This bill mandates that insurance providers cover a variety of pain management therapies as alternatives to opioid treatments, requiring insurers to include non-opioid therapies such as behavioral health interventions, manual treatments, movement therapies, acupuncture, and massage therapy. Each policy must provide a minimum of 12 visits for each category of pain management services and ensure coordination of care among licensed providers. Insurers are also required to submit a comprehensive pain services management plan for approval by the insurance commissioner and to provide educational materials to policyholders and in-network providers regarding pain management options. The bill introduces new sections to RSA 415, specifically sections 415:6-bb and 415:18-hh, which outline these requirements.

Additionally, the bill prohibits insurers from imposing more restrictive utilization controls on non-opioid therapies compared to those applied to opioid medications, aiming to ensure equitable access to pain management services. It amends existing statutes to include provisions related to health service corporations and health maintenance organizations, specifically adding RSA 415:6-bb and RSA 415:18-gg and -hh. The bill also emphasizes the need for an external actuarial review to assess the costs and benefits of the new coverage mandate, which has historically cost the Department between $20,000 and $40,000. The act is set to take effect on July 1, 2025, but it is noted that the rates for the plan year 2025 have already been established, potentially leading to financial challenges for insurance companies due to insufficient premiums to cover the new services.

Statutes affected:
Introduced: 420-A:2, 420-B:20