State Law

New Hampshire Statutes-Title XXXVII-Chapter 420-J: Managed Care Law

08/15/2023 New Hampshire Section 420-J:8-e

Reasonable Value of Health Care Services

OON-Payment Issues

In the event of a dispute between a health care provider and an insurance carrier relative to the reasonable value of a service under RSA 329:31-b, the commissioner shall have exclusive jurisdiction to determine if the fee is commercially reasonable. Either the provider or the insurance carrier may petition for a hearing under RSA 400-A:17. The petition shall include the appealing party’s evidence and methodology for asserting that the fee is reasonable, and shall detail the efforts made by the parties to resolve the dispute prior to petitioning the commissioner for review. The department may require the parties to engage in mediation prior to rendering a decision.