that harms consumers, especially older adults. He praised New Hampshire's leadership in digital assets via HB 302 and offered friendly amendments: a $3,000 daily transaction limit for new customers in the first seven days to trigger suspicious activity reporting; extending the 48-hour hold to 72 hours for first transactions to allow cancellation; barring local ordinances stricter than state law to prevent shifting problems; adding board-approved anti-fraud blockchain analytics to reduce the 1.2% fraudulent transactions; and enhanced due diligence for customers over 60. He emphasized legitimate uses for unbanked individuals and urged advancing the bill to protect consumers while preserving access to digital assets. During Q&A, Baker addressed discrepancies in fraud statistics between Iowa (95% fraudulent) and Kansas/TRM Labs (98.8% legitimate), noting lack of methodology for Iowa's figure and sharing the TRM study. He clarified that after seven days, no limit for demonstrated responsible users, analogous to learner's permits, and highlighted use cases for unbanked and cash-based investments in crypto as a strong-performing asset.
SB482: Information Only 04:51:21.036 - 2:50:47 PM; Mike Geiselhart, with background in Homeland Security focusing on cybersecurity and crypto crimes, represented Bitcoin Depot and offered to serve as a resource on machine usage, current protections, and the threat landscape. He described their process: account creation with ID verification, guidance to third-party non-custodial wallets, repeated ID scans, multiple fraud warnings (e.g., government agencies never ask for money via kiosks, prohibiting sends to non-owned wallets), text alerts, and physical signs, creating friction to deter scams. Transactions take 15 minutes post-verification. He outlined user groups: crypto-curious individuals preferring brick-and-mortar over centralized exchanges for privacy; cash-heavy operators needing cash-to-crypto conversion; self-custody believers avoiding centralized risks like FTX collapse; and remitters sending money overseas safely without high fees. In Q&A, he explained ID verification ties wallets to users, stopping transactions if not self-owned, and creates friction against coached scams. He advocated broader scam mitigation like curbing caller ID spoofing by telecoms and data sales fueling AI voice scams, noting industry best practices reduced FBI-reported scams in late last year. He differentiated centralized exchanges (like Robinhood, funds held by platform) from self-custody apps (like banking app, user controls funds). Defended against Iowa's 95% fraud claim as unverified, citing TRM Labs' 98% legitimate figure and ongoing litigation.
SB482: Oppose 05:02:49.897 - 3:02:15 PM; Steve Zemanek, with degrees in computer science and IT security, opposes SB 482, arguing it won't stop scams despite his experience with security incidents and as a cryptocurrency enthusiast. He shares a personal story of being debanked due to past NH legislation affecting Poloniex, highlighting regulatory overreach. He criticizes the bill for lacking data privacy safeguards, potential issues with 48-hour holds on transactions amid price volatility, inaccurate operator counts (only 5 national operators, none local), high compliance costs driving up fees, and ineffective blockchain analytics for scam prevention. He notes problems with two-way ATMs and flagged transactions, emphasizing that the bill penalizes legitimate users without addressing root causes like debanking from Operation Chokepoint.
SB482: Oppose 05:14:52.124 - 3:14:18 PM; Riley Blake, who is blind and has used a Bitcoin ATM, opposes SB 482. He acknowledges scam concerns for elderly and disabled people but argues for education over burdensome regulations that hinder Bitcoin ATM operations and entry for new operators.
SB482: Oppose 05:16:01.356 - 3:15:27 PM; Christopher Wade, a business owner with a computer science and forensics background, opposes SB 482, advocating education as the key solution rather than targeting kiosks. He proposes bank-level interventions like alerts for unusual withdrawals from vulnerable accounts, noting existing NH law allowing tellers to halt suspicious transactions. He argues kiosks can't prevent scams due to lack of customer history, compares to other irreversible methods like wire transfers and mailing cash, and warns the bill creates new scams via forced refunds exploiting price fluctuations. He cites low scam rates (less than 1%) and states the bill would make operations unviable, benefiting international business more than local protections.
