This RSA section is an unofficial mirror, is not legal advice, and may be incomplete, outdated, or incorrectly processed.
RSA 420-J:6-b · Self-Referrals for Chiropractic Care
420-J:6-b Self-Referrals for Chiropractic Care. – A health benefit plan under this chapter offering chiropractic benefits shall provide benefits to a covered person who utilizes services of a chiropractic provider (doctor of chiropractic) by self-referral for 12 visits under the following conditions:
Copy linkUnless otherwise provided for by the health benefits plan, self-referral visits shall not apply to wellness care visits.
Copy linkA covered person may utilize the services of a doctor of chiropractic as defined in RSA 316-A, without discrimination relative to access and fees, subject to the terms and conditions of the policy.
Copy linkThe health benefit plan shall fully disclose to the certificate holder in clear and understandable language the exact terms and conditions of each option that the certificate holder has purchased along with the co-payments or other cost-sharing features of each option.
Copy linkWithin 10 working days of the first visit or consultation, the doctor of chiropractic shall send to the health benefit plan, or its designee, the chiropractic case findings. This shall be sufficient documentation for the initial 12 visits.
Copy linkAfter 12 self-referral visits, a covered person who is continuing chiropractic care may be subject to utilization review from the health plan, or its designee, for the purpose of continued care. A provider of the same specialty shall be consulted when making any utilization review determination under this section.
Copy linkIf the chiropractic provider recommends care beyond 12 visits, the participating doctor of chiropractic shall send to the insurer, or its designee, documentation containing information on the covered person's progress and necessity of care as well as a care plan for extended chiropractic care. The care recommendation shall be deemed authorized if the health benefit plan does not respond to the care recommendation within 7 business days. If the doctor of chiropractic fails to provide the required documentation, the insured or its covered person shall not be liable to the chiropractic provider for any unpaid fees.
Copy linkThe covered person shall retain the right to choose chiropractic care on an elective, self-pay, fee-for-service basis; no entity regulated under this chapter shall prohibit a doctor of chiropractic from continuing care on an elective, self-pay, fee-for-service basis.
Copy linkNothing in this section is intended to limit the health plan's ability to credential providers or structuring with network providers. Source. 2000, 14:1, eff. April 18, 2000.
Copy linkSource note
Source. 2000, 14:1, eff. April 18, 2000.
Source history
- 2000, 14:1, eff. April 18, 2000
Related materials
Bill relationships
-
2026 HB1268
reference · effective 2027-01-01
pharmacy or pharmacist to reverse and rebill the claim in question. (3) All claims adjudications, appeals, and utilization review processes shall comply with the requirements of RSA 420-J and rules promulgated thereunder. (b) For every drug for which the health carrier or pharmacy benefit manager establishes a maximum allowable cost to determine the drug product reimbursement, the health carrier or p
-
2026 HB1323
amend · effective 2027-01-01
shall consider the factors set forth in RSA 461-A:6. 10 New Section; Managed Care Law; Prior Authorization for Physical Therapy and Occupational Therapy; When Required. Amend RSA 420-J by inserting after section 6-e the following new section: 420-J:6-f Prior Authorization for Physical Therapy and Occupational Therapy; When Required. I. A health carrier shall not require prior authorization for
-
2026 HB1323-FN
amend · effective 2027-01-01
shall consider the factors set forth in RSA 461-A:6. 10 New Section; Managed Care Law; Prior Authorization for Physical Therapy and Occupational Therapy; When Required. Amend RSA 420-J by inserting after section 6-e the following new section: 420-J:6-f Prior Authorization for Physical Therapy and Occupational Therapy; When Required. I. A health carrier shall not require prior authorization for
-
2026 HB1463
reference
nduct a detailed analysis and report, in consultation with practicing community physicians in every New Hampshire county and health system, to assess compliance with RSA 420-E and RSA 420-J and make recommendations for appropriate penalties for insurers and insurance carriers not in compliance with such chapters of law. The department shall report its findings to the speaker of the house of representative
-
2026 HB1463-FN
reference
nduct a detailed analysis and report, in consultation with practicing community physicians in every New Hampshire county and health system, to assess compliance with RSA 420-E and RSA 420-J and make recommendations for appropriate penalties for insurers and insurance carriers not in compliance with such chapters of law. The department shall report its findings to the speaker of the house of representative
-
2026 HB1638
amend
ep therapy protocols when medically necessary. Be it Enacted by the Senate and House of Representatives in General Court convened: 1 New Subdivision; Step Therapy. Amend RSA 420-J by inserting after section 26 the following new subdivision: Step Therapy 420-J:27 Definitions. As used in this subdivision: I. "Advanced, metastatic cancer" means a cancer that has spread from the primary or orig
-
2026 HB1638-FN
amend
ep therapy protocols when medically necessary. Be it Enacted by the Senate and House of Representatives in General Court convened: 1 New Subdivision; Step Therapy. Amend RSA 420-J by inserting after section 26 the following new subdivision: Step Therapy 420-J:27 Definitions. As used in this subdivision: I. "Advanced, metastatic cancer" means a cancer that has spread from the primary or orig
-
2026 HB1744
amend
Be it Enacted by the Senate and House of Representatives in General Court convened: 1 New Section; Managed Care Law; Mental Health Coverage Reporting and Oversight. Amend RSA 420-J by inserting after section 6-e the following new section: 420-J:6-e Mental Health Coverage Reporting and Oversight. I. Each health insurance carrier offering health benefit plans in this state shall submit an annual r
-
2026 HB1744-FN
amend
Be it Enacted by the Senate and House of Representatives in General Court convened: 1 New Section; Managed Care Law; Mental Health Coverage Reporting and Oversight. Amend RSA 420-J by inserting after section 6-e the following new section: 420-J:6-e Mental Health Coverage Reporting and Oversight. I. Each health insurance carrier offering health benefit plans in this state shall submit an annual r
-
2026 HB241
amend · effective 2027-01-01
sed standards used in deciding which therapies should be available. 2 New Section; Managed Care Law; Development of a Comprehensive Program of Pain Management Services for the Management of Chronic Pain. Amend RSA 420-J by inserting after section 7-e the following new section: 420-J:7-f Development of a Comprehensive Program of Pain Management Services for the Management of Chronic Pain. I. Health carriers shall develop, in a
-
2026 HB241-FN
amend · effective 2027-01-01
ich therapies should be available. 2 New Section; Managed Care Law; Development of a Comprehensive Program of Pain Management Services for the Management of Chronic Pain. Amend RSA 420-J by inserting after section 7-e the following new section: 420-J:7-f Development of a Comprehensive Program of Pain Management Services for the Management of Chronic Pain. I. Health carriers shall develop, in accorda
-
2026 HB705
amend · effective 2026-03-16
transparency. Be it Enacted by the Senate and House of Representatives in General Court convened: 5:1 New Subdivision; Managed Care Law; Transparency in Coverage. Amend RSA 420-J by inserting after section 26 the following new subdivision: Transparency in Coverage 420-J:27 Definitions. In this subdivision: I. “Billed charge” means the total charges for an item or service billed to a healt