1 Coverage for Emergency Services; Prior Authorization. Amend RSA 417-F:3 to read as follows:

417-F:3 Prior Authorization.

A participating provider or other authorized representative of the plan that gives prior authorization shall not rescind or modify the authorization after the health care provider has rendered the authorized emergency services care in good faith and the enrollee's, insured's, or subscriber's coverage was effective on the date of service.

2 Managed Care Law; Access to Enhanced 911 System. Amend RSA 420-J:3-a, IV to read as follows:

IV.

No person who issues a health benefit plan subject to this chapter shall use false or misleading language in its enrollment sales materials or in any other materials provided to covered persons to discourage or prohibit covered persons from accessing the enhanced 911 system for response and/or transportation for emergency services.

3 Managed Care Law; Substance Use Disorders. Amend RSA 420-J:17, IV and V to read as follows:

IV.

If an insurance policy does not require prior authorization for short-term inpatient withdrawal management services or clinical stabilization services, paragraphs II and III shall not apply.

V . Nothing in this section shall be construed to require coverage for services provided by a non-participating provider.

4 New Section; Exceptions to Prior Authorizations. Amend RSA 420-J by inserting after section 19 the following new section:

420-J:20 Exceptions to Prior Authorizations. When prior authorizations are required under a health benefit plan:

I. There shall be no revocation, limitation, condition or restriction of prior authorizations, if care is provided within 45 days from the date the health care provider received prior authorization.

II. The authorization shall be valid for one year from the date the health care provider receives the prior authorization.

III. Additional medically necessary services or procedures required during the course of an otherwise authorized service or services shall not be denied or require additional authorization.

IV. All notifications and disclosures of prior authorization requirements and written notices of new or amended requirements shall be provided to all impacted health care providers within 60 days of the effective date.

5 Repeal. RSA 420-J:18, relative to authorization for medication-assisted treatment, is repealed.

6 Effective Date. This act shall take effect 60 days after its passage.

1 Coverage for Emergency Services; Prior Authorization. Amend RSA 417-F:3 to read as follows:

417-F:3 Prior Authorization.

I. A participating provider or other authorized representative of the plan that gives prior authorization shall not rescind or modify the authorization after the health care provider has rendered the authorized emergency services care in good faith and the enrollee's, insured's, or subscriber's coverage was effective on the date of service.

II. When emergency services are a covered benefit under a health plan subject to this chapter, no prior authorization shall be required for emergency health care services necessary to screen and stabilize an individual.

2 Managed Care Law; Access to Enhanced 911 System. Amend RSA 420-J:3-a, IV to read as follows:

IV. No health benefit plan shall require a prior authorization for medically necessary interfacility transports by emergency medical services.

V. No person who issues a health benefit plan subject to this chapter shall use false or misleading language in its enrollment sales materials or in any other materials provided to covered persons to discourage or prohibit covered persons from accessing the enhanced 911 system for response and/or transportation for emergency services.

3 Managed Care Law; Substance Use Disorders. Amend RSA 420-J:17, IV and V to read as follows:

IV. When substance use disorder services are a covered benefit under a health benefit plan, no prior authorization shall be required for medication-assisted treatment for treatment of opioid use disorders.

V. If an insurance policy does not require prior authorization for short-term inpatient withdrawal management services or clinical stabilization services, paragraphs II , III and IV shall not apply.

V VI . Nothing in this section shall be construed to require coverage for services provided by a non-participating provider.

4 New Section; Exceptions to Prior Authorizations. Amend RSA 420-J by inserting after section 19 the following new section:

420-J:20 Exceptions to Prior Authorizations. When prior authorizations are required under a health benefit plan:

I. There shall be no revocation, limitation, condition or restriction of prior authorizations, if care is provided within 45 days from the date the health care provider received prior authorization.

II. The authorization shall be valid for one year from the date the health care provider receives the prior authorization.

III. Additional medically necessary services or procedures required during the course of an otherwise authorized service or services shall not be denied or require additional authorization.

IV. All notifications and disclosures of prior authorization requirements and written notices of new or amended requirements shall be provided to all impacted health care providers within 60 days of the effective date.

5 Repeal. RSA 420-J:18, relative to authorization for medication-assisted treatment, is repealed.

6 Effective Date. This act shall take effect 60 days after its passage.