New Hampshire Insurance Department Releases Updated Bulletin on Prior Authorization Requirements

CONCORD, NH (January 3, 2025) – The New Hampshire Insurance Department (NHID) has issued a new bulletin detailing updated guidance on prior authorization processes for health insurers and related entities. This bulletin aims to streamline and clarify prior authorization protocols, ensuring efficient access to medically necessary care for New Hampshire residents while enhancing administrative transparency.

Effective immediately, the bulletin (Docket #INS 25-001-AB) outlines essential standards and expectations for insurers, healthcare providers, and other stakeholders engaged in the prior authorization process. These updates are designed to address common challenges in obtaining timely authorizations, reducing administrative delays, and fostering clear communication among all parties involved in patient care.

“These updates reaffirm our commitment to ensuring that prior authorization processes do not serve as a barrier to essential healthcare services for Granite Staters,” said Insurance Commissioner DJ Bettencourt. “By refining these protocols, we aim to maintain the intended purpose of prior authorization: to prevent premium increases while supporting high-quality, efficient, and patient-centered healthcare delivery in our state.”

Key provisions in the bulletin include:

• Standardized timeframes for decision-making to prevent unnecessary delays in care delivery.
• Improved documentation requirements to enhance the accuracy and completeness of authorization requests.
• Enhanced mechanisms for appeals and grievances to address denials of prior authorization requests.

“The NHID will closely monitor adherence to these updated guidelines to ensure compliance and address concerns raised by consumers and providers,” said Deputy Insurance Commissioner Keith Nyhan. “We are committed to working collaboratively with stakeholders to ensure a smooth transition to these enhanced standards.”

The complete bulletin, Docket #INS 25-001-AB, is available at https://mm.nh.gov/files/uploads/nhid/documents/ins-25-001-ab-prior-auth.pdf. 

The New Hampshire Insurance Department Can Help

The New Hampshire Insurance Department’s mission is to promote and protect the public good by ensuring the existence of a safe and competitive insurance marketplace through the development and enforcement of the insurance laws of the State of New Hampshire. Contact us with any questions or concerns you may have regarding your insurance coverage at 1‐800‐852‐ 3416 or (603) 271‐2261, or by email at consumerservices@ins.nh.gov. For more information, visit https://insurance.nh.gov/.