New Hampshire HB 648: relative to insurance coverage for glucose monitoring.

Bill Text

HB 648-FN - AS INTRODUCED

2025 SESSION

 25-0120

 05/11

HOUSE BILL 648-FN

AN ACT relative to insurance coverage for glucose monitoring.

SPONSORS: Rep. Damon, Sull. 8; Rep. Balboni, Rock. 38; Rep. Beauchemin, Hills. 3; Rep. Newell, Ches. 4; Rep. Selig, Straf. 10; Rep. Spier, Hills. 6; Rep. Mandelbaum, Rock. 21; Rep. Nagel, Belk. 6; Rep. Rollins, Sull. 3; Sen. Gannon, Dist 23; Sen. Prentiss, Dist 5; Sen. Ward, Dist 8; Sen. Rochefort, Dist 1

COMMITTEE: Commerce and Consumer Affairs

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ANALYSIS

 This bill requires health insurance providers to cover glucose monitoring devices and supplies for individuals with diabetes.

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 Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

 25-0120

 05/11

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Twenty Five

AN ACT relative to insurance coverage for glucose monitoring.

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

 1 Accident and Health Insurance; Individual; Coverage for Diabetes Services and Supplies; Glucose Monitoring Devices. Amend RSA 415:6-e to read as follows: 

 415:6-e Coverage for Diabetes Services and Supplies. 

 I. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for medically appropriate and necessary outpatient self-management training and educational services, pursuant to a written order of a primary care physician or practitioner, including, but not limited to medical nutrition therapy for the treatment of diabetes, provided by a certified, registered, or licensed health care professional with expertise in diabetes, subject to the terms and conditions of the policy. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses which provides a prescription rider shall cover medically appropriate or necessary insulin, oral agents, and equipment used to treat diabetes subject to the terms and conditions of the policy and this section. 

 II. Each insurer that provides coverage for prescription insulin drugs shall cap the total amount that a covered person is required to pay for each covered insulin drug prescription at an amount not to exceed $30 for each 30-day supply of each insulin prescription. The maximum $30 copayment for each 30-day supply of each covered insulin drug prescription shall apply when an original prescription is dispensed as well as when refills of the prescription are dispensed, including early refills. Coverage for prescription insulin drugs shall not be subject to any deductible. 

 III. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses which provides [for] pharmacy or durable medical equipment coverage shall provide coverage for medically appropriate or necessary equipment used to treat diabetes subject to the terms and conditions of the policy and this paragraph. Equipment shall include traditional blood glucose monitors and continuous glucose monitoring systems (CGMS) and the necessary supplies for any person with a diagnosis of Type 2 diabetes or gestational diabetes. In this paragraph, a “continuous glucose monitoring system” means an instrument or device designed for the purpose of measuring glucose levels continuously through an in-dwelling sensor and the necessary supplies. "Supplies" shall include, but are not limited to, sensors, transmitters, receivers, lancets, and test strips.

 (a) Coverage under this paragraph shall be provided without regard to the form of treatment. Insulin utilization, frequency of administration of insulin, or frequency of blood glucose testing shall not be a requirement for coverage of blood glucose monitoring or CGMS. Preferred providers or formularies shall include at least 2 of each kind of device. An endocrinology referral or prescription shall not be required. Prior authorization shall not be required. 

 (b) To qualify for continued coverage under this paragraph, the recipient must participate in follow-up care with their treating licensed health care practitioner, in person or through telehealth, at least once every 6 months during the first 18 months of the glucose monitoring, to assess the efficacy of using the monitor for treatment of his or her diabetes. After the first 18 months, such follow-up care must occur a