NH Senate backs changes to prior authorization law involving drug care

Measure would allow payment to providers without previous OK from insurers

The NH Senate on Thursday passed a bill requiring that health insurance companies reimburse providers for initial treatment of substance abusers without prior authorization.

“This is the window of opportunity,” said Sen. David Boutin, R-Manchester. “If they are kept waiting and they walk away and shoot up, the consequence could be the loss of a life.”

Both chambers passed similar versions of Senate Bill 532, but the Senate Health and Human Services Committee recommended that the bill be sent to a committee of conference to work out the differences, over a House floor amendment that would apply some of the language in the bill to another section of existing insurance law.

“It creates a confusing position over what its true intent was,” said Sen. Andy Sanborn, R-Bedford, chair of the Health and Human Services Committee.

He assured the committee it would just clear up the ramifications of the change, and would eventually pass a version of the bill. He said that in any case providers prescribe treatment to those who need it because only a small percentage of such claims have been successfully challenged.

But Sen. Dan Feltes, D-Concord, worried that the committee might strip the bill of the crucial word “until” from a section – it said that insurance companies would reimburse providers until a determination was made.

“That is the critical purpose of the bill,” he said. “Let’s trust the providers without any assurance that they will get paid. What happens if they become skittish, while waiting for an insurance company to call them back?”

Sen. Jeb Bradley, R-Wolfeboro, who favored the bill going to committee of conference, also indicated that it was a bigger issue than just working out technical language.

“Our insurance markets require the effective use of prior authorization,” he said. “We should not undermine prior authorization in our health care delivery service.”

‘Precious moments slip by’

But other Republicans broke ranks, worried that the bill could die in conference – and feared that some people might even die as a result.

“Trying to get to perfect can lead to failure,” said Boutin. He said that, on average, one person per day was dying of opioid addiction in New Hampshire. “I can tell you that many bills with the best of intentions are left on the table (at committee of conference). I don’t think we can take that risk in this case.”

Sen. Russell Prescott, R-Kingston, agreed

“Precious moments slip by” while waiting for authorization, he said. “The clinician needs to know to move forward and not worry about the need for paperwork, and do the wrong thing for a person in need, because within two hours, they are going to be gone.”

The Senate voted 16-8 to accept the House amendment, sending the bill to Gov. Maggie Hassan.

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