NH| Bulletin #INS 25-001-AB from the New Hampshire Insurance Department announces changes to prior authorization requirements for health care services. The bulletin outlines new provisions resulting from the adoption of SB 561, which took effect on January 1, 2025. These changes include shortened time frames for health carriers to make prior authorization decisions, the introduction of peer-to-peer review options for healthcare providers, and new data reporting requirements for health carriers.
Key points:
- Health carriers must now make prior authorization decisions within shorter timeframes, ranging from 72 hours for urgent requests to 14 calendar days for non-urgent, non-electronic submissions.
- Healthcare providers can request peer-to-peer reviews before initial determinations are made on prior authorization requests.
- Health carriers are required to collect and submit prior authorization data annually, with the first submission due by April 1, 2026, for the 2025 calendar year.