SB482: Information Only 05:24:41.130 - 3:24:07 PM; Larry Lipka provides information on CoinFlip's operations, explaining unhosted vs. hosted wallets and why kiosks can't verify wallet ownership due to blockchain anonymity. He describes protective measures like wallet pinning, fraud checks, scam warnings, and customer service interventions that educate and block suspicious transactions. He refutes high scam statistics from the Iowa AG, citing CoinFlip's 1% refund rate in refund-friendly states like Minnesota and voluntary fee refunds. He supports regulation but criticizes SB 482's strict liability provisions, such as paper receipt requirements leading to consumer fraud claims, and calls for collaborative changes like cure periods.
SB496: Support 05:31:56.363 - 3:31:22 PM; Senator Tim McGuigan introduces SB 496, explaining how the COVID pandemic shifted work to remote and hybrid models. He notes FINRA's adoption of a residential supervisory location rule, embraced by 46 states but not NH, allowing financial firms to designate private residences for supervisory functions without branch registration. This supports a major employer in his district and aligns NH with national standards for business-friendly updates.
SB496: Support 05:35:38.492 - 3:35:04 PM; Jesse Stanessa and Ron Morales from Fidelity Investments support SB 496 to align NH securities law with FINRA Rule 3110.19 on residential supervisory locations (RSLs). Fidelity employs over 7,400 in NH, with 400 supervisors benefiting from hybrid work for retention, hiring, and resiliency. RSLs enable secure remote supervision like approving digital trade logs without branch registration, maintaining compliance via risk assessments, inspections, and no in-person customer interactions or fund handling. They've collaborated with the Bureau of Securities Regulation.
SB496: Support 05:41:29.800 - 3:40:55 PM; Nate Graves from the Business Industry Association supports SB 496, which allows companies like Fidelity to let supervisors work from home without registering residences as branches, preventing unexpected customer visits and aligning with 40+ other states.
SB496: Support 05:41:57.880 - 3:41:23 PM; Katie Taylor, staff attorney with the New Hampshire Bureau of Securities Regulation, accompanied by Brian Linares, senior staff attorney and head of licensing and registration, testified in support of Senate Bill 496. They explained that the bill creates a necessary change to the definition of branch office in RSA 421B, the New Hampshire Securities Act, to promote regulatory consistency across states and for those registered with the office. During Q&A, they addressed concerns about potential downsides, emphasizing that heightened supervisory provisions in FINRA Rule 3110.19 for residential supervisory locations ensure safety and custody of documents. They clarified that the private residence must be where the supervisor resides for the majority of time and cannot be taken on vacation. Enforcement would involve adapted examination procedures, relying on no customer trades occurring there and heightened internal inspections by firms like Fidelity to catch issues. They noted the current law treats these as full branch offices, allowing examiners to visit residences, which is archaic, and most other states have modernized to align with the RSL rule.
SB256: Support 05:48:52.101 - 3:48:18 PM; As the prime sponsor, Senator Tim McHugh introduced Senate Bill 256, which addresses white bagging and brown bagging of clinician-administered drugs, defined as outpatient prescription drugs other than vaccines that cannot be self-administered and are typically given in licensed healthcare facilities. He noted the bill passed the Senate unanimously after being refined from prior versions, with safeguards including patient and provider consent, prohibition on directing patients to specific distant pharmacies, and careful language on chain of custody, transportation, and liability. McHugh argued it protects patients, especially in rural areas like the North Country, from travel burdens during treatments like chemotherapy, without creating an outright ban but ensuring transparency and choice. He contended that bagging practices save costs at the expense of patient outcomes and access, citing risks like drugs spoiling during delivery or dosing issues due to real-time lab results. During Q&A, he discussed lack of specific cost data but emphasized net savings when factoring delays and waste, clarified differences in rural vs. hospital-based settings, and affirmed the practice occurs despite contracts, benefiting patients by allowing provider input.
