Written by Andrew Horn of Amherst, NH
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Executive Summary
SB 119-FN – Notable for requiring pharmacists to dispense brand-name drugs under Medicaid when preferred, potentially expanding medication access for beneficiaries while raising questions about higher costs.
SB 127-FN-A – Notable for increasing public guardianship funding and slots, addressing a critical need for adults lacking sufficient support but also raising concerns about government spending.
SB 255-FN – Notable for creating a dedicated fund and advisory commission for the 988 behavioral health crisis line, promising expanded crisis services but funded by new surcharges and fees.
SB 53-FN – (Cancelled) Notable for introducing a “natural organic reduction” (NOR) option for human remains, offering an environmentally friendly alternative that would require new licensing and regulatory frameworks.
SB 145-FN – (Cancelled) Notable for piloting a mobile evidence collection program to expedite the handling of sexual assault evidence, particularly aiding rural areas but posing potential budget questions.
View the Senate Calendar
Note: The Senate Judiciary Committee meeting is cancelled.
Quick Summary - All Bills
Senate Health And Human Services
SB 119-FN (1 sponsor, Republican)
Requires pharmacists to dispense brand-name drugs to Medicaid beneficiaries if those drugs appear on the preferred list, and instructs the department to establish standing orders for certain over-the-counter items.SB 127-FN-A (1 sponsor, Republican)
Expands and funds public guardianship services by adding a rate-setting methodology, mandating a needs assessment every five years, and appropriating money for new contract guardian slots.SB 135-FN (1 sponsor, Republican)
Establishes annual rate parity for Medicaid state plan case management services by directing the Department of Health and Human Services to set equitable reimbursement rates.SB 126-FN (1 sponsor, Republican)
Requires a 60-day notice to healthcare providers for significant contract changes and mandates a good faith estimate of any large financial impacts.SB 255-FN (4 sponsors, Republican)
Establishes a trust fund, advisory commission, and new funding mechanisms (including a telecommunications surcharge and special license plates) to support 988 behavioral health crisis services statewide.
Senate Judiciary (Cancelled)
SB 146-FN (7 sponsors, Lean Democratic)
Streamlines medical certification of death by removing certain body-viewing requirements for medical examiners, aiming to reduce costs and administrative burdens.SB 53-FN (2 sponsors, Bipartisan)
Authorizes “natural organic reduction” (NOR) of human remains, sets licensing guidelines for NOR facilities, and clarifies permit procedures for this environmentally friendly alternative to burial or cremation.SB 140-FN (1 sponsor, Republican)
Creates a domestic violence fatality review committee within the Department of Justice to examine deaths related to domestic violence and recommend systemic improvements.SB 145-FN (1 sponsor, Democratic)
Allocates funding for a mobile evidence collection pilot program to expedite the transport of sexual assault evidence, particularly benefiting rural communities.
In-Depth Analysis - All Bills
Senate Health And Human Services
SB 119-FN
AN ACT relative to Medicaid pharmaceutical services.
1 sponsor, Republican
Sponsor(s): (Prime) Sen. James Gray (R)
Selected quote(s) from the bill:
2 Department of Health and Human Services; General Provisions. Amend RSA 126-A:3, V to read as follows:
V. Pharmacists shall substitute generically equivalent drug products for all legend and non-legend prescriptions paid for by the department of health and human services, [including the Medicaid program,] unless the prescribing practitioner specifies that the brand name drug product is medically necessary. Such notification shall be in the practitioner's own handwriting or as otherwise authorized by law or regulation and shall be retained [in the pharmacist's file] by the pharmacy. Pertaining to Medicaid, pharmacists shall dispense brand name drug products to Medicaid beneficiaries when the brand name drug product is listed on the department’s Medicaid preferred drug list, and not substitute generically equivalent drugs. … For Medicaid fee for service [clients] beneficiaries, no prior authorization [for generically equivalent drugs shall be required] shall be required for generic drug products unless the drug class is recommended by the drug utilization review board for clinical appropriateness and safety utilization review.
