New Hampshire Insurance Department Issues New Reporting Guidance for Pharmaceutical Rebates

CONCORD, NH (November 4, 2024) – The New Hampshire Insurance Department (NHID) has announced updated reporting requirements for insurers and Pharmacy Benefit Managers (PBMs) concerning pharmaceutical rebates, ensuring enhanced transparency and accountability within the prescription drug benefits sector. This guidance aligns with recent amendments to state law, which mandate detailed disclosures from PBMs and insurers about rebates received from pharmaceutical manufacturers.

Effective March 1, 2025, and annually thereafter, insurers must submit reports to the NHID demonstrating compliance with these requirements. The NHID will also require PBMs to file annual or quarterly reports, capturing data on rebates collected based on patient utilization in New Hampshire for the prior year. This reporting, mandatory for all applicable health benefit plans, will enable the NHID to track the rebates applied to reduce costs for policyholders and improve public insights into pharmaceutical cost management.

“These new requirements mark a significant step in providing transparency around pharmaceutical rebates in New Hampshire,” said Insurance Commissioner DJ Bettencourt. “By shedding light on how these rebates are utilized, we can ensure that savings from drug manufacturers are passed on to Granite State consumers, supporting fair pricing and increased access to essential medications.”

The bulletin outlines specific guidelines for the submission of these reports. Pharmacy Benefit Managers (PBMs) must submit a summary of rebates received and passed on, including the value applied to reduce out-of-pocket costs for insured individuals. These reports must be filed using the NHID PBM Annual Rebate Summary template no later than March 15, 2025. Insurers are required to submit attested reports detailing rebate distribution and the methodology used to estimate future rebate amounts for plan design. These filings, due by March 1, 2025, must use the NHID’s designated Insurer Rx Rebate Attestation template.

 “The NHID will carefully review each submission, offering feedback to ensure clarity and compliance,” said Deputy Insurance Commissioner Keith Nyhan. “This collaborative approach is vital in helping insurers and PBMs transition to these standards seamlessly.”

For further information or questions, stakeholders are encouraged to contact NHID at healthcareanalytics@ins.nh.gov. The bulletin, Docket #INS 24-067-AB, may be found on the NHID website at https://mm.nh.gov/files/uploads/nhid/documents/20241024-bulletin-ins-24-067-ab.pdf.

The New Hampshire Insurance Department Can Help

The New Hampshire Insurance Department’s mission is to promote and protect the public good by ensuring the existence of a safe and competitive insurance marketplace through the development and enforcement of the insurance laws of the State of New Hampshire. Contact us with any questions or concerns you may have regarding your insurance coverage at 1‐800‐852‐ 3416 or (603) 271‐2261, or by email at consumerservices@ins.nh.gov. For more information, visit https://insurance.nh.gov/.