Committee Debates Bill to Allow Eight Initial Physical/Occupational Therapy Visits Without Prior Authorization

Senate Bill 480, introduced in committee as a measure to reduce prior‑authorization barriers for physical and occupational therapy, prompted testimony from dozens of clinicians and insurers. Senator Sue Apprentice framed the bill as a cost‑saving, early‑intervention policy that “guarantees eight medically necessary treatments” before prior authorization, arguing that early therapy reduces risk of surgery, imaging and opioid prescriptions.

Physical‑therapy associations and frontline clinicians told the committee that current prior‑authorization practices often allow only a handful of visits before paperwork forces patients to stop or wait for approval, sometimes creating week‑long gaps that interrupt recovery. Tracy Adams, president of the New Hampshire chapter of the American Physical Therapy Association, said national data show 85–90% of episodes are completed within 12 visits and that moving prior‑authorization triggers later in care would reduce administrative burden and avoidable delays.

Insurers and the state’s Insurance Department did not oppose the goal but raised concerns about mandating a fixed minimum of visits. Michelle Heaton, life and health director at the Insurance Department, said plans currently use clinical management to tailor authorizations by diagnosis and patient need and warned that a statutory minimum could increase plan costs and limit flexibility.

Committee members asked about real‑world turnaround times for authorizations and the potential for unnecessary visits if a guaranteed number were established; clinicians replied that ethical and professional standards constrain overuse and that documentation of medical necessity would still be required.

The hearing produced strong advocacy on both sides; the committee did not vote on the bill during the session and signaled it will weigh amendments that preserve timely access while accommodating plan oversight.