3 New Paragraph; Department of Health and Human Services; General Provisions. Amend RSA 126-A:3 by inserting after paragraph V the following new paragraph:
V-a.(a) When deemed medically necessary and cost effective by the department of health and human services’ chief medical officer, a standing order may be issued by the chief medical officer for certain Medicaid covered over-the-counter (non-legend) medications, medical supplies, and laboratory tests. Such standing order shall be reviewed annually by the chief medical officer for continuation or discontinuation of the standing order.
(b) No health care professional, acting in good faith and with reasonable care, who issues a standing order, or who dispenses, or distributes over-the-counter (non-legend) medications, medical supplies, or laboratory tests by standing order shall be subject to any criminal or civil liability, or any professional disciplinary action, for any action authorized by this paragraph or any outcome resulting from an action authorized by this paragraph.
Summary:
This bill mandates that pharmacists dispense brand-name drugs to Medicaid beneficiaries when those drugs are on the Department of Health and Human Services' preferred drug list and directs the department to create standing orders for specific over-the-counter medications, medical supplies, and lab tests deemed medically necessary and cost-effective.
Potential Argument For:
This bill improves access to necessary medications for Medicaid beneficiaries by prioritizing brand-name drugs on the preferred drug list and establishing standing orders for certain over-the-counter items.
Potential Argument Against:
This bill could increase Medicaid costs by requiring brand-name drugs and potentially expanding access to over-the-counter items, potentially straining the program's budget.
Hearing: Thursday, Feb 06 at 10:00 a.m. in Room 101 in the Legislative Office Building and streaming on YouTube.
SB 127-FN-A
AN ACT relative to the office of the public guardian and making appropriations to the department of health and human services.
1 sponsor, Republican
Sponsor(s): (Prime) Sen. Kevin Avard (R)
Selected quote(s) from the bill:
2 Protective Services to Adults; Guardianship. Amend RSA 161-F:52 to read as follows:
161-F:52 Guardianship. If all other remedies are exhausted, the commissioner or his authorized representative may seek to have a guardian or conservator appointed by the probate court, pursuant to RSA 464-A, for any adult who is in need of protective services including adults in a post-acute hospital stay, clinically ready for discharge, who require the service of a guardian to assist with discharge planning and to ensure proper care and placement of the adult.
3 Public Guardianship and Protection Program; Contract for Program Services. Amend RSA 547-B:6 to read as follows:
547-B:6 Contract for Program Services.
I. … The contract shall fix the cost per guardianship based on a ratesetting methodology that ensures reimbursement covers contractors’ costs and ensures timely access to services and shall permit the contracting organization to subcontract for such consulting services as may be necessary to carry out the program's guardianship responsibilities. The compensation for operation of the public guardianship and protection program shall be such sums as may be fixed by the contract, and shall ensure access for those in need of the service, subject to the appropriations made therefor.
…
III. The department shall assess the need for professional public guardianship services for indigent individuals at least every 5 years and ensure that sufficient capacity exists to meet the needs of individuals in need of said services.
4 Appropriations; Department of Health and Human Services.
I. The sum of $252,200 for the fiscal year ending June 30, 2026 is hereby appropriated to the New Hampshire department of health and human services. Said appropriation shall be used by the department to create 50 new contract guardian slots to meet the obligations created in RSA 161-F:52. The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated.
II. The sum of $1,647,800 for the fiscal year ending June 30, 2026 is hereby appropriated to the New Hampshire department of health and human services. Said appropriation shall be used by the department to create 100 new contract guardian slots for individuals served under RSA 171-A and RSA 135-C. The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated
Summary:
This bill amends the obligations of the department of health and human services regarding public guardianship contracts, adds a rate-setting methodology to ensure cost coverage and timely service access, mandates a quinquennial needs assessment for public guardianship services, and appropriates funds for 150 new contract guardian slots.
Potential Argument For:
This bill addresses the unmet need for public guardianship services by increasing funding and implementing a rate-setting methodology to ensure adequate compensation for providers and timely access to services.
Potential Argument Against:
This bill may lead to increased government spending without sufficient evidence that the additional funding will effectively solve the problem of unmet needs for public guardianship services.
