What's happening
This bill allows Medicaid patients to receive more than the standard number of therapy visits per year if medically necessary.
Why it matters
Expands access to medically necessary therapy. By allowing a healthcare professional or therapy provider to attest to the need for additional therapy visits, the bill ensures that patients are not arbitrarily limited by annual visit caps if their medical condition requires more care.
Supports patients with complex or chronic conditions. For individuals whose recovery or management of a health condition demands more intensive rehabilitation, this amendment removes a key barrier to ongoing progress, potentially reducing long-term disability or hospitalizations.
Reduces administrative delays. The process of attestation streamlines approval for extra therapy, which may minimize gaps in care and improve health outcomes, especially important for patients at risk of regression without continuous therapy.
Promotes individualized care. Rather than a “one-size-fits-all” limit, the law recognizes that medical necessity varies, empowering practitioners to tailor therapy plans to each patient’s actual needs rather than insurance-imposed maximums.
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Expand Medicaid Therapy Visits
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History
- Referred to ways and means
- Reported referred to ways and means
- Referred to health
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
4846
2019-2020 Regular Sessions
IN ASSEMBLY
February 5, 2019
Introduced by M. of A. BARRETT -- read once and referred to the Committee on Health
AN ACT to amend the social services law, in relation to providing extended speech, physical or occupational therapy under Medicaid
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Paragraph (h) of subdivision 2 of section 365-a of the social services law, as amended by section 5 of part A of chapter 57 of the laws of 2018, is amended to read as follows:
(h) speech therapy, and when provided at the direction of a physician or nurse practitioner, physical therapy including related rehabilitative services and occupational therapy; provided, however, that speech therapy and occupational therapy each shall be limited to coverage of twenty visits per year unless the professional at whose direction the therapy or services are provided or the provider of the therapy or services attests to the medical necessity of additional visits; physical therapy shall be limited to coverage of forty visits per year unless the professional at whose direction the therapy or services are provided or the provider of the therapy or services attests to the medical necessity of additional visits; such limitation shall not apply to persons with developmental disabilities or, notwithstanding any other provision of law to the contrary, to persons with traumatic brain injury;
§ 2. This act shall take effect on the one hundred eightieth day after it shall have become a law; provided that, effective immediately, the addition, amendment, and/or repeal of any rules and regulations necessary to implement the provisions of this act on its effective date are authorized and directed to be completed on or before such effective date.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00472-01-9
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.