Revision: Jan. 28, 2026, 1:21 p.m.
HB 241-FN - AS AMENDED BY THE HOUSE
7Jan2026... 2990h
2025 SESSION
25-0358
05/08
HOUSE BILL 241-FN
SPONSORS: Rep. Nagel, Belk. 6; Rep. T. Dolan, Rock. 16; Rep. Lundgren, Rock. 16; Rep. Palmer, Sull. 2
COMMITTEE: Health, Human Services and Elderly Affairs
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AMENDED ANALYSIS
This bill requires health carriers to develop, in accordance with guidelines established by the insurance department, a program to provide access to a broad spectrum of covered pain management services for the management of chronic pain.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
7Jan2026... 2990h 25-0358
05/08
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Five
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Statement of Findings and Purpose.
I. The general court recognizes the following:
(a) The causes of the opioid crisis are complex and multifactorial.
(b) One of the major causes was the failure of the health care system, as a whole, to provide meaningful access to a broad range of non-opioid, non-interventional evidence-based therapies including complimentary alternative medicine provided by licensed professionals as either single modality therapy or integrative care for those who suffer from acute, chronic, and/or end of life pain.
(c) Executive and legislative entities both at the federal and state level pursued public health polices to combat the crisis which, in effect, abandoned those in pain, particularly those on opioid therapies, by creating barriers to opioid therapy without creating access to non-opioid therapies resulting in unnecessary and extensive morbidity and mortality for those patients.
(d) While government based and commercial insurers do provide some access to these therapies, the availability is limited and insufficient to address the scope of the problem.
(e) While the litmus test for what therapies should be made available is evidence-based, it is concerning that a double standard is used between therapies provided by allopathic and non-allopathic providers in determining strength of evidence required, and this double standard unfairly favors allopathic providers.
II. The purpose of this act is to both increase access to these therapies in a cost-effective, evidence-based manner in the commercial insurance market and to level the evidence-based standards used in deciding which therapies should be available.
2 New Section; Managed Care Law; Development of a Comprehensive Program of Pain Management Services for the Management of Chronic Pain. Amend RSA 420-J by inserting after section 7-e the following new section:
420-J:7-f Development of a Comprehensive Program of Pain Management Services for the Management of Chronic Pain.
I. Health carriers shall develop, in accordance with guidelines established by the insurance department, a program to provide access to a broad spectrum of covered pain management services, including, but not limited to, non-medication, nonsurgical treatment modalities, and non-opioid medication treatment options that serve as alternatives to opioid prescribing. This plan shall be approved by the department as a component of the form filing and approval process.
II. Health carriers shall provide to covered persons who suffer from a chronic pain condition information regarding the pain management program and how to access services included in the program. Such information shall also be publicly available on the health carrier’s website.
III. Health carriers shall annually distribute educational materials about the program to providers within their networks.
IV. Health carriers shall not require a covered person accessing services as part of the program to obtain prior authorization for covered, non-medication, nonsurgical treatment modalities that include restorative therapies, behavioral health approaches or integrative health therapies, including acupuncture, chiropractic treatments, massage and movement therapies.
V. No program under this section may establish utilization controls, including prior authorization or step therapy requirements, for clinically appropriate non-opioid drugs approved by the United States Food and Drug Administration for the treatment or management of pain, that are more restrictive or extensive than the least restrictive or extensive utilization controls applicable to any clinically appropriate opioid drug.
3 Effective Date. This act shall take effect January 1, 2027.
25-0358
Revised 1/28/26
HB 241-FN- FISCAL NOTE
AS AMENDED BY THE HOUSE (AMENDMENT # 2025-2990h)
FISCAL IMPACT:
Estimated State Impact | ||||
| FY 2026 | FY 2027 | FY 2028 | FY 2029 |
Revenue | $0 | Indeterminable Increase (range not provided by agency) | Indeterminable Increase (range not provided by agency) | Indeterminable Increase (range not provided by agency) |
Revenue Fund(s) | General Fund | |||
Expenditures* | $0 | $0 | $0 | $0 |
Funding Source(s) | None | |||
Appropriations* | $0 | $0 | $0 | $0 |
Funding Source(s) | None | |||
*Expenditure = Cost of bill *Appropriation = Authorized funding to cover cost of bill | ||||
| ||||
Estimated Political Subdivision Impact | ||||
| FY 2026 | FY 2027 | FY 2028 | FY 2029 |
County Revenue | $0 | $0 | $0 | $0 |
County Expenditures | $0 | Indeterminable | Indeterminable | Indeterminable |
Local Revenue | $0 | $0 | $0 | $0 |
Local Expenditures | $0 | Indeterminable | Indeterminable | Indeterminable |
METHODOLOGY:
This bill requires health carriers to provide expanded coverage for non-opioid pain management services and limits the use of utilization controls for those services for policies issued or renewed on or after January 1, 2027.
The Insurance Department states this bill requires health carriers in the fully insured health insurance market to develop and maintain comprehensive pain management programs for the treatment of chronic pain and to provide information on those programs to consumers on an annual basis. The bill also requires that medical management techniques for non-opioid drugs approved to treat pain be no more stringent than the medical management techniques used for opioid drugs.
The Department states that if the expanded coverage requirements increase utilization of health care services, overall health care costs and insurance premiums could increase, which would result in a corresponding increase in Insurance Premium Tax revenues. However, the Department is unable to estimate the extent to which utilization of health care services would increase under the bill and therefore cannot estimate the fiscal impact on Insurance Premium Tax revenues, which is indeterminable.
To the extent counties and municipalities purchase fully insured health insurance, they could experience increased health insurance costs if utilization of health care services increases.
AGENCIES CONTACTED:
Insurance Department