0145-hb 0533

CHAPTER 145

HB 533 - FINAL VERSION

AN ACT relative to health carrier disclosure for medical child support enforcement.

SPONSORS: Rep. Emerton, Hills 48; Rep. Wallner, Merr 40

This bill requires health carriers to disclose certain policy information to the department of health and human services for medical child support enforcement purposes.

The bill also changes references to the Health Care Financing Administration (HCFA) to the Centers for Medicare and Medicaid services (CMS).

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

AN ACT relative to health carrier disclosure for medical child support enforcement.

Be it Enacted by the Senate and House of Representatives in General Court convened:

145:1 New Paragraph; Alternative Method of Support Enforcement for Dependent Children; Medical Support Enforcement; Disclosure to Health Insurance Carriers. Amend RSA 161-C:3-b by inserting after paragraph V the following new paragraph:

VI. The department may provide certain information to health carriers, as defined in RSA 420-G:2, public agencies or its contracted agents concerning individuals who are subject to an order to provide health insurance coverage for dependents administered by the office of child support enforcement services, and their dependent children covered by such medical support orders, as necessary to cross-match the individuals with policyholder and subscriber information pursuant to RSA 161-C:3-e and rules adopted by the commissioner pursuant to that section, for the purpose of enforcing orders for medical support. The department may identify such individuals by name, the last 4 digits of the individual's social security number or other taxpayer identification number, date of birth, last known address, employer, or any combination thereof.

145:2 New Section; Alternative Method of Support for Dependent Children; Disclosure of Health Carrier Information for Medical Child Support Enforcement. Amend RSA 161-C by inserting after section 3-d the following new section:

161-C:3-e Disclosure of Health Carrier Information for Medical Child Support Enforcement.

I. Each health carrier, as defined in RSA 420-G:2, shall electronically cross-match claims data, policyholder, and subscriber information with the department of health and human services to provide health insurance coverage information, for the purpose of enforcing medical child support orders administered by the office of child support enforcement services under RSA 161-C:3-b, concerning individuals subject to an order to provide health insurance coverage for dependents administered by the office of child support enforcement services, or dependents covered by such medical support orders, in accordance with rules adopted by the commissioner under RSA 161-C:28.

II. Such electronic cross-match shall be made by any health carrier upon certification by the department that all persons identified on the electronic medium are individuals subject to an order to provide health insurance coverage for dependents administered by the office of child support enforcement services, or dependents covered by such medical support orders.

III. All information disclosed by the department for the purpose of the electronic cross-match shall remain property of the state of New Hampshire. Any health carrier, public agency, or contracted agent engaged by the department to perform the electronic cross-match shall purge any information received from the department pursuant to this section concerning individuals or dependents from its records and databases immediately upon the completion of the data match exchange.

IV. In any case where the department administers a medical child support order on behalf of a dependent child who does not receive temporary assistance to needy families or medical assistance, the transaction costs associated with the electronic cross-match shall be paid in advance by the custodial parent or guardian, and the non-custodial parent shall reimburse the custodial parent for such transaction costs.

V. Any health carrier who supplies information in accordance with this section and with rules adopted under RSA 161-C:28 shall have immunity from any civil or criminal liability that might otherwise be imposed or incurred.

145:3 Portability, Availability, and Renewability of Health Coverage; Disclosure; Cross-Match of Information for Medical Child Support Enforcement. Amend RSA 420-G:11, II to read as follows:

II. All health carriers shall electronically provide to the department of health and human services:

(a) Data on claims and subscribers filed in accordance with rules adopted under RSA 126:27[~~; and~~].

(b) Cross-matched claims data on requested policyholders, and subscriber information necessary for third party liability for benefits provided under RSA 167, filed in accordance with rules adopted under RSA 167:3-c.

(c) Cross-matched claims data on requested policyholders, and subscriber information necessary to enforce medical child support orders administered by the office of child support enforcement services under RSA 161-C:3-b and RSA 161-C:3-e.

145:4 Portability, Availability, and Renewability of Health Coverage; Disclosure of Information for Medical Child Support Enforcement; Reference Change. Amend RSA 420-G:11, III to read as follows:

III. All health carriers shall accept electronic claims submitted in [~~health care financing administration (HCFA)~~] Centers for Medicare and Medicaid Services (CMS) format for UB-92 or HCFA-1500 records, or as amended by [~~HCFA~~] CMS.

145:5 Insurance Department; Standardized Claim Forms for Health Insurance; Reference Change. Amend RSA 400-A:15-a to read as follows:

400-A:15-a Standardized Claim Forms for Health Insurance. All health insurers, health maintenance organizations, health service corporations, hospital service corporations, medical service corporations, preferred provider programs and third party administrators shall use "HCFA-1500" and "UB-92" forms for all paper and electronic submissions and shall not routinely require additional forms or information. When [~~HCFA~~] CMS officially replaces the "HCFA-1500" or the "UB-92" form, the replacements shall be considered the official form under this section.

145:6 Health Maintenance Organizations; Medicare Risk Contracts; Reference Change. Amend RSA 420-B:8-l, II to read as follows:

II. In the event of termination of the contract between the [~~Health Care Financing Administration (HCFA)~~] Centers for Medicare and Medicaid Services (CMS) and the contractor, all current enrollees of the contractor who will lose their coverage as a result of this contract termination, shall be given an opportunity to enroll, without evidence of insurability, in any Medicare Supplement policy approved for sale in this state which is then being offered by the contractor.