Warning: Bill numbers and names are based on text-to-speech transcript which may have errors due to transcription issues or ad hoc/incomplete language use by committee.
Explains the purpose of the amendment to collect aggregated, anonymous data on animal testing in the state, including from companies, institutions of higher education, and others. The data would be reported annually to the Governor's Commission on Humane Treatment of Animals, with the first report due January 2028. Emphasizes confidentiality, no individual company identification, and no penalties for noncompliance initially to encourage collaboration. Notes the effective date of January 1, 2027.
SB444 1676
Information Only00:22:59.180 - 10:21:20 AM
Confirms the amendment replaces the original bill and focuses solely on data collection and reporting without prohibiting any activities. Discusses including all types of animals used in testing to get comprehensive data.
SB444 1676
Information Only00:26:43.090 - 10:25:04 AM
Inquires about the governor's concerns via Representative Hines, who suggested limiting to cosmetic companies to avoid veto impacting biotech industry. Open to passing as is or amending, believing the aggregated data poses no risk.
SB444 1676
Information Only00:20:36.647 - 10:18:57 AM
Relays secondhand information that the governor would veto the bill as it could deter biotech companies from operating in the state, suggesting a change to limit reporting to cosmetic companies.
SB544
Information Only00:32:53.831 - 10:31:14 AM
Discusses amendment for effective date change to July 1, but notes it should be further amended to January 1, 2027, to align with the new plan year for formulary changes mid-year.
SB550
Information Only00:34:00.792 - 10:32:21 AM
Similar to SB544, recommends changing the effective date to January 1, 2027, instead of July 1, to match the start of the new plan.
SB573 1675H
Information Only00:35:45.737 - 10:34:06 AM
Reviews the amendment with no issues raised by the committee. Invites input from comfort dog representatives without requiring a pink slip.
SB573 1675H
Information Only00:36:39.479 - 10:35:00 AM
Confirms no questions or problems with the amendment after review.
SB606 1685H
Information Only00:37:28.774 - 10:35:49 AM
Discusses the amendment as a cleanup but notes ongoing issues and suggests interim study for further work on the bill.
SB606 1685H
Information Only00:38:46.158 - 10:37:07 AM
Testifies on challenges with the bill's language, originally requested by Alzheimer's Association and others to expand access to biomarker tests. Appreciates department efforts but unable to agree on language. Requests interim study to work over summer and fall on effective language. Concerns focus on Medicaid determining covered tests, which codifies current practice without expanding access. Advocates for coverage of all biomarker tests within original bill's parameters like scientific evidence and FDA approval, without separate Medicaid determination. Clarifies not seeking to stop current coverage but to expand it. Notes good intentions all around and need for appropriate care language.
SB606 1685H
Oppose00:40:55.224 - 10:39:16 AM
Expresses concern that interim study might stop current practices while waiting for more information. Believes Medicaid knows what they're doing and high-quality people are involved. Misunderstands testimony as wanting to stop biomarker use but is corrected that it's about expanding access, not stopping. Agrees current situation unchanged by interim study.
SB665
Support00:43:03.850 - 10:41:24 AM
Notes amendment changes effective date to July 1st and asks if any questions, indicating approval.
SB665 1687H
Support00:43:03.850 - 10:41:24 AM
Provides background on bill drafted with Senator Rochefort to combine PBM regulation concepts. Explains amendment incorporates 90% of previous concerns, achieving consensus. Walks through sections: removes subsidiary PBM exception for licensure; updates penalties to $5,000 per violation; requires written agreements between PBM and health carrier similar to TPA statutes, without fiduciary duty; enhances reporting for transparency on drug costs, rebates, fees; clarifies examination authority; removes duplicative language from SB544; amends managed care law for clarity and due process; adds 15-day notice for retroactive denials; defines and requires disclosure of spread pricing for group plans. Addresses concerns on formularies, generics, exceptions process, appeals, tiering, and data usage for health cost transparency. Notes annual reporting instead of semi-annual, first report in 2028. Explains self-funded plans differences to avoid litigation.
SB665 1687H
Information Only00:44:13.350 - 10:42:34 AM
Asks if Curtis Barry was involved in amendment; confirms yes.
SB665 1687H
Information Only00:47:36.850 - 10:45:57 AM
Recalls concerns on pricing, generics vs. brand names, and exceptions process.
