Prior Authorization in New Hampshire
New Hampshire requires PA decisions within specified timeframes and provides external review for denied claims under RSA 420-J. The state also enacted step therapy override protections allowing prescribers to request exceptions based on clinical criteria.
Key Facts About PA in New Hampshire
- ✓ Step therapy override protections available to prescribers
- ✓ External review available through the NH Insurance Department
- ✓ PA decisions must be timely with expedited process for urgent requests
- ✓ Anthem BCBS is the dominant commercial carrier in NH
Quick Stats
- Typical Appeal Filing Window: 30 days
- External Review Available: Yes
- Major Payers: 4
Top Payers in New Hampshire
RxCheckUp generates payer-specific Letters of Medical Necessity for each of these New Hampshire carriers:
Anthem BCBS New HampshireHarvard PilgrimCignaUnitedHealthcare