N.H. Admin. Code § He-C 5010.08

Current through Register No. 49, December 5, 2024

Section He-C 5010.08 - Public Hearing Requirements

In furtherance of He-C 5010.07(c) above, the DUR board shall:

(a) Hold a public hearing, in accordance with RSA 91-A, 2002, 281:9, III, as repealed and reenacted by 2003, 319:176, and 2009, 19:1, to afford opportunity for the public to present its views regarding the components of the prior authorization process and any changes thereto;

(b) Give public notice of the DUR board hearing agenda as it relates to prior authorized medications and any meeting date, time, and location in a public notice advertisement in a publication of daily statewide circulation at least 30 days in advance of the public meeting;

(c) Make available at least 15 days in advance of the public hearing, the specific proposed criteria or proposed changes to the list of medications subject to prior authorization;

(d) Conduct the hearing in accordance with the following:

(1) A record of the public hearing shall be kept by electronic recording or other method that will provide a verbatim record;

(2) The presiding officer at the public hearing shall be the medicaid pharmacy director or the individual designated by the medicaid pharmacy director to preside at the hearing;

(3) The presiding officer shall open the public hearing by describing in general terms the purpose of the hearing and procedures governing its conduct; and

(4) Testimony at the public hearing shall adhere to the following requirements:

a. Anyone wishing to submit written testimony or exhibits at the public hearing shall submit them to the presiding officer, provided such testimony or exhibit is signed and dated by the individual submitting it;

b. Anyone wishing to testify at the public hearing shall submit in writing to the presiding officer the person's name, address, and whom, if anyone, that person represents;

c. The presiding officer shall call each person to present testimony; and

d. The presiding officer shall rule any comments, questions, or discussions that the presiding officer determines not to be relevant to the subject of the public hearing out of order, and proceed to the next speaker; and

(e) Recommend to the commissioner the components of the prior authorization process and any changes thereto after considering the following, to the extent reasonably available:

(1) Review of evidence-based comparative effectiveness reviews addressing medications, to include consideration of diagnosis, disease states, drug interactions, diagnostic testing, complicating medical factors, and potential for abuse or misuse;

(2) Identification of the availability of more cost effective, alternative medications;

(3) Clinical advantages, disadvantages, and medical necessity for medications identified in (2) above;

(4) Identification of drug contraindications that would affect the quality of care provided to recipients;

(5) Efficacy of available pharmaceuticals;

(6) Appropriate clinical use of medications for recipients considering their individual clinical circumstances including but not limited to age, gender, race, comorbidities, and allergies; and

(7) Comments on components of the prior authorization process submitted by the public for consideration.

N.H. Admin. Code § He-C 5010.08

#5529, eff 12-16-92; amd by #5608, eff 4-6-93; ss by #6907, eff 12-9-98; ss by #8743, eff 10-24-06; ss by #9587, eff 11-4-09

Amended by Volume XXXVIII Number 06, Filed February 8, 2018, Proposed by #12460, Effective 1/13/2018, Expires 1/13/2028.