SB665 1687H
Information Only00:49:49.850 - 10:48:10 AM
Asks about reporting requirements on page two, line 17; if new or modified. Seeks understanding of data use by department.
SB665 1687H
Information Only00:52:01.344 - 10:50:22 AM
Asks about data collection issues for exceptions on page three, line 13; notes semi-annual to annual change.
SB665 1687H
Information Only00:59:19.045 - 10:57:40 AM
Explains spread pricing as a compensation model allowing flexibility, especially in ERISA market; suggests data on it might be important but questions if proprietary.
SB665 1687H
Support01:01:41.751 - 11:00:02 AM
Confirms agreement with amendment changes: strikes fiduciary duty, steering provision (section 16), changes reporting to annual. Notes remaining concerns from members. Explains fiduciary not applicable as PBMs follow contracts with carriers/employers, not independent decisions. Addresses vertical integration as opinion/federal matter. Clarifies contracts: PBMs/carriers don't directly contract with pharmacies; any willing provider statute allows network access. Debunks gag clauses; cites statutes 415:26 and 420-J:8 requiring lowest of usual/customary or copay, and prohibiting prohibitions on divulging beneficial info. Notes no position on section 13 (disclosure); pharmacists free to discuss coupons.
SB665 1687H
Oppose01:04:16.503 - 11:02:37 AM
Questions striking fiduciary duty, compares to stockbrokers; concerned about advantage-taking without patient-best interest. Notes most don't choose insurance.
SB665 1687H
Oppose01:06:19.498 - 11:04:40 AM
Appreciates work but concerns on fines: $5,000 per violation ok, but each day as separate violation (lines 23-24, page 1; line 17, page 5) removed from HB1197. Requests per violation only. Also, mandatory semi-annual audits (page 2, lines 11-14) burdensome for integrated entities; suggest 'may' or written agreement controls.
SB665 1687H
Support01:10:48.025 - 11:09:09 AM
Supports original intent for lowest price disclosure to consumers. Shares example saving $60 on Ezetimibe by asking for lower price vs. insurance copay. Notes most unaware; pharmacies bound by contracts won't offer automatically. Bill had bipartisan support initially but watered down to signage/telling if asked. Advocates adding back section 16 on steering for awareness of lower prices via rebates/coupons. Cites US healthcare costs high vs. other countries; disclosure lowers costs.
SB665 1687H
Information Only01:15:54.198 - 11:14:15 AM
Confirms original intent not in current bill; seeks process explanation for lower prices.
Seeks clarification on contracts between PBMs/insurers and pharmacies; notes PSAOs.
SB665 1687H
Oppose01:29:29.295 - 11:27:50 AM
Nonprofit carrier without owned PBM; echoes audit concerns (page 2, lines 11-14). Audits time-intensive; sophisticated entities have contracts, regular reporting, meetings. Suggests 'may' or annual for flexibility; right to audit ok but not mandatory semi-annual.
SB665 1687H
Information Only01:31:31.183 - 11:29:52 AM
Asks if Harvard gets lowest prices on Medicare/Medicaid.
SB665 1687H
Information Only01:32:45.161 - 11:31:06 AM
Notes Medicare can't use coupons; questions lowest prices for government.
SB665 1687H
Oppose01:28:21.352 - 11:26:42 AM
Transparency lacking in PBM models; bill doesn't support patients getting lowest prices or PBM reform.
SB498
Support01:34:16.929 - 11:32:37 AM
President of New Futures, with Emma Savini, Children's Behavioral Health Policy Director. Legislation from 2020-2021 conversations on gap in services; frames issue and position for passage.
SB498
Support01:35:50.566 - 11:34:11 AM
Michelle Merritt continues her testimony on the need for private insurance coverage for the Fast Forward program, a wraparound in-home service that prevents children from requiring higher tiers of care like psychiatric hospitalization. She explains that while Medicaid provides seamless access across all five tiers, private insurance does not cover this Tier 3 service. Ongoing conversations with insurers have stalled, and the state has been funding privately insured children with a $2 million general fund appropriation. She advocates for shifting the cost to carriers through assessment or coverage rather than taxpayers, noting recent Senate-originated efforts that were pulled due to House rules. Despite recent progress discussed with the department, she believes the bill should move forward, possibly with amendments for exemptions to encourage voluntary coverage.
