New Hampshire § 420-J:8-h Coverage and Payment for Services Provided at Participating Facilities by Nonparticipating Providers

New Hampshire Statutes

§ 420-J:8-h — Coverage and Payment for Services Provided at Participating Facilities by Nonparticipating Providers

New Hampshire § 420-J:8-h

Title XXXVIIINSURANCE

Ch. 420-JMANAGED CARE LAW

This text of New Hampshire § 420-J:8-h (Coverage and Payment for Services Provided at Participating Facilities by Nonparticipating Providers) is published on Counsel Stack Legal Research, covering New Hampshire primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

N.H. Rev. Stat. Ann. § 420-J:8-h (2026).

Text

I.Each health carrier that issues or renews any policy of health insurance shall cover services provided by nonparticipating providers at a participating facility in the same manner and without imposing any additional requirements as if the services were provided by a participating provider.

II.The patient's cost-sharing for items or services provided by a nonparticipating provider at a participating facility shall be calculated by the health carrier based on the lesser of the qualified payment amount, the billed amount, or the allowed amount for the item or service.

III.The health carrier shall pay the nonparticipating provider 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 be

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I. Each health carrier that issues or renews any policy of health insurance shall cover services provided by nonparticipating providers at a participating facility in the same manner and without imposing any additional requirements as if the services were provided by a participating provider.
II. The patient's cost-sharing for items or services provided by a nonparticipating provider at a participating facility shall be calculated by the health carrier based on the lesser of the qualified payment amount, the billed amount, or the allowed amount for the item or service.
III. The health carrier shall pay the nonparticipating provider 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 and a health carrier 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.