Senate Bill S8747

2023-2024 Legislative Session

Limits co-payments for physical and occupational therapy services

download bill text pdf

Sponsored By

Current Bill Status - In Senate Committee Insurance Committee


  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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2023-S8747 (ACTIVE) - Details

See Assembly Version of this Bill:
A5278
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 4235, 4301 & 4322, Ins L

2023-S8747 (ACTIVE) - Summary

Limits co-payments for physical and occupational therapy services.

2023-S8747 (ACTIVE) - Sponsor Memo

2023-S8747 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8747
 
                             I N  S E N A T E
 
                               March 6, 2024
                                ___________
 
 Introduced  by  Sen. ADDABBO -- read twice and ordered printed, and when
   printed to be committed to the Committee on Insurance
 
 AN ACT to amend the insurance  law,  in  relation  to  health  insurance
   coverage of physical and occupational therapy services
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. Paragraph 23 of subsection  (i)  of  section  3216  of  the
 insurance  law,  as added by chapter 593 of the laws of 2000, is amended
 to read as follows:
   (23) If a policy provides for reimbursement for physical  and  occupa-
 tional therapy service which is within the lawful scope of practice of a
 duly  licensed  physical  or occupational therapist, an insured shall be
 entitled to reimbursement for such service whether the said  service  is
 performed  by a physician or through a duly licensed physical or occupa-
 tional therapist, provided however, that nothing contained herein  shall
 be  construed  to  impair any terms of such policy including appropriate
 utilization review and the requirement that said  service  be  performed
 pursuant to a medical order, or a similar or related service of a physi-
 cian, PROVIDED, FURTHER, THAT SUCH TERMS SHALL NOT IMPOSE CO-PAYMENTS IN
 EXCESS  OF  TWENTY PERCENT OF THE TOTAL REIMBURSEMENT TO THE PROVIDER OF
 CARE.
   § 2. Subparagraph (A) of paragraph 1 of subsection (f) of section 4235
 of the insurance law, as amended by chapter 219 of  the  laws  of  2011,
 item  (ii)  as amended by chapter 479 of the laws of 2022, is amended to
 read as follows:
   (A) Any policy of group accident, group health or group  accident  and
 health  insurance  may include provisions for the payment by the insurer
 of benefits for expenses incurred on account  of  hospital,  medical  or
 surgical  care or physical and occupational therapy by licensed physical
 and occupational therapists upon  the  prescription  or  referral  of  a
 physician  for  the  employee  or other member of the insured group, the
 employee's or member's spouse, the employee's or member's child or chil-
 dren, or other persons chiefly dependent upon the employee or member for
 support and maintenance; provided that:
   (i) a policy of hospital,  medical,  surgical,  or  prescription  drug
 expense insurance that provides coverage for children shall provide such
 coverage  to  a married or unmarried child until attainment of age twen-
              

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