N.H. Insurance Dept. Issues Bulletin Regarding Printed and Electronic Provider Directory Obligations

CONCORD, New Hampshire, Nov. 20 -- The New Hampshire Department of Insurance issued the following news release:

New Hampshire Insurance Department (NHID) Commissioner Christopher Nicolopoulos issued a bulletin reminding insurers of their statutory obligations respecting provider directories, including detailing recent legislative changes that will be effective January 1, 2022.

All insurers offering or issuing policies of health and dental insurance in New Hampshire that include a provider network are required to maintain for each plan a current and accurate electronic provider directory that is publicly accessible. The electronic directory must include, in plain language, a description of criteria used by the insurer to build the network for each plan.

The provider directory must be open and searchable, and include specific professional information for health care professionals, hospitals and other medical facilities. The bulletin outlines specific requirements for detailing information regarding tiered plans and select innetwork services. Additionally, provider directories must also include (1) a customer service email and telephone number or (2) an electronic link that can be used to notify the insurer of inaccurate information on the provider directory.

"Insurers are required to update their provider directories at least monthly and must periodically audit their directories for accuracy," said Tyler Brannen, NHID's Director of Life and Health. "Documentation of such audits must be retained and provided to the Department upon request."

"Transparency in healthcare coverage is important to ensuring a robust insurance marketplace in the Granite State," said NHID Commissioner Christopher Nicolopoulos. "In the event that the NHID becomes aware of a pattern of inaccuracy, the Department has the enforcement authority to bring carriers into compliance, including the creation and implementation of action plans to research the extent of, and ultimately resolve, any deficiencies in reporting."

"The importance of accurate directories cannot be overstated," said Keith Nyhan, NHID's Director of Consumer Services. "Consumers who unknowingly receive services from out of network providers too frequently must pay higher than expected out of pocket costs." The complete bulletin, Docket Number INS 21-102-AB, is located at https://www.nh.gov/insurance/media/bulletins/2021/documents/ins-21-102-ab.pdf.