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HB 1680 Needs Your Help!

Posted: April 20, 2016



The major legislative priority of the NH Community Behavioral Health Association in 2016 was reauthorizing the NH Health Protection Program. We are happy to report that HB 1696 was signed into law two weeks ago by Governor Hassan. The community mental health centers are immensely grateful to legislators on both sides of the aisle who supported the bill, particularly Senators Jeb Bradley and Chuck Morse, and Speaker Shawn Jasper. We also want to thank our fellow healthcare advocates and providers for their hard work getting this legislation across the finish line!

But our other 2016 priority needs your help now: HB 1680, extending the suspension of prior authorization requirements for a community mental health program on drugs used to treat mental illness, which is pending in the Senate Health and Human Services Committee. Passage of HB 1680 will ensure that the most severely mentally ill individuals in our state do not experience delays or denials in getting the medications they need. In addition to NHCBHA, HB 1680 is strongly supported by NAMI-NH, the NH Medical Society, and the NH Hospital Association.

Since the State’s Medicaid program went to a managed care model in late 2013, two managed care organizations (MCOs) have made decisions about prescriptions using their own formularies and their own staff. They and the Department of Health and Human Services strongly oppose HB 1680, primarily for financial reasons. In spite of that opposition, HB 1680 passed the House Health and Human Services Committee and the full House unanimously last month.

Last year, the House and Senate passed a law creating a one-year moratorium on the use of prior authorizations for drugs used for severe mental illness. The hope was that consensus could be reached by the CMHCs, the MCOs, and the Department on changes to the prior authorization process before June 2016. However, medical directors at the CMHCs have reported continued problems with prior authorizations, and we have numerous examples of how our consumers have suffered. We need HB 1680 passed to continue the moratorium.

We know that the State has a financial interest in seeing that Medicaid managed care works, and we have worked hard with the State and the MCOs to make that system work as well. But we seriously question the figure of $3 million that the Department of Health and Human Services has used as the fiscal impact of the moratorium on prior authorizations; and we have yet to see specifics about which drugs are included in that figure. We have also pointed out to legislators that the MCOs are not responsible for the costs of NH Hospital, hospital emergency rooms, or jail, when patients are denied their prescriptions and end up there.

The community mental health system is one that has experienced many challenges over the years.  In addition to inadequate fiscal resources, we continue to face significant workforce shortages due to an inability to offer competitive salaries compared to other healthcare providers; fewer medical students choosing psychiatry as their specialty; and the burden of paperwork that comes with being a designated community mental health provider.  The additional workload resulting from an overzealous prior authorization process has only served to delay or deny necessary medications for patients and further reduce our capacity to provide timely access to care because prescribers need to spend more time and effort into advocating for necessary medications for their patients.

Our prescribers have no financial interest in the medications that are prescribed.  They are trying to do what they believe is clinically and ethically best for their patients.  The excess hurdles they are being required to jump over significantly decrease their availability to provide access to care in a system that is already under-resourced.  Passage of HB 1680 will allow prescribers to focus on the provision of quality care to some of our most vulnerable and sickest citizens.

 Please contact your Senators and ask them to vote YES on this critical legislation!

Members of the Senate Health & Human Services Committee representing this region are:

Chairman Sanborn, Sen. Avard, and Sen. Carson

Andy Sanborn  Chairman
Molly Kelly  V Chairman
Kevin Avard
Sharon Carson
Martha Fuller Clark
Contact information for all 24 Senators can be found at:

Thank you!

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