Amendment vs bill Amendment: #2025-3029s vs Introduced

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SB 256-FN - AS INTRODUCED SESSION 25-1003 05/11 SENATE BILL 256-FN AN ACT relative to the affordability and safety of clinician administered drugs.
Senate Health and Human Services October 22, 2025 2025-3029s 05/09 Amendment to SB 256-FN Amend the title of the bill by replacing it with the following:
SPONSORS:
3 AN ACT establishing safety and care requirements for clinician-administered drugs.
Sen.
5 Amend the bill by replacing all after the enacting clause with the following:
McGough, Dist 11;
7 1 New Subdivision;
Sen.
Managed Care Law;
Gannon, Dist 23;
Clinician-Administered Drugs.
Sen.
Amend RSA 420-J by inserting after section 26 the following new subdivision:
Rochefort, Dist 1;
Clinician-Administered Drugs 420-J:27 Definition of Clinician-Administered Drug.
Rep.
In this subdivision, "clinician-administered drug" means an outpatient prescription drug, other than a vaccine, that:
Potucek, Rock.
13;
Rep.
Miles, Hills.
12 COMMITTEE:
Health and Human Services ───────────────────────────────────────────────────────────────── ANALYSIS This bill requires a health plan to utilize the lowest cost method of reimbursement for clinician administered drugs and requires a health maintenance organization to cover clinician-administered drugs if the drug cannot reasonably be self-administered and is typically administered by a health care professional.
The bill also prohibits a health maintenance organization from requiring that a pharmacy dispense a medication to a patient with the expectation that the patient will transport it to a health care setting for administration by a health care professional.
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Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.] Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
SB 256-FN - AS INTRODUCED 25-1003 05/11 STATE OF NEW HAMPSHIRE In the Year of Our Lord Two Thousand Twenty Five AN ACT relative to the affordability and safety of clinician administered drugs.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section;
Health Maintenance Organizations;
Dispensing of Clinician-Administered Drugs.
Amend RSA 420-B by inserting after section 26 the following new section:
420-B:27 Dispensing of Clinician-Administered Drugs.
As used in this section, “clinician-administered drug” means an outpatient prescription drug other than a vaccine that:
Cannot reasonably be self-administered by the patient to whom the drug is prescribed or by an individual assisting the enrollee with self-administration;
(a) Cannot reasonably be self-administered by the patient to whom the drug is prescribed or by a non-clinician individual assisting the patient with the self-administration;
and II.
and (b) Is typically administered:
Is typically administered:
(1) By a health care professional authorized under the laws of this state to administer the drug, including when acting under a physician’s delegation and supervision;
(a) By a health care professional authorized under the laws of this state to administer the drug, including when acting under a physician’s delegation and supervision;
and (2) In a physician’s office, hospital outpatient infusion center, or other clinical setting.
and (b) In a physician’s office, hospital outpatient infusion center, or other clinical setting.
420-J:28 Safety, Care, and Choice Requirements for Clinician-Administered Drugs.
I.
No health insurer or pharmacy benefit manager shall mandate that a clinician- administered drug be dispensed by a pharmacy selected by the insurer or PBM and delivered to a provider for administration ("white bagging"), unless:
(a) There is a written agreement between the provider and the dispensing pharmacy outlining responsibilities for each party including, but not limited to, procedures for delivery, handling, storage, and liability;
and (b) The provider has given prior written consent to use that arrangement.
A health maintenance organization or a third party acting on its behalf shall not refuse to authorize, approve, or pay a provider for a covered clinician-administered drug that was dispensed by any in-network hospital or clinic, provided that:
No health insurer or pharmacy benefit manager shall mandate that a pharmacy dispense a clinician-administered drug to a patient for transport to a health care provider for administration ("brown bagging"), unless:
(a) According to medical standards of care for the patient’s condition, the medication must be provided to the patient more expeditiously than the medication could be provided via any other channel covered by the insurer;
(a) There is a written attestation from the patient and provider that transporting the medication will not compromise care.
and (b) The dispensing and any associated authorization, approval, or payment occurs consistent with the terms and conditions of similarly situated network participants and according to the benefit offered by the health maintenance organization.
(b) The patient and provider have given prior written consent to use that arrangement.
III.
Amendment to SB 256-FN - Page 2 - III.
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Unless otherwise requested in writing by the patient or prescriber, a health maintenance organization, pharmacy benefits manager, or other third party acting on behalf of the health maintenance organization, shall not, by contract, written policy, or written procedure, require that a pharmacy dispense a clinician-administered drug directly to a patient with the expectation or intention that the patient will transport the medication to a health care setting for administration by a health care professional.
Pursuant to paragraphs I and II, a health carrier or pharmacy benefit manager shall not:
(a) Interfere with the enrollee's right to choose to obtain a clinician-administered drug from their provider or pharmacy of choice.
(b) Limit or exclude coverage for a clinician-administered drug when not dispensed by a pharmacy selected by the health carrier, if such drug would otherwise be covered.
(c) Require that an enrollee pay an additional fee, higher copay, higher coinsurance, second copay, second coinsurance, or any other form of price increase for clinician-administered drugs when not dispensed by a pharmacy selected by the health carrier or pharmacy benefit manager.
(d) Condition, deny, restrict, refuse to authorize or approve, or reduce payment to a participating health care provider for providing covered clinician-administered drugs and related services to covered persons when all criteria for medical necessity are met, because the participating health care provider obtains clinician-administered drugs from a pharmacy that is not a participating provider in the health carrier’s network or managed or owned by the pharmacy benefit manager.
This act shall take effect January 1, 2026.
This act shall take effect January 1, 2027.
LBA 25-1003 1/21/25 SB 256-FN- FISCAL NOTE AS INTRODUCED AN ACT relative to the affordability and safety of clinician administered drugs.
Amendment to SB 256-FN - Page 3 - 2025-3029s AMENDED ANALYSIS This bill establishes certain safety and procedural requirements for clinician-administered drugs.
FISCAL IMPACT:
This bill does not provide funding, nor does it authorize new positions.
Estimated State Impact FY 2025 FY 2026 FY 2027 FY 2028 Revenue $0 Indeterminable Indeterminable Indeterminable Revenue Fund(s) Insurance premium tax revenue Expenditures* $0 $0 $0 $0 Funding Source(s) None Appropriations* $0 $0 $0 $0 Funding Source(s) None *Expenditure = Cost of bill *Appropriation = Authorized funding to cover cost of bill METHODOLOGY:
This bill adds a new section to RSA 420-B relative to dispensation of clinician-administered drugs.
Among other things, the new section prohibits health maintenance organizations (HMO) from requiring pharmacies to dispense clinician-administered drugs directly to patients for patients to then bring to their health care professional.
The Insurance Department notes that this practice, known as "brown-bagging," is thought to reduce costs to patients and/or insurers.
The Department states that prohibiting brown-bagging may therefore cause insurers to raise premiums to offset these increased costs, resulting in an increase in insurance premium tax revenue collected by the state.
The Department cautions that the extent of any such impact is indeterminable, and that the bill would apply only to HMOs and not to other types of insurers.
AGENCIES CONTACTED:
Insurance Department