SB256: Support 05:59:37.167 - 3:59:03 PM; Kathy Pizarro-Thunberg represented the New Hampshire Hospital Association, supporting all 26 acute care and specialty hospitals. She provided history, noting the bill was retained in Senate HHS last year due to concerns, leading to amendments passed unanimously. The bill addresses white bagging (insurer sends drug from own pharmacy to provider) and brown bagging (drug sent to patient's home for transport to provider), practices created by carriers for cost savings via specialty pharmacies. NHHA supports the amended bill for prohibiting bagging when dosage depends on current labs or clinical presentation, requiring mutual agreement on quality and safety, and limiting brown bagging to necessary cases with patient-provider consent. She highlighted provider costs beyond drug price (e.g., storage, handling), patient risks like delivery delays, and attached patient stories showing care impacts. Even with contracts, carriers can change policies mid-term to impose bagging. Citing Insurance Department data, she showed bagging can cost more, e.g., $11 million extra for Stelara claims if not hospital-purchased, due to vertical integration. The bill ensures agreements for responsibilities in white bagging and patient consent for brown bagging without outright bans. During Q&A, she clarified agreements allow bagging only when in patient's best interest, providing guardrails for collaboration among provider, patient, and payer.
SB256: Information Only 06:07:54.500 - 4:07:20 PM; Jason Aziz from the New Hampshire Insurance Department provided neutral information, noting no official position but referencing their report on bagging practices (white, brown, clear collectively). He defined bagging and noted non-trivial claims volume in New Hampshire, praising the bill's aim to edit managed care law for balancing patient safety, care, accessibility, and cost containment. Analysis showed aggregate savings for the healthcare system via bagging across drugs, though not monotonic—some drugs cheaper via buy-and-bill, others via bagging, with market dynamics influencing. He emphasized viewing costs population-wide, not individually, and that current choices enable savings. Passing the bill might inhibit carrier cost containment, potentially reducing net savings by limiting options. During Q&A, he clarified savings occur under current law due to delivery choices, and individual stories don't capture aggregate impacts; bagging isn't always cheaper but overall beneficial systemically.
SB256: Support 06:13:32.452 - 4:12:58 PM; Matthew Borden, Pharmacy Director at Thayer Hospital Medical Center in Keene, supported SB 256, highlighting issues with bagging in hospital settings for supply chain management, safety, and efficacy. The hospital maintains over 60 monitored fridges, DSCSA compliance, and trained staff for receiving, especially hazardous medications, ensuring integrity and staff safety. Bagging introduces risks: medications unavailable when needed, unprepared handling, patients forgetting home meds (e.g., left in hot cars, causing denaturation in biologics), or delays from non-loading dock deliveries like FedEx, leading to wasted time slots and treatment delays. Time-sensitive schedules affect multiple patients. Poor counseling can lead to self-administration hazards like reactions. As a pharmacist, he cannot stand behind street-sourced meds, akin to restaurants not cooking brought-in food, prioritizing patient safety and efficacy.
SB256: Oppose 06:17:31.499 - 4:16:57 PM; Sabrina Dunlap from Anthem opposed SB 256, noting specialty drugs are 2% of volume but 50% of costs nationally. Carriers use specialty networks for lower-cost delivery of the same medications to hospitals (white bagging). Anthem does not use white bagging in NH, having negotiated reasonable buy-and-bill pricing with all 26 hospitals, crediting them for negotiating but noting the alternative of specialty networks prompted it. The bill effectively bans white bagging, removing negotiation leverage, leading to higher hospital prices as in other states, estimating $30 million annual cost increase. Last year's bill tied coverage to reasonable pricing, but that language was removed without carrier input. Without controls, it drives up specialty drug costs, the biggest driver. Anthem requests inexpedient to legislate. During Q&A, she suggested adding back language requiring coverage under buy-and-bill consistent with network terms and benefits. On safety/storage concerns from supporters, she noted no widespread evidence beyond anecdotes; drugs enter hospitals via chain of custody either way, and in other states using specialty pharmacies, no major issues seen.
