Chris Dunstan

Dear Representatives I am writing to you as a practicing occupational therapist in New Hampshire to respectfully request your support for legislation that would eliminate preauthorization requirements for outpatient therapy services unless a patient requires more than 8 visits, SB480. SB480 represents an essential step toward ensuring timely, effective, and uninterrupted care for the patients we serve. As healthcare providers, we routinely witness the negative impact that preauthorization requirements have on patient health, safety, and functional outcomes. The administrative burden associated with preauthorization has grown to an unsustainable level for therapy practices across the state: • 40% reported waiting five business days or longer for authorization decisions—delays that directly postpone the start of urgently needed therapy. • As a result, 90% of providers reported delays in treatment initiation. • Most concerning, more than 41% of outpatient therapy practices reported at least one adverse event occurring while a patient awaited preauthorization. • 80% of New Hampshire outpatient therapy practices surveyed reported needing dedicated staff solely to manage preauthorization requests. • Over 97% reported experiencing a moderate to high administrative burden associated with these requirements. These statistics reflect what we see daily: preauthorization processes frequently force patients to delay or abandon treatment, placing them at risk for worsened conditions, avoidable decline in function, unnecessary medical visits, and prolonged recovery. Providers often spend excessive time navigating preauthorization instead of dedicating those hours to direct patient care. This burden is especially challenging for small and rural practices that do not have the administrative infrastructure to absorb these demands. A 8-visit threshold before requiring preauthorization is a reasonable and evidence-informed approach. It balances the need for payer oversight with the clinical reality that timely access to therapy is essential for preventing deterioration, reducing long-term healthcare costs, and supporting patient independence. Early intervention is often the determining factor in whether a patient returns to work, avoids surgery, or remains safe in their home. Passing SB480 would reduce unnecessary administrative barriers, improve patient outcomes, and allow therapists across our state to focus on delivering high-quality, effective care. I urge you to support this legislation and stand with patients and providers who are working to ensure access to timely therapy services. Thank you for your consideration and for your commitment to improving healthcare for the people of New Hampshire. I welcome the opportunity to discuss this further or provide additional information from the clinical perspective. Sincerely, Chris Dunstan Dunstan Pediatric