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NH lawmaker seeks insurance-department study to make prior-authorization rules easier to find
Summary
Rep. Trinidad Tejas told the House Commerce Committee a 2024 law left a transparency gap: insurers must post prior-authorization criteria in “readily understandable” language but, in practice, clinicians struggle to find or interpret those rules. The bill would require the Insurance Department to gather provider perspectives and report on carrier compliance.
Representative Trinidad Tejas, prime sponsor of the bill, asked the House Commerce and Consumer Affairs Committee to direct the New Hampshire Insurance Department to assess how well carriers are meeting an existing legal requirement to make prior-authorization criteria "readily accessible" to enrollees and health care professionals. "I am Representative Trinidad Tejas, the prime sponsor, requiring the insurance department to conduct an analysis and produce a report detailing compliance with the state's managed care and medical utilization review laws," Tejas said.
The bill builds on 2024 reforms enacted in SB 561, which shortened insurer decision timelines, expanded peer-to-peer review access and required carrier reporting of prior-authorization metrics. Tejas and physician witnesses told the committee the numerical reporting template the department released…
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