SB256: Support 06:24:44.549 - 4:24:10 PM; Ben Bradley from the New Hampshire Hospital Association responded briefly to prior testimony. He noted the Insurance Department's analysis on bagging, providing a response for committee inboxes, arguing bagging isn't universally cost-containing; e.g., claims data for Stelara shows $11 million savings via hospital buy-and-bill. Even with contracts like Anthem's (unverified), carriers can change policies mid-term to impose bagging, limiting protections—hence the bill's guardrails requiring provider-carrier agreements and patient consent for brown bagging. On aggregate savings, he explained the Department's median price comparison overlooks claim volumes; drugs cheaper via buy-and-bill have high volumes, yielding millions in savings. Some drugs are less expensive hospital-sourced. The bill doesn't eliminate negotiation; hospital-carrier contracts cover more than drugs, and agreements allow bagging when needed (e.g., unavailable inventory) with safety plans. On claims that banning white bagging ends negotiation incentives, he disagreed, as broader contract dynamics persist. Regarding cost increases, he countered the $30 million estimate with evidence questioning bagging savings.
SB256: Oppose 06:32:43.971 - 4:32:09 PM; Paula Rogers testified on behalf of America's Health Insurance Plans, recalling the original form of SB 256 and the initial amendment discussed in the Senate, which she viewed as a reasonable compromise. She expressed discomfort with the current amended version passed by the Senate, noting a lack of collaboration in its development. She highlighted the competitive market, high drug costs, and studies showing cost savings from white bagging compared to hospital pharmacies. Rogers argued that prohibiting white bagging would limit tools to address drug costs and emphasized the need to maintain competitiveness. She acknowledged patient safety concerns but suggested they should be addressed separately without undermining cost-saving measures like white bagging.
SB256: Support 06:37:34.147 - 4:37:00 PM; Dustin Butler, Director of Pharmacy at Huggins Hospital in Wolfboro, supported the bill as amended. He described real-world issues with white and brown bagging affecting elderly and behavioral health patients who struggle to manage sensitive drugs delivered to them, posing safety risks. He noted compromises in the bill allowing continuation for capable patients. Butler discussed delays from overnight shipping during storms, leading to discarded meds and rescheduled appointments, transportation issues, tampered packages, incorrect doses, and recalls. He emphasized hospital safeguards like 24-7 monitoring and chain of custody under federal regulations, arguing the bill prioritizes patient safety while accommodating needs.
SB256: Oppose 06:40:51.027 - 4:40:17 PM; Sam Hollemeyer from the Pharmaceutical Care Management Association (PCMA), representing pharmacy benefit managers serving employers and governments, opposed the bill. He clarified that PCMA was not involved in amendment discussions and viewed the bill as a de facto ban on white bagging. Referencing a Department of Insurance report, he highlighted specialty drugs as major cost drivers. He cited studies showing hospital markups of 200-400% under buy-and-bill systems and how white bagging reduces spending without clinical changes. Hollemeyer noted Vermont's repeal of a similar ban due to cost increases and argued SB 256 only affects fully insured commercial plans (less than 30% of residents), raising premiums while benefiting hospitals.
SB256: Oppose 06:42:11.329 - 4:41:37 PM; Curtis Barry, also from PCMA, supported Hollemeyer's points and provided additional details from their packet, including references to the original SB 256 language and a prior House Bill 513 that was not recommended. He emphasized the cost focus absent from the bill and reiterated opposition based on premium payer impacts and lack of data supporting hospital claims on safety and smaller practices.
SB256: Support 06:47:35.187 - 4:47:01 PM; Carrie Federico, Director of Pharmacy at Speer Memorial Hospital and former patient safety officer, supported the bill to refocus on patient-centered care and shared decision-making. She clarified that 'errors' refer to delays in care rather than mixing or administration issues, emphasizing timely high-quality care. Federico highlighted waste from dose changes in white-bagged meds, citing a $4,000 drug in her fridge facing disposal. She noted issues with late ordering restrictions for white bagging, causing shipment delays that harm patients and strain the healthcare system.
SB256: Oppose 06:50:11.698 - 4:49:37 PM; John Reynolds, State Director for the National Federation of Independent Business (NFIB) representing 1,700 small businesses, opposed the bill due to its impact on healthcare costs, the second biggest issue after taxes for members. He noted recent premium hikes and 98% concern over affordability. Reynolds argued for lowest acquisition costs for expensive drugs driving premiums, citing Vermont's experience where similar restrictions led to 50% small group and 71% individual market premium increases, prompting a markup cap that caused access issues. He supported an earlier bill version addressing waste and access while limiting premium impacts and urged returning to it.