RI H7347

Prohibits health insurers from requiring prior authorization for rehabilitative or habilitative services (including physical therapy) for the first 12 visits of each new episode of care; after 12 visits, prior authorization may not be required more frequently than every 6 visits or every 30 days

Eliminates prior authorization requirements for physical medicine or rehabilitation services for chronic pain patients for the first 90 days following diagnosis to allow nonpharmacologic pain management

Requires health insurers to respond to prior authorization requests within 24 hours; if additional information is needed, insurers must specify requirements within 24 hours and render a decision within 24 hours of receiving that information

Deems prior authorization automatically approved if the insurer fails to respond within required timeframes or if the insurer indicates (orally, online, or in plan documents) that prior authorization is not required

Requires insurers to establish procedures for retroactive authorization of medically necessary services, prohibiting denial of coverage solely for failure to obtain prior authorization if medical necessity can be determined after services are provided; takes effect January 1, 2027