HB 1638 · 2026 · House · Commerce and Consumer Affairs Committee
Bypassing insurer step therapy rules
AI-generatedcreating a bypass mechanism for health insurer step therapy protocols when medically necessary.
Creates a mechanism allowing health insurer step therapy protocols to be bypassed when medically necessary.AI-generated
Status
Referred to interim study (House) · March 11, 2026- ✓Introduced
- ✕House
- Senate
- Governor
- Law
Analysis
This bill creates a bypass mechanism for health insurer step therapy protocols when medically necessary.
From the bill's official ANALYSIS section.
In the bill's words
Quoted verbatim from the bill as introduced. Passages chosen from the operative text.Computed by this site
“"Advanced, metastatic cancer" means a cancer that has spread from the primary or original site of the cancer to nearby tissues, lymph nodes, or other areas or parts of the body.”
“Clinical review criteria used to establish a step therapy protocol shall be based on clinical practice guidelines that:”
“In the absence of clinical practice guidelines that satisfy the requirements under RSA 420-J:28, peer-reviewed publications may be used as a substitute.”
“When establishing a step therapy protocol, a utilization review organization shall also take into account the needs of atypical patient populations and diagnoses when establishing clinical review criteria.”
Official record
gc.nh.gov · the authoritative source
Sponsors
- Rep. Wayne MacDonaldRChair· Health, Human Services and Elderly Affairs
- Sen. Kevin AvardRDeputy Majority Whip
- Sen. Cindy RosenwaldDDeputy Democratic Leader
Also: Rep. David LundgrenR, Rep. Julie MilesR, Rep. Mark PearsonR, Rep. Lilli WalshR, Rep. Gary WoodsD
Public testimony
26 signed in online · 6 wrote testimony
92% support8% oppose0% neutral
In their wordsVerbatim, exactly as submitted
“The New Hampshire Medical Society supports HB 1638. While step therapy protocols are designed to standardize care and as cost-containment tools, they often delay patients’ access to the most appropriate care.…”
“Our family knows that health care can’t be one-size-fits-all. Sometimes, waiting to “step” through layers of protocols delays the right treatment. HB 1638 is vital because it allows doctors to bypass step therapy when it’s medically necessary.…”
“My name is Krysten Evans and I am writing in strong support of HB 1638. Step therapy too often forces patients to fail first before they can access the medication their doctor has already determined is medically necessary. It delays care. It prolongs suffering.…”
Verbatim excerpts of submitted testimony, quoted from the testimony tool.
Read the testimony · as of Aug 12, 2026
Votes
yeanay- Feb 18, 2026HouseCommittee report· consent calendar: Refer for Interim Study15–0Overall100% yea
- Mar 11, 2026HouseVoice voteRefer for Interim Studyadopted
Hearings and debates
- Feb 17, 2026Public hearingHouse Commerce and Consumer Affairs2:18:16–2:27:379m 21slocated in the stream transcriptPublic Hearing
- Feb 18, 2026Public hearingHouse Commerce and Consumer AffairsWatchnot located in the transcript — opens the full streamCommittee Report: Refer for Interim Study; Full Committee Work Session; Executive Session
- Mar 11, 2026Floor debateHouse floorWatchnot located in the transcript — opens the full streamRefer for Interim Study — adopted, voice vote
Timestamps locate where this bill is taken up in the chamber's YouTube stream.
Legislative history
- Jan 7, 2026HouseIntroduced 01/07/2026 and referred to Commerce and Consumer Affairs HJ 1 P. 29
- Feb 17, 2026HousePublic Hearing: 02/17/2026 11:00 am GP 159
- Feb 18, 2026HouseFull Committee Work Session: 02/18/2026 10:00 am GP 229
- Feb 18, 2026HouseExecutive Session: 02/18/2026 01:00 pm GP 229
- Feb 18, 2026HouseCommittee Report: Refer for Interim Study 02/18/2026 (Vote 15-0; CC) HC 10 P. 9
- Mar 11, 2026HouseRefer for Interim Study: MA VV 03/11/2026 HJ 7 P. 13
Coverage
No reporting linked yet.
Documents (PDF)
Bill text & amendments link direct to gc.nh.gov; committee reports stream from the state record.