SB498
Information Only01:37:51.806 - 11:36:12 AM
The chair thanks Merritt for the explanation and suggests hearing from the Insurance Department about recent discussions, referencing a message from the commissioner indicating progress. Merritt confirms awareness of the dialogue but insists on amending the bill for a runway rather than interim study, emphasizing that private insurers should cover these services instead of the state.
SB498
Information Only01:40:04.258 - 11:38:25 AM
Jennifer Smith, Legislative Director for the NH Insurance Department, joined by Deputy Commissioner Marissa Hentz of DHHS, updates on post-hearing stakeholder meetings involving the department, DHHS, CMEs, and Anthem to explore non-legislative solutions like getting CMEs into networks or single case agreements without assessments. Discussions since fall have identified roadblocks, such as transparency with families, and recent meetings were productive, with ongoing talks on billing codes. The commissioner issued a bulletin listing mental health billing codes and is committed to close monitoring if interim study is pursued, including weekly reports and biweekly meetings to ensure progress toward agreements and network inclusion.
SB498
Support01:45:36.071 - 11:43:57 AM
Marissa Hentz affirms DHHS's support alongside the Insurance Department for progress on this issue, remaining agnostic on payment mechanisms but emphasizing the program's role in preventing costly inpatient or residential treatment for families with intense needs. She highlights evidence-based outcomes and cost savings of the Fast Forward program. Hentz urges accountability in any interim study to avoid repeated studies without results, recalling prior legislative reports since 2020-2021 that yielded little progress, and stresses the need for guarantees to benefit families and taxpayers.
SB498
Information Only01:50:51.679 - 11:49:12 AM
Representative Purpitt seeks clarification on the tiers of care, emphasizing fiscal responsibility in New Hampshire. He expresses concern about financial goals and costs, noting the need to address the 'money wall' at higher tiers to ensure value for taxpayers.
SB498
Information Only01:50:51.679 - 11:49:12 AM
The representative elaborates on the continuum of children's mental health services, focusing on Tier 3 (Fast Forward) as essential for acute cases to prevent escalation to expensive higher tiers like Hampstead Hospital ($1,500/day) or residential treatment (up to $1M/year). The fiscal note estimates $2.5M in state general funds for commercially insured children, with actual program costs higher, aiming to shift burden from taxpayers to insurers via evidence-based practices endorsed by CMS.
SB498
Information Only01:54:51.339 - 11:53:12 AM
Smith adds that pursuing single case agreements will reveal true costs immediately, informing future network contracts. The commissioner will push all carriers, not just Anthem, toward agreements to determine costs and integrate services.
SB498
Support01:55:45.419 - 11:54:06 AM
A committee member questions if the commissioner will be as assertive as in the ambulance billing case, which resolved quickly. Smith affirms his commitment to prevent backsliding, with biweekly meetings to drive progress.
SB498
Support01:56:47.173 - 11:55:08 AM
Representative Sullivan notes differences between insurance and Medicaid operations, stressing the importance of adapting the program for commercial coverage while maintaining its integrity.
SB498
Support01:57:50.125 - 11:56:11 AM
The speaker highlights challenges in architecting single case agreements (one patient, one carrier) and advocates maintaining momentum with amendments for a runway to contracts, ensuring progress without full assessment.
SB498
Support01:57:50.125 - 11:56:11 AM
Merritt expresses concern over unbundling services into fee-for-service, which could undermine the program's holistic effectiveness. She advocates for mechanisms like capitated payments or assessments to preserve the full bundle of care.
SB498
Support02:00:04.090 - 11:58:25 AM
The representative references a chart showing 30% commercial market coverage gap, insisting insurers should pay rather than the state. They push for swift resolution via mandates or amendments with carve-outs, setting deadlines to avoid interim study pitfalls lacking incentives.
SB498
Information Only02:02:09.970 - 12:00:30 PM
Hentz confirms Fast Forward as best practice per CMS bulletins, widely delivered but with varying commercial coverage. New Jersey retrospectively charges insurers, but no clear prospective billing model exists; NH could pioneer one.
SB498
Information Only02:04:29.110 - 12:02:50 PM
The chair, upon returning, references the commissioner's email and bulletin providing codes, believing the issue can be resolved non-legislatively, recommending interim study with a September threat of forced action if needed. He criticizes the assessment mechanism as inappropriate for this, preferring negotiation.
