New HampshireInsurers would offer review talks after care approval denials
If adopted, the measure would let insured people or their providers request a physician review after a prior approval denial, including during an appeal.
What it does
After an insurer denies prior approval for care, an insured person or provider may request a physician review, even if an appeal has begun.
At or before the review conversation begins, insurers must give the provider the reviewer’s name, license type and state, and identification number.
Insurers that fail to follow the review rules would commit an unfair insurance practice and could face administrative penalties.
Argument forPeople whose care is denied could ask to speak with a physician reviewer during an appeal and learn who reviewed the request.
Argument againstMore review calls could add work for insurers, which may affect their costs and could affect premiums paid by people and local governments.
More detail
After an unfavorable prior approval decision, an insured person or provider may request a peer-to-peer review with a physician. The review applies to an adverse prior approval decision under a managed care plan or health carrier. For managed care plans, the reviewer must meet all three listed qualifications: an active license in the same or a similar specialty, active practice in a similar field, and expertise assessing the specific service’s medical need. For health carriers, the printed text joins the three qualifications with “or,” rather than “and.” The insurer must schedule the conversation within 5 business days after the request.
The insurer must give the requesting provider the reviewer’s identifying and license information. This applies to peer-to-peer reviews conducted by an insurer. The insurer must disclose the information whether the provider or insurer starts the call. The disclosure is due at or before the start of the conversation.
An insurer’s failure to follow these review rules would count as an unfair insurance practice and may lead to administrative penalties. This applies to insurers that fail to comply with the peer-to-peer review requirements. The insurance commissioner may impose administrative penalties.
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Where it stands
- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- Aug 5Public Hearing: 02/17/2026 02:15 pm GP 159Latest
- Jun 2Conference Committee Report; Not Signed Off; SJ 14
- May 26Conference Committee Meeting: 05/26/2026 12:00 pm GP 229
- May 20President Appoints: Senators Innis, Murphy, Prentiss; (In Recess 05/14/2026); SJ 13
- May 20Sen. Innis Accedes to House Request for Committee of Conference, MA, VV; (In recess 05/14/2026); SJ 13
- May 14Speaker Appoints: Reps. Hunt, Miles, Herbert, Potucek 05/14/2026 HJ 13
- May 14House Non-Concurs with Senate Amendment 2026-1980s and Requests CofC (Rep. Hunt): MA VV 05/14/2026 HJ 13 P. 148
- May 14Ought to Pass with Amendment # 2026-1980s, MA, VV; OT3rdg; 05/14/2026; SJ 12Passed Senate
- May 14Sen. McGough Floor Amendment # 2026-1980s, AA, VV; 05/14/2026; SJ 12
- May 14Sen. McGough Moved Ought to Pass; 05/14/2026; SJ 12
- May 14Inexpedient to Legislate, MF, VV; 05/14/2026; SJ 12
- May 14Special Order to be the first bill after the lunch break, Without Objection, MA; 05/14/2026; SJ 12
- May 7Committee Report: Inexpedient to Legislate, 05/14/2026, Vote 5-0; SC 18Minor
- May 7Special Order to 05/14/2026, Without Objection, MA; 05/07/2026 SJ 11
- May 7HB 1554 was Removed from the Consent Calendar; 05/07/2026; SJ 11
- Apr 29Committee Report: Inexpedient to Legislate; Vote 5-0; CC; 05/07/2026; SC 17Minor
- Apr 2Hearing: 04/07/2026, Room 100, SH, 10:40 am; SC 13
- Mar 17Introduced 03/12/2026 and Referred to Commerce; SJ 7Minor
- Mar 11Ought to Pass with Amendment 2026-0805h: MA DV 244-92 03/11/2026 HJ 7 P. 69Passed House
- Mar 11Amendment # 2026-0805h: AA DV 192-143 03/11/2026 HJ 7 P. 68
- Mar 4Minority Committee Report: Refer for Interim Study
- Mar 4Majority Committee Report: Ought to Pass with Amendment # 2026-0805h 03/03/2026 (Vote 13-2; RC) HC 10 P. 31Minor
- Feb 25Full Committee Work Session: 03/03/2026 10:00 am GP 229
- Feb 25==CONTINUED== Executive Session: 03/03/2026 01:00 pm GP 229
- Feb 11Full Committee Work Session: 02/18/2026 10:00 am GP 229
- Feb 11==RECESSED== Executive Session: 02/18/2026 01:00 pm GP 229
- 2025
- Dec 10Introduced 01/07/2026 and referred to Commerce and Consumer Affairs HJ 1 P. 25Introduced
Healthcare