Hearing: Thursday, Feb 06 at 10:15 a.m. in Room 101 in the Legislative Office Building and streaming on YouTube.
SB 135-FN
AN ACT relative to rate setting parity for Medicaid state plan case management services.
1 sponsor, Republican
Sponsor(s): (Prime) Sen. Kevin Avard (R)
Selected quote(s) from the bill:
1 New Section; Rate Setting Parity for Medicaid State Plan Case Management Services. Amend RSA 126-A by inserting after section 18-b the following new section:??
126-A:18-c Rate Setting Parity for Medicaid State Plan Case Management Services.
I. Annually, on or before October 1, the department of health and human services shall establish unit rates for all case management services paid under the state Medicaid plan which better reflect the average cost to deliver services.
II. The department shall consider the factors of economy, efficiency, quality of care, and access to care, in accordance with guidelines in federal regulations.
III. The department shall ensure equitable rate parity by giving comprehensive consideration to factors which cause disparity, including but not limited to administrative payments of overhead costs made to certain providers, in the calculations to achieve parity.
Summary:
This bill mandates the Department of Health and Human Services to annually set Medicaid state plan case management service rates to achieve rate parity.
Potential Argument For:
This bill ensures equitable access to vital Medicaid case management services by establishing fair and consistent reimbursement rates.
Potential Argument Against:
This bill may increase Medicaid expenditures without a clear demonstration of improved service quality or patient outcomes.
Hearing: Thursday, Feb 06 at 10:30 a.m. in Room 101 in the Legislative Office Building and streaming on YouTube.
SB 126-FN
AN ACT relative to notice of changes to provider contracts.
1 sponsor, Republican
Sponsor(s): (Prime) Sen. Kevin Avard (R)
Selected quote(s) from the bill:
1 New Subparagraph; Managed Care Law; Provider Contract Standards. Amend RSA 420-J:8, VIII by inserting after subparagraph (f) the following new subparagraph:
(g)(1) A health carrier shall provide a participating provider or facility with 60 days notice of a proposed change to a contract, including any attachment, exhibit, and provider manual, only 4 times per calendar year effective on January 1, April 1, July 1, and October 1, except that at any time:
(A) The carrier and the participating provider or facility may mutually agree to waive the 60 day notice requirement;
(B) A carrier may file a notice of a proposed change in response to a requirement of the state or federal government; or
(C) A carrier may file a notice of a proposed change due to a change in current procedural terminology codes used by the American Medical Association.
(2) As part of the notice requirement under this subparagraph, a health carrier shall provide to the participating provider or facility, printed or electronically, a copy of the contract, including any attachment, exhibit, and provider manual, without the changes and a copy of the revised contract, attachment, exhibit, and/or provider manual with changes indicated by underlining and bolding added language and by visually striking through deleted language.
(3) If the change to a contract, attachment, exhibit, or provider manual results in an aggregate change in provider reimbursement of more than $500,000 per calendar year across all participating providers or facilities in the state with whom the carrier has a provider contract, the carrier shall submit to each participating provider or facility a good faith estimate of the total annual aggregate financial impact of the changes to their contract. The estimate and an explanation for all financial impacts as a result of the change under this subparagraph shall be submitted annually to the commissioner of insurance to be published annually on the insurance department's official website or be made publicly available upon request of the department.
Summary:
This bill amends RSA 420-J:8, VIII by adding a new subparagraph (g) that requires health carriers to provide participating providers with 60 days' notice of proposed contract changes, including a copy of the revised contract with changes highlighted, and a good faith estimate of the total annual aggregate financial impact if the changes exceed $500,000.
Potential Argument For:
This bill protects healthcare providers by ensuring they receive adequate notice and understanding of contract changes from health carriers, promoting fairness and transparency in their business relationships.
Potential Argument Against:
This bill could place an undue administrative burden on health carriers, potentially leading to increased costs and delays in implementing necessary contract changes.
Hearing: Thursday, Feb 06 at 10:45 a.m. in Room 101 in the Legislative Office Building and streaming on YouTube.
