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Who cares
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Sponsors
16 Co-sponsors
24 Multi-sponsors
- Robert Barra
- Phil Boyle
- Richard Brodsky
- William Colton
- Jane Corwin
- Michael Cusick
- Steven Cymbrowitz
- Joseph Errigo
- Stephen Hawley
- Andrew Hevesi
- Janele Hyer-Spencer
- George Latimer
- Charles Lavine
- Joseph Lentol
- Donna Lupardo
- Margaret Markey
- John McEneny
- Amy Paulin
- Audrey Pheffer
- J. Gary Pretlow
- Andrew Raia
- Teresa Sayward
- Robert Sweeney
- Kenneth Zebrowski
History
- Print number 8171a
- Amend and recommit to insurance
- Referred to insurance
- Referred to insurance
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Prohibits payors from imposing higher co-pays on consumers for physical therapy services on the basis of provider or setting
In Senate Committee · Insurance · Sponsor Neil D. Breslin
Full text
The text isn't available here yet. Check nysenate.gov.
Sponsor's memo
BILL NUMBER:A8171A
Title of bill
An act to amend the insurance law, in relation to physical therapy services
Purpose or general idea of bill
To limit the imposition of co-payments for physical therapy services to no more than twenty percent of the reimbursement to the provider of care.
Summary of provisions
Sections 1 through 5 prohibit payors from imposing costs on insureds for the provision of physical therapy services in excess of 20 percent of the reimbursement to the provider of care.
Section 6. Effective Date.
Justification
This bill will protect consumers by prohibiting plans from inappropriately shifting the cost of physical therapy care to consumers by limiting co-payments to no more than 20 percent of the total reimbursement to the provider of care. Under existing law, health plans must cover physical therapy services. Despite that requirement, health plans have shifted the vast majority ofthe cost of physical therapy services by imposing increasingly high co-payments on consumers. Under certain health plans, co-payments for physical therapy services have exceeded the reimbursement paid by the plan to the provider of care.
This cost shift has imposed a financial burden on consumers, and it has restricted access to physical therapy services. Consumers frequently cannot afford the cost imposed by these copayments for medically necessary physical therapy care. physical therapy services generally require multiple visits over the healing process. A co-payment of $50 for a physical therapy plan of care of 3 times a week for a month will cost the consumer $600 in out-of-pocket expenses which is beyond the means of many consumers. As.a result, New Yorkers are forgoing medically necessary care running the risk of worsening the underlying condition or risking re-injury.
This bill would reestablish the obligation of health plans to cover the expense of physical therapy services by limiting co-payments to no more than twenty percent of the total reimbursement to the provider of care. The 20 percent limitation will allow plans to require co-payments that discourage inappropriate care but will prohibit plans from inappropriately shifting the cost of physical therapy care to consumers.
Prior legislative history
New Bill.
Fiscal implications
None.
Effective date
180 days after it shall have become a law.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.