SB498
Information Only02:05:22.218 - 12:03:43 PM
Various members debate amendments with carve-outs for compliant insurers versus interim study, citing past delays and need for incentives/accountability. Concerns include legal issues with assessments, unknown child numbers, and fulfilling executive council expectations for billing private insurance. The chair insists on negotiation commitment from all parties, recessing discussion until afternoon.
SB524 2024-1579h
Vote02:17:52.372 - 12:16:13 PM
The committee discusses and votes on amendment 2024-1579h to SB524, with no new issues raised. Representative Patusek moves ought to pass as amended, seconded by Representative Burroughs. The subcommittee votes 7-0 in favor.
SB444
Information Only02:25:25.488 - 12:23:46 PM
The committee reviews SB444, amended for reporting on animal testing alternatives, with no bans, focusing on confidential data collection. The governor's office indicates a veto threat due to anti-business concerns for biotech, suggesting amendment to cosmetics only. Members debate passing as is versus amending to avoid veto, noting it's purely disclosure and aggregated anonymously.
SB444
Information Only02:30:06.922 - 12:28:27 PM
David Kazi expressed opposition to Representative Sullivan's amendment as currently written. He suggested that if the bill were limited strictly to cosmetics and included specific changes, New Hampshire Life Sciences would be neutral. He recommended aligning the definition of 'animal' with the Federal Animal Welfare Act, which excludes rats and mice, and providing a definition for 'cosmetics' and 'cosmetic testing facility.' He offered to supply suggested language for these definitions and noted that universities might not be impacted by the bill even with these adjustments.
Unclear 1703
Vote02:37:16.715 - 12:35:37 PM
The committee discussed an amendment to change the effective date to January 1. Representative Speer moved to pass with amendment 1703, seconded by the chair. There was a question about the bill's intent regarding mid-year formulary changes, noting the amendment allows 60 days notice instead of 45 but still permits mid-year changes. The amendment passed 5-1 (Berselli, Hunt, Thaxton, Herbert, Speer in favor). The motion to ought to pass with amendment also passed 5-1.
HB550 1702
Oppose02:41:21.747 - 12:39:42 PM
A representative spoke briefly against the bill, arguing that naturopathic providers are not doctors as they have not attended medical school. They highlighted concerns about it being an insurance mandate.
Unclear
Vote02:43:14.869 - 12:41:35 PM
Representative Speer moved for interim study on the bill. The motion was seconded and passed unanimously with seven votes in favor.
HB614
Vote02:44:12.228 - 12:42:33 PM
Representative Miles moved ought to pass on HB614 with no amendment. The motion was seconded and implied to pass, noting an effective date of July 1.
HB1626
Vote02:45:08.709 - 12:43:29 PM
Representative Miles, seconded by Representative Hunt, moved ought to pass as amended on HB1626. The amendment passed unanimously, followed by the main motion passing 7-0.
HB573 1675
Vote02:46:11.348 - 12:44:32 PM
Moved amendment 1675, described as a cleanup of a previous amendment. Reference to a call from Justin praising the bill. Representative Patusek seconded. The amendment passed 7-0, followed by ought to pass as amended, passing 7-0.
SB665
Vote02:47:18.474 - 12:45:39 PM
Discussion on SB665 noted it was not ready for prime time, language does not meet intent, and fails to improve transparency. Representative Miles, seconded by Representative Burroughs, moved inexpedient to legislate. The motion passed 7-0.
SB665
Information Only02:47:18.474 - 12:45:39 PM
Provided background that the bill was previously considered for interim study but moved to ITL due to inadequacies, including testimony from a gentleman from Nashua.
HB498
Vote02:50:48.123 - 12:49:09 PM
Representative Purcelli, seconded by Representative Speer, moved interim study on HB498. Discussion noted the need for more time to do it right rather than rushing an amendment. The motion passed 7-0.
HB498
Information Only02:48:51.279 - 12:47:12 PM
Mentioned preparing an amendment, but the committee opted for interim study instead.
HB498
Information Only02:48:51.279 - 12:47:12 PM
Discussion about taking a lunch break and returning at 2 o'clock, with only one bill left. Noted that some members wanted to go home and that rushing would not be appropriate.