New Hampshire HB 1656: relative to insurance coverage for pelvic health therapy.

Bill Text

HB 1656-FN - AS INTRODUCED

2026 SESSION

 26-3056

 07/08

HOUSE BILL 1656-FN

AN ACT relative to insurance coverage for pelvic health therapy.

SPONSORS: Rep. Beauchemin, Hills. 3; Rep. Colby, Merr. 9; Rep. Lucas, Graf. 7; Rep. Mandelbaum, Rock. 21; Rep. Tellez, Hills. 40; Sen. Perkins Kwoka, Dist 21

COMMITTEE: Commerce and Consumer Affairs

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ANALYSIS

This bill:

 I. Requires insurers to offer pelvic health insurance coverage.

 II. Requires insurers to report on data regarding pelvic health treatment and care.

 III. Requires the insurance department to publish an annual report relative to insurer data concerning pelvic health insurance coverage.

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Explanation: Matter added to current law appears in bold italics.

 Matter removed from current law appears [in brackets and struckthrough.]

 Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

 26-3056

 07/08

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Twenty-Six

AN ACT relative to insurance coverage for pelvic health therapy.

Be it Enacted by the Senate and House of Representatives in General Court convened:

 1 Statement of Findings. The general court hereby finds that:

 I. Pregnancy, childbirth, gynecologic conditions, pelvic surgeries, menopause, and aging commonly cause pelvic-floor dysfunction. 

 II. Conservative pelvic-floor physical therapy (PFPT) and supervised pelvic-floor muscle training (PFMT) are evidence-based first-line treatments that improve symptoms, quality of life, and often reduce need for surgeries related to pelvic-floor dysfunction.

 III. Leading clinical guidelines and recent systematic reviews recommend supervised PFMT programs of approximately 8–12 weeks as a first-line care for stress or mixed urinary incontinence and support PFPT for fecal incontinence, pelvic organ prolapse conservative management, pelvic pain and sexual pain disorders. 

 IV. Coverage expansion for such treatment would promote prevention and speedy recovery, reduces downstream costs, and improves maternal mental health.

 2 New Chapter; Pelvic Health Insurance Coverage. Amend RSA by inserting after chapter 420-Q the following new chapter:

CHAPTER 420-R

PELVIC HEALTH INSURANCE COVERAGE

 420-R:1 Definitions. In this chapter: 

 I. "Pelvic floor physical therapy" means assessment and treatment by a licensed physical therapist or other licensed clinician with pelvic-health training addressing pelvic floor muscle function, bladder/bowel training, manual therapy, biofeedback, therapeutic exercise, education and behavioral interventions.

 II. "Covered diagnoses" means urinary incontinence, fecal incontinence, pelvic organ prolapse, diastasis recti, pelvic girdle pain, dyspareunia, pelvic pain, vulvodynia, rehab after cesarean or vaginal birth, and peri or menopausal pelvic dysfunction.

 III. "Prehabilitation" means targeted pelvic floor physical therapy prior to pelvic surgery to optimize functional status and reduce postoperative morbidity.

 420-R:2 Baseline Coverage. 

 I. Notwithstanding any other provision of law to the contrary, all health insurance plans in this state shall include pelvic-floor physical therapy (PFPT) as a covered rehabilitative benefit. No plan subject to this chapter shall categorically exclude coverage for PFPT.

 II. Initial evaluations shall be covered without prior authorization when ordered by an authorized provider.

 III. Notwithstanding any other provision of law to the contrary, insurers shall allow direct access to pelvic-health physical therapy in compliance with this chapter. 

 IV. Co-pays and deductibles for services under this chapter shall be no less favorable than those for other physical therapy services.

 420-R:3 Diagnosis-Specific Coverage. Insurers shall provide coverage for the following:

 I. Initial assessments and supervised pelvic-floor physical therapy (PFPT) programs for the following diagnoses: 

 (a) Stress urinary incontinence (SUI), urgency urinary incontinence (UUI), and mixed urinary incontinence (MUI); 

 (b) Fecal incontinence; 

 (c) Pelvic organ prolapse (POP); 

 (d) Diastasis recti abdominis (DRA) and abdominal separation-related dysfunction; 

 (e) Pelvic girdle pain;

 (f) Dyspareunia, pelvic pain syndromes, and vulvodynia;

 (g) Rehabilitation after cesarean or vaginal birth, including perineal tear repair follow-ups; and

 (h) Pelvic-floor dysfunction related to menopause.

 II. One initial comprehensive evaluation.

 III. Twelve weeks of supervised PFPT:

 IV. For postpartum patients with perineal tears, immediate postpartum PFPT visits.

 V. Therapeutic exercises, biofeedback, vaginal or rectal manual therapy, myofascial release, neuromuscular retraining, bladder or bowel retraining, behavior modification, educatio