SB 255-FN
AN ACT establishing and developing crisis stabilization services.
4 sponsors, Republican
Sponsor(s): (Prime) Sen. Kevin Avard (R), Rep. Mark Pearson (R), Rep. Jodi Nelson (R), Rep. David Nagel (R)
Selected quote(s) from the bill:
1 New Subparagraph; State Treasurer and State Accounts; Application of Receipts. Amend RSA 6:12, I(b) by inserting after subparagraph (399) the following new subparagraph:
(400) Moneys deposited in the 988 trust fund as established in RSA 135-C:70.
…
4 New Sections; Public Health; New Hampshire Mental Health Services System. Amend RSA 135-C by inserting after section 69 the following new sections:
135-C:70 988 Trust Fund; Fund Established.
I. There is hereby established in the state treasury the 988 trust fund that shall be kept distinct and separate from all other funds. The 988 trust fund consists of:
(a) Revenues from the 988 coordinated crisis services telecommunications surcharge established under RSA 135-C:74;
(b) Revenues from the 988 number plates;
(c) Appropriations made by the general court;
(d) Federal funds allocated to the state to implement the 988 suicide prevention and behavioral health crisis system;
(e) Gifts, grants, and donations to the fund from public and private sources; and
(f) Moneys deposited into the fund from other sources.
…
135-C:72 Behavioral Health Crisis Services Advisory Commission Established.
I. There is hereby established a behavioral health crisis services advisory commission.
…
135-C:73 Behavioral Health Crisis Services Advisory Commission; Duties. The behavioral health crisis services advisory commission established in RSA 135-C:72 shall be responsible for:
I. Consulting with and advising the commissioner of the department of health and human services on the administration and management of the 988 trust fund under RSA 135-C:70, and advise and make recommendations on expenditures from that fund under RSA 135-C:71.
II. Advising and making recommendations to the governor, general court, department of health and human services, and other necessary stakeholders on strategies to support and fund the behavioral health crisis system.
III. Overseeing and making recommendations about the provision of 988 and behavioral health crisis services throughout the state.
135-C:74 988 Coordinated Crisis Services Telecommunications Surcharge Established.
I. In compliance with the National Suicide Hotline Designation Act, and by recommendation of the commission on behavioral health crisis services, the 988 centers, and the services furnished by such, shall be funded through a surcharge to be levied upon each residence and business telephone exchange line, including private branch exchange (PBX) trunks and Centrex lines, each individual commercial mobile radio service number and each voice over internet protocol (VoIP) service number with a place of primary use within New Hampshire, and each semi-public and public coin and public access line.
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5 New Section; Certificates of Title Registration of Motor Vehicles; 988 Number Plates. Amend RSA 261 by inserting after section 91-a the following new section:
261:91-b 988 Number Plates.
I. The director of the division of motor vehicles of the department of safety is hereby authorized to issue special 988 number plates, in lieu of other number plates. The design of these special plates shall be determined by the department of health and human services and the department of safety. The plates shall retain the "live free or die" logo. Such plates shall be issued only upon application and upon payment of a $30 fee that shall be in addition to the regular motor vehicle registration fee and any other number plate fees otherwise required.
Summary:
This bill creates a trust fund to support the 988 behavioral health crisis service system, establishes a telecommunications surcharge and special license plates to fund it, and creates an advisory commission to oversee the fund.
Potential Argument For:
This bill will improve access to vital behavioral health crisis services by creating a dedicated funding source and enhancing the 988 system.
Potential Argument Against:
This bill may impose an undue financial burden on taxpayers through a new telecommunications surcharge and license plate fee, without guaranteeing improved service outcomes.
Hearing: Thursday, Feb 06 at 11:00 a.m. in Room 101 in the Legislative Office Building and streaming on YouTube.
Senate Judiciary (Cancelled)
SB 146-FN
AN ACT relative to medical examiner's certificates and medical certification of the death record.
7 sponsors, Lean Democratic
Sponsor(s): (Prime) Sen. Suzanne Prentiss (D), Sen. David Watters (D), Sen. Regina Birdsell (R), Sen. Cindy Rosenwald (D), Sen. Rebecca Perkins Kwoka (D), Sen. Donovan Fenton (D), Sen. Pat Long (D)
Selected quote(s) from the bill:
1 Cremation of Human Remains; Medical Examiner's Certificate. Amend RSA 325-A:18, I to read as follows:
I. The body of a deceased person shall not be cremated within 48 hours after his or her decease unless he or she died of a contagious or infectious disease. If the death occurred within the state, the body shall not be cremated by the crematory authority until the crematory authority has received the certificate of burial permit required by law before burial, and a certificate from a medical examiner that he or she has [viewed the body and] made personal inquiry into the cause and manner of death, and is of the opinion that no further examination or judicial inquiry concerning the same is necessary. If the death occurred within the state but the body is being transferred out of state for cremation, the transfer shall not occur until the medical examiner has conducted such [a view and] an inquiry and has issued a certificate. …
2 Death Registration Forms and Procedures; Cremation. Amend RSA 5-C:71, I to read as follows:
I. When the body of a deceased person is to be disposed of by cremation, the crematory operator, the funeral director, next of kin, or designated agent in charge of the final disposition arrangements shall present a copy of the death certificate and the burial permit or emergency burial permit [with the body] to a medical examiner in order to obtain the medical examiner's certificate.
3 Death Registration Forms and Procedures; Medical Certification of the Death Record. Amend RSA 5-C:64, VI to read as follows:
VI. … [The person determining the cause of death shall have viewed the deceased within 24 hours after death.]
Summary:
This bill amends requirements for viewing a deceased body regarding medical examiner certificates and medical certification of death records, removing the requirement for viewing the body and reducing related travel costs.
Potential Argument For:
This bill improves efficiency in death certification and cremation processes by eliminating unnecessary body viewings, saving taxpayer money and reducing burdens on medical examiners.
Potential Argument Against:
This bill could potentially compromise thorough death investigations by removing the requirement for a mandatory body viewing in certain circumstances.
Hearing: Thursday, Feb 06 at 1:00 p.m. in Room 100 in the State House and streaming on YouTube. (Cancelled)
SB 53-FN
AN ACT relative to natural organic reduction of human remains.
2 sponsors, Bipartisan
Sponsor(s): (Prime) Sen. Daniel Innis (R), Sen. David Watters (D)
Selected quote(s) from the bill:
1 Short Title. This act may be known as and cited to as the "Live Free and Die Free Act."
2 New Chapter; Natural Organic Reduction of Human Remains. Amend RSA by inserting after chapter 325-A the following new chapter:
CHAPTER 325-B
NATURAL ORGANIC REDUCTION OF HUMAN REMAINS
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325-B:2 ?Natural Organic Reduction Facility; License Required. ? A NOR facility shall not be established, operated, or maintained in this state except by a natural organic reduction authority licensed by the board under RSA 325. ? The board shall issue a license to a NOR authority that satisfies the requirements for licensure under the chapter. ?Human remains shall not be naturally organically reduced in this state except at a NOR facility operated by a NOR authority licensed under this chapter.
325-B:3 ? Building and Location Requirements.
I. ? A NOR facility shall conform to all building codes and environmental regulations.
II. ?A NOR facility may be constructed at any location, including within a funeral home or a crematorium, consistent with applicable zoning and environmental regulations.
…
3 Vital Records Administration; Burial Permit Procedures. Amend RSA 5-C:68 to read as follows:
5-C:68 Burial Permit Procedures. … When the body is to be disposed by natural organic reduction (NOR), at least 48 hours shall elapse before NOR can take place in accordance with RSA 325-B and a separate certificate shall be obtained from the medical examiner and submitted to the NOR facility with the burial permit pursuant to RSA 325-B.
Summary:
This bill establishes a licensing and regulatory framework for natural organic reduction (NOR) of human remains in New Hampshire, outlining facility requirements, licensing procedures, and associated fees.
Potential Argument For:
This bill provides a new, environmentally friendly option for the disposition of human remains, offering families a more sustainable alternative to traditional burial or cremation.
Potential Argument Against:
This bill may impose new costs on the state and families, while the actual fiscal impact remains uncertain.
Hearing: Thursday, Feb 06 at 1:15 p.m. in Room 100 in the State House and streaming on YouTube. (Cancelled)
SB 140-FN
AN ACT establishing a domestic violence fatality review committee.
1 sponsor, Republican
Sponsor(s): (Prime) Sen. Regina Birdsell (R)
Selected quote(s) from the bill:
1 New Section; The Department of Justice; Domestic Violence Fatality Review Committee. Amend RSA 21-M by inserting after section 16 the following new section:
21:16-a Domestic Violence Fatality Review Committee.
I. There is hereby established the domestic violence fatality review committee within the department of justice to conduct comprehensive, multidisciplinary reviews of deaths related to domestic violence for the purpose of preventing domestic violence related fatalities through the identification of barriers to victim safety, the evaluation of the response by law enforcement and other government and non-government agencies and service delivery systems, and the creation of recommendations to improve the systemic and community response to domestic violence.
II. For the purpose of this section, a "domestic violence fatality" means a death which arises as a result of domestic violence as defined in RSA 173-B, RSA 631:2-b, or a fatality that, in the sole discretion of the domestic violence fatality review committee, was either directly or indirectly related to domestic violence.
Summary:
This bill establishes a domestic violence fatality review committee within the Department of Justice to review domestic violence-related deaths and prevent future fatalities, and it creates a criminal penalty for intentionally disclosing information from committee proceedings.
Potential Argument For:
This bill will improve the state's response to domestic violence by identifying systemic issues and improving community responses to prevent future deaths.
Potential Argument Against:
This bill may create unnecessary bureaucracy and confidentiality concerns, potentially hindering investigations and prosecutions of domestic violence cases.
Hearing: Thursday, Feb 06 at 1:30 p.m. in Room 100 in the State House and streaming on YouTube. (Cancelled)
SB 145-FN
AN ACT establishing a mobile evidence collection unit pilot program and providing an appropriation therefor.
1 sponsor, Democratic
Sponsor(s): (Prime) Sen. Debra Altschiller (D)
Selected quote(s) from the bill:
2 New Section; Mobile Evidence Collection Pilot Program. Amend RSA 21-M by inserting after section 19 the following new section:
21-M:20 Mobile Evidence Collection Pilot Program.
I. The department of safety may develop a mobile evidence collection pilot program to alleviate long waiting periods for evidence to be safely delivered to the state laboratory, where it can be properly stored pending analysis. A special emphasis shall be placed on supporting law enforcement in rural communities where resources are limited.
II. In this program, all evidence collected in a sexual assault case shall be scheduled for pickup from the hospital within 10 days of collection and picked up by the mobile unit no later than 20 days after collection.
III. The department of safety shall adopt rules under to 541-A for the design, administration, and reporting requirements of the program.
3 Appropriation. The sum of $200,000 for the fiscal year ending June 30, 2026, and the sum of $200,000 for the fiscal year ending June 30, 2027, shall be appropriated from the general fund to the department of safety for the purpose of funding the mobile evidence collection pilot program at the state forensic laboratory, with yearly expenditures to include $140,000 for the purpose of transitioning 2 part-time staff positions to 2 full-time staff positions to manage the program and $20,000 for the purpose of purchasing refrigerated lock-boxes and other equipment for existing transport vehicles. The governor is authorized to draw a warrant for any general fund sum out of any money in the treasury not otherwise appropriated.
Summary:
This bill allows the Department of Safety to create a mobile evidence collection pilot program to reduce wait times for sexual assault evidence delivery to the state laboratory, prioritizing rural areas.
Potential Argument For:
This bill improves the timely processing of sexual assault evidence, ensuring victims receive quicker justice and reducing the backlog of unprocessed kits.
Potential Argument Against:
This bill may be an inefficient use of funds, as the cost of the mobile evidence collection pilot program could exceed initial appropriations.
Hearing: Thursday, Feb 06 at 1:45 p.m. in Room 100 in the State House and streaming on YouTube. (Cancelled)