HB 191 - AS INTRODUCED
2021 SESSION
21-0280
10/04
HOUSE BILL 191
AN ACT relative to prior authorizations and patient transfers under managed care group
health insurance policies.
SPONSORS: Rep. Marsh, Carr. 8; Rep. Knirk, Carr. 3; Rep. Woods, Merr. 23; Rep. Weston,
Graf. 8; Rep. Murphy, Graf. 12; Sen. Sherman, Dist 24; Sen. Cavanaugh, Dist 16;
Sen. Kahn, Dist 10
COMMITTEE: Commerce and Consumer Affairs
─────────────────────────────────────────────────────────────────
ANALYSIS
This bill adds requirements for prior authorizations under managed care health benefit plans
and the administration of patient transfers to another health care facility.
---------------------------------------------------------------------------
Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
 HB 191 - AS INTRODUCED
21-0280
10/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty One
AN ACT relative to prior authorizations and patient transfers under managed care group
health insurance policies.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 1 New Sections; Managed Care Law; Prior Authorization; Patient Transfers. Amend RSA 420-J
2 by inserting after section 12 the following new sections:
3 420-J:12-a Exceptions to Prior Authorizations. When prior authorizations are required under a
4 health benefit plan:
5 I. The authorization shall be valid for 6 months from the date the health care provider
6 requests the prior authorization.
7 II. Additional medically necessary services or procedures required during an otherwise
8 authorized service or services shall not be denied or require additional authorization.
9 III All notifications and disclosures of prior authorization requirements and written notices
10 of new or amended requirements shall be provided to all impacted health care providers 60 days
11 prior to the effective date.
12 IV. Nothing in this section shall be construed to require coverage for services that have been
13 prior authorized if the health plan coverage is not effective on the date of service.
14 420-J:12-b Standards for Patient Transfers.
15 I. A health benefit plan shall respond to a request for a patient transfer within one business
16 day.
17 II. When a health benefit plan has determined a lower level of care at a health care facility
18 is clinically appropriate, the health benefit plan shall not require a prior authorization for medically
19 necessary interfacility transport to the receiving health care facility.
20 III. When a health benefit plan has determined a lower level of care at a health care facility
21 is clinically appropriate and does not provide accommodations to ensure the necessary
22 transportation to the receiving facility, the health benefit plan shall reimburse the originating
23 facility not less than the daily contracted reimbursement rate.
24 2 Effective Date. This act shall take effect January 1, 2022.