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Subcommittee asks insurers, advocates to surface denials after hearing on coverage for Down syndrome services
Summary
A New Hampshire Commerce and Consumer Affairs subcommittee heard that the Insurance Department has not logged clear, systemic denials for behavioral therapy billed to treat children with Down syndrome; the department offered to review claims coding and requested concrete denied cases to investigate.
The House Commerce and Consumer Affairs subcommittee examined Bill 353 focused on coverage for behavioral therapies used by children with Down syndrome and asked the New Hampshire Insurance Department to probe whether denials are a coding problem rather than a coverage gap. Michelle Heaton, director of life and health at the Insurance Department, told the committee the department "receive[s] complaints all the time about a variety of different issues" but has not identified a clear pattern of denials specific to this issue and urged anyone who has been denied commercial coverage to…
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