Text to be removed highlighted in red.
1 New Section; Managed Care Law; Prior Authorization for Rehabilitative or Habilitative Services; When Required. Amend RSA 420-J by inserting after section 6-e the following new section:
420-J:6-f Prior Authorization for Rehabilitative or Habilitative Services; When Required.
?? I. A health carrier shall not require prior authorization for rehabilitative or habilitative services, including, but not limited to, physical therapy services and occupational therapy services, for the first 12 visits of each new episode of care. For purposes of this section, "new episode of care" means treatment for a new condition or treatment for a recurring condition for which an enrollee has not been treated within the previous 60 days. ?
II. This section does not limit the right of a health carrier to deny a claim when an appropriate prospective or retrospective review concludes that the health care services or treatment rendered were not medically necessary.
2 Effective Date. This act shall take effect 60 days after its passage.
Text to be added highlighted in green.
1 New Section; Managed Care Law; Prior Authorization for Rehabilitative or Habilitative Services; When Required. Amend RSA 420-J by inserting after section 6-e the following new section:
420-J:6-f Prior Authorization for Rehabilitative or Habilitative Services; When Required.
?? I. A health carrier shall not require prior authorization for rehabilitative or habilitative services, including, but not limited to, physical therapy services and occupational therapy services, for the first 12 visits of each new episode of care. For purposes of this section, "new episode of care" means treatment for a new condition or treatment for a recurring condition for which an enrollee has not been treated within the previous 60 days. ?
II. This section does not limit the right of a health carrier to deny a claim when an appropriate prospective or retrospective review concludes that the health care services or treatment rendered were not medically necessary.
2 Effective Date. This act shall take effect 60 days after its passage.