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Substance Use Disorder Treatment Market Conduct Exams
This page contains information about the New Hampshire Insurance Department's market conduct examinations on substance use disorder treatment practices of the states three largest health insurance companies.
 
  • In November 2015, the Department began a formal market conduct examination to look very specifically at how health insurance companies handle preauthorization, claim denials, and utilization review practices for substance use disorder claims. The examination is also focusing on covered persons' access to substance use disorder treatment providers -- including whether the companies' networks are adequate -- and on the companies' systems for handling appeals of claim denials. The market conduct examination looks at 2015 claims.
  • On Feb. 19, 2016, the Insurance Department presented its preliminary findings to the Governor's Commission on Alcohol and Drug Abuse Prevention, Treatment, and Recovery (a link to the presentation: Insurers' SUD Claims Handling Practices: Preliminary Findings). Adobe Acrobat Reader Symbol
  • After the first phase of the examination, the Insurance Department expanded the scope to include medication assisted treatment and parity.
  • On March 2, 2017, the Department released the final reports:

Resources:


 
   

New Hampshire Insurance Department | 21 South Fruit Street, Suite 14 | Concord, NH 03301
Phone 603.271.2261 | Fax 603.271.1406 | Consumer Hotline 1.800.852.3416

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