New Hampshire Statutes

Insurance companies in New Hampshire can no longer require their members to get prior authorization before getting coverage for emergency mental health or substance use care when it is provided by a mobile crisis team, outside a licensed hospital.

This act amends RSA 330-A by adding a new section to establish a commission on the business environment for mental health providers in the state. The act specifies who must be on such committee and the focus of such committee, including examining billing practices and regulations, access to affordable education, insurance rates and mental health parity, and methods to strengthen the network of providers within the state.

Enacted through SB 115

This act amends RSA 417-E:1, II to authorize the Insurance Commissioner to enforce the Federal Parity Law and its implementing regulations. The commissioner must periodically examine and evaluate insurers, health service corporations, and health maintenance organizations for compliance and the results of such examinations and evaluations must be made available to the public.

Enacted through  SB 272

Created by NH SB 534.

This is a comprehensive bill that addresses many areas related to substance use disorders, focusing on opioids. Among many things, the bill requires that when substance use disorder services are a covered benefit, no prior authorization should be required for the first 2 routine visits of an episode of care or the first 72 hours of inpatient treatment for emergency services.

This bill requires all policies issued or renewed after December 31, 2016 to provide either coverage for medically necessary substance use disorder treatment without prior authorization or a 24-hour hotline capable of offering a drug treatment assessment. If treatment is found to be necessary via the hotline, prior authorization must occur within 12 hours of the initial call.
The bill requires that insurers use American Society for Addiction Medicine (ASAM) criteria when making medical necessity determination. On January 1 of each year, insurers must file an annual attestation with the commissioner of insurance showing that they are using the most current ASAM criteria.

 This is a comprehensive bill that addresses many areas related to substance use disorders, focusing on opioids. Among many things, the bill requires that when substance use disorder services are a covered benefit within a health plan, no prior authorization should be required for the first 2 routine outpatient visits of substance use disorder treatment. The bill also requires insurers use the American Society for Addiction Medicine criteria when making medical necessity determinations.

Created by NH SB 84.

This bill requires the commissioner of the Department of Health and Human Services to submit a state plan amendment to the Center for Medicare and Medicaid Services to provide substance use disorder services to beneficiaries. The benefits must be consistent with the Substance Abuse and Mental Health Service Administration (SAMHSA) treatment guidelines. The commissioner must also detail the process and timeline for implementing the services.

This bill created a committee in the General Court to study parity for the purposes of potentially changing the sections of the state insurance law about parity. The committee was to specifically look into the following:

• Other state parity laws throughout the country
• Costs and benefits associated with expanding behavioral health coverage
• Whether any addition to the law should require plans to cover treatment of all conditions in the DSM
• Whether the law can/should apply to self-insured plans
• Whether any addition to the law should require mandatory coverage
• Whether any addition to the law should apply to small employer fully-insured plans with more than 25 employees
• Whether deductibles and copayments should be capped at a certain percentage

The statute requires that benefits for mental or nervous conditions shall conform to RSA 415:18-a or the basic health services requirements for HMOs. The statute also requires coverage for the treatment of chemical dependency, including alcoholism, up to a specified limit and allows the Commissioner to adopt, as necessary, rules to effectuate any provisions of the Mental Health Parity Act of 2008 that relate to the business of insurance.

Amended by NH HB 330.