This RSA section is an unofficial mirror, is not legal advice, and may be incomplete, outdated, or incorrectly processed.

RSA 420-J:6-c · Third-Party Payment of Covered, Court-Ordered Services

Title: XXXVII: INSURANCE
Chapter: 420-J · MANAGED CARE LAW
Status: current
Official source linked: Yes

Official source Copy section link

420-J:6-c Third-Party Payment of Covered, Court-Ordered Services. – The existence of a court order under RSA 169-B, RSA 169-C, or RSA 169-D for a service, program, or placement that is covered under any insurance for the minor shall not be considered in determining qualification for third-party payment under such insurance. Benefits for such services shall be subject to the same dollar limits, deductibles, co-payments and co-insurance factors and to the terms and conditions of the policy or certificate, including any managed care provisions. However, the claimant or claimant's representative shall have 48 hours from the commencement of a court-ordered service, placement, or program to seek any pre-authorization, pre-certification, or referral required under the terms of the policy. The determination of these preservice claims for court-ordered services for a minor shall be made as soon as possible, taking into account the medical exigencies, but in no event later than 48 hours after receipt of the request and sufficient information, unless the claimant or claimant's representative fails to provide sufficient information to determine whether, or to what extent, benefits are covered or payable. In the case of such failure, the insurer shall notify the claimant or claimant's representative within 24 hours of receipt of the request and shall advise the claimant or claimant's representative of the specific information necessary to determine to what extent benefits are covered or payable. The claimant or claimant's representative shall be afforded a reasonable amount of time, taking into account the circumstances, but not less than 48 hours, to provide the specified information. Thereafter, notification of the claim determination shall be made as soon as possible, but in no case later than 48 hours after the earlier of:

Copy link

The insurer's receipt of the specified additional information; or

Copy link

II.

The end of the period afforded the claimant or claimant's representative to provide the specified additional information. Source. 2004, 117:4, eff. Aug. 15, 2004.

Copy link

Source note

Source. 2004, 117:4, eff. Aug. 15, 2004.

Source history

2004, 117:4, eff. Aug. 15, 2004

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