Prohibits health carriers from requiring prior authorization for a patient's first physical or occupational therapy visit in a new episode of care, requires approval of at least 8 medically necessary treatments after initial evaluation, and preserves insurers' ability to deny non-medically-necessary claims.
limiting certain prior authorization requirements for physical therapy, occupational therapy, and similar rehabilitative services.
I support SB 480 because it reduces unnecessary administrative barriers by eliminating prior authorization for the first PT/OT visit and guaranteeing a medically-justified course of treatment before additional review. This improves transparency, cuts delays in care, and ensures patients can access essential rehabilitative services without insurer-driven friction.
Dear Representatives I am writing to you as a practicing occupational therapist in New Hampshire to respectfully request your support for legislation that would eliminate preauthorization requirements for outpatient therapy services unless a patient requires more than 8 visits, SB480. SB480 represents an essential step toward ensuring timely, effective, and uninterrupted care for the patients we serve. As healthcare providers, we routinely witness the negative impact that preauthorization requirements have on patient health, safety, and functional outcomes. The administrative burden associated with preauthorization has grown to an unsustainable level for therapy practices across the state: • 40% reported waiting five business days or longer for authorization decisions—delays that directly postpone the start of urgently needed therapy. • As a result, 90% of providers reported delays in treatment initiation. • Most concerning, more than 41% of outpatient therapy practices reported at least one adverse event occurring while a patient awaited preauthorization. • 80% of New Hampshire outpatient therapy practices surveyed reported needing dedicated staff solely to manage preauthorization requests. • Over 97% reported experiencing a moderate to high administrative burden associated with these requirements. These statistics reflect what we see daily: preauthorization processes frequently force patients to delay or abandon treatment, placing them at risk for worsened conditions, avoidable decline in function, unnecessary medical visits, and prolonged recovery. Providers often spend excessive time navigating preauthorization instead of dedicating those hours to direct patient care. This burden is especially challenging for small and rural practices that do not have the administrative infrastructure to absorb these demands. A 8-visit threshold before requiring preauthorization is a reasonable and evidence-informed approach. It balances the need for payer oversight with the clinical reality that timely access to therapy is essential for preventing deterioration, reducing long-term healthcare costs, and supporting patient independence. Early intervention is often the determining factor in whether a patient returns to work, avoids surgery, or remains safe in their home. Passing SB480 would reduce unnecessary administrative barriers, improve patient outcomes, and allow therapists across our state to focus on delivering high-quality, effective care. I urge you to support this legislation and stand with patients and providers who are working to ensure access to timely therapy services. Thank you for your consideration and for your commitment to improving healthcare for the people of New Hampshire. I welcome the opportunity to discuss this further or provide additional information from the clinical perspective. Sincerely, Chris Dunstan Dunstan Pediatric
I work for a small critical access hospital in the northern part of the state. Our outpatient therapy clinics see over about 2,000 new patients a year, totaling over 15,000 visits per year. In 87% of our cases, the patients will have completed therapy in 12 visits or less. I'm sure you've heard many people say there is an ever-growing administrative burden related to healthcare and prior authorizations. What we are asking for is to lessen this burden for 87% of our cases. With a change like this, there is also going to be a significant reduction in administrative burden on behalf of the insurance companies. Every time we submit paperwork for prior authorization someone has to review it and make a decision. Each time they request a peer-to-peer review, at least three individuals are involved in this process. The root of the issue here is that patients are getting the brunt of this issue. Just this week, we had three patients who required authorization after their initial evaluation, and we had to cancel their first follow up appointment because we had not heard back from the insurance company regarding their authorization status. Patient care is affected. For most commercial payers, we have to submit for authorization after the initial evaluation. Here is a typical scenario we see every day: A therapist evaluates a patient referred to them from the emergency room with an acute exacerbation of low back pain from repetitive lifting and based on their assessment feels like the patient will be appropriate for discharge in about 12 visits. The therapist asks for 12 visits and the clinic receives notification from the insurance that they are approving 4 visits. So, after two weeks and 4 visits, we then have to submit authorization for more visits. The therapist requests 8 additional visits and we receive notification that they are approving 4 visits. So then two more weeks go by, a total of 8 visits has been used, the patient is making progress and now we have to submit for yet another authorization. The therapist asks for 4 visits. The insurance company comes back and says, before they approve the visits, there needs to be a peer-to-peer review completed. They give the therapist a number to call to schedule a peer-to-peer. The therapist has a full day of patients and therefore the only time to make a call in order to not impact patient care, is during their lunch hour. They call the reviewer who asks a few questions that they could have answered if they had reviewed the therapist's documentation and says okay, the 4 visits are approved. We've now submitted 2 prior authorizations and had a peer-to-peer review in order to get the 12 visits that the therapist had initially requested at the start of care. Our own federal government already uses a system like this. The VA currently approves 15 visits before needing to submit for authorization. Medicare does not require authorization for therapy services. Because the research shows that about 90% of all therapy cases are completed in 12 visits or less. The United States Military utilizes Physical Therapists as primary care providers. In September 2023 there was a landmark review of the economic value of physical therapy, and I invite you to review the findings of this report that support our profession's impact on reducing financial burden on the healthcare system. https://www.valueofpt.com/globalassets/value-of-pt/economic_value_pt_u.s._report_from_apta-report.pdf Thank you for your time and consideration on this matter that will have a direct impact on your constituents who are navigating care in our medical system and reduce the administrative burden on hospitals, clinics, and insurance companies alike.
Honorable Committee Members, I am a practicing physical therapist in New Hampshire and I also serve as the VP of Regulatory and Compliance for Powerback Rehabilitation. In this role, I oversee care for some of our state’s most frail citizens—individuals for whom even a minor delay in treatment can result in a permanent loss of independence. I respectfully request your support for SB480. At Powerback, we witness the detrimental impact of preauthorization delays on a daily basis. This legislation is a critical step toward ensuring that New Hampshire patients receive the timely, uninterrupted care they deserve. The current administrative requirements for authorization of therapy services have reached an unsustainable level, creating a barrier between providers and their patients. Recent data from New Hampshire outpatient practices highlights the severity of this issue: Treatment Delays: 90% of providers report delays in treatment initiation, with 40% waiting five business days or longer for a decision. Patient Safety Risks: Most alarmingly, over 41% of practices reported at least one adverse event occurring while a patient was stuck in the preauthorization queue. Administrative Exhaustion: Over 97% of providers report a moderate to high administrative burden, with 80% of practices requiring dedicated staff solely to manage these requests. Impact on New Hampshire’s Vulnerable Populations For the frail citizens we serve, therapy is not elective—it is the determining factor in whether a patient can safely remain in their home, avoid surgery, or prevent a life-altering fall. When we are forced to navigate bureaucratic hurdles instead of providing immediate intervention, the results include functional decline, increased medical visits, and higher long-term healthcare costs. SB480 is a balanced, evidence-informed solution. It recognizes that early intervention is the most effective way to support patient recovery and reduce the overall cost of care. I urge you to support SB480 to remove these unnecessary barriers and allow New Hampshire’s therapists to return our focus where it belongs: on delivering high-quality, life-changing care to our patients. Respectfully, Ami E. R. Faria PT, DPT VP of Regulatory and Compliance, Powerback Rehabilitation
My name is Alyson Condict OT, CHT and I am an Occupational Therapist/ Hand Therapist reaching out to you today in support of SB480. This bill will help residents of New Hampshire access medically necessary healthcare in a timely manner, avoid delays in receiving that care and decrease unnecessary administrative burden. Thank you for your support of SB480.
My name is Shannon Gile and I am a physical therapist reaching out to you today to ask for your support of SB480. This bill will help residents of New Hampshire access medically necessary healthcare in a timely manner, avoid delays in receiving that care and decrease unnecessary administrative burden. Thank you for supporting SB480.
Private insurances have been restricting access to needed healthcare on the basis of maximizing profits. However, if people are able to participate in medical care at a location they choose and in a timely fashion, they could cost their insurance less costs overall from decreased risk of complications or developing chronic dysfunction. In the rural regions of the state, access to care is already limited by a variety of factors, insurance should not be one of them.
I am a Physical Therapist in support of this bill. By supporting this bill you will help patients get the care they need in a timely manner, without delay!!! As it stands now, people have to wait sometimes weeks or longer in order to get the therapies they need. Please consider supporting this bill. The health and care of the people of NH may depend on this. Thank you for your time and considerations. Best regards, Greg Alnwick, PT, DPT Gorham, NH
As a doctor of physical therapy currently practicing in NH, I have seen time and time again that prior authorizations are nothing but a tool by the for-profit insurance industry to delay and deny necessary care. These authorizations are often determined by automated systems and the results are frequently not clinically relevant. Decisions about what physical therapy care is necessary should be made by a patient and their physical therapist, not an automated system that exists solely to increase profits to an industry that preys on society. Thank you, Samuel Gagnon, PT, DPT
As a Physical Therapist (PT, DPT) with 11 years of clinical experience, currently practicing in a rural setting, I have seen firsthand how delays in access to care can negatively impact patient outcomes. Throughout my career in both rural and mixed practice environments, insurance authorization requirements have frequently created barriers that delay necessary treatment and hinder recovery. New Hampshire Senate Bill 480 offers a practical and patient-centered solution by allowing up to eight visits of physical and occupational therapy without delay. In many cases, this early access is sufficient for patients to achieve meaningful improvements in pain, mobility, and overall function. Timely intervention often enables individuals to continue working and safely perform their daily responsibilities without prolonged disruption. For patients in rural communities, where access to healthcare services is already limited, this legislation is especially critical. SB480 supports early, effective care, helping to prevent avoidable functional decline while promoting independence and quality of life. I strongly support this bill as a common-sense measure to improve access, outcomes, and efficiency within our healthcare system.
Subject: Support for SB 480 – Improving Access to Rehabilitation Services Dear Members of the New Hampshire House Commerce and Consumer Affairs Committee, I am writing to express my strong support for SB 480 in the 2026 legislative session. This bipartisan bill represents a thoughtful and necessary step toward improving access to essential rehabilitation services for residents of New Hampshire. SB 480 addresses a significant barrier in healthcare delivery: the administrative burden of prior authorization for physical therapy, occupational therapy, and related rehabilitative services. By prohibiting insurers from requiring prior authorization for the first visit in a new episode of care, the bill ensures that patients can begin treatment without unnecessary delays at a critical point in their recovery. Additionally, the requirement that insurers approve at least eight medically necessary visits following the initial evaluation provides a reasonable and evidence-informed framework for continuity of care. This provision supports clinical decision-making while still allowing insurers to retain oversight through medical necessity determinations. The benefits of SB 480 are clear: Improved patient outcomes through timely initiation and continuation of care Reduced administrative burden on providers, allowing more time for patient care Increased efficiency within the healthcare system by minimizing delays and interruptions in treatment As a professional invested in education and healthcare practice, I recognize how essential early and consistent rehabilitation services are in promoting recovery, independence, and long-term health. Delays caused by prior authorization can lead to worsening conditions, increased healthcare costs, and decreased quality of life for patients. SB 480 strikes an appropriate balance between access and accountability. It protects patients while maintaining insurers’ ability to deny services that are not medically necessary. I respectfully urge you to support SB 480 and advance this important legislation to improve access to care for individuals across New Hampshire. Thank you for your time and consideration. Sincerely, Rebecca C Moore OTD, MS, OTR/L Professor of Practice Russel Sage College, Practicing Occupational Therapist, St Joseph's Hospital, Outpatient Rehab, Hudson NH [Your City, NH]
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