2018 -- S 2544

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LC004881

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2018

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A N   A C T

RELATING TO INSURANCE -- PHYSICAL THERAPY COPAY

     

     Introduced By: Senators Pearson, Lombardo, Picard, Seveney, and Satchell

     Date