I. Health carriers shall credential qualified entities administering community mental health programs as defined under N.H. Rev. Stat. § 135-C:7, entities administering community substance use disorder treatment programs as defined under N.H. Rev. Stat. § 172:2-c, and community health centers as facilities when paneling and enrolling participating providers, consistent with health carriers’ facility credentialing standards and practices, unless the entity requests professional level credentialing. Health carriers shall not be required to credential entities who do not meet the health carriers’ facility credentialing eligibility standards. If an entity disagrees with the outcome of a health carrier’s application of its facility credentialing standards and practices, the entity may request a formal hearing and review of the carrier’s decision by the New Hampshire insurance department pursuant to N.H. Rev. Stat. § 400-A:17 and/or file a complaint with the New Hampshire insurance department’s health care provider complaint process.
II. Nothing in this section shall be construed to require a health carrier to select or enroll a specific facility as a participating provider.

Terms Used In New Hampshire Revised Statutes 420-J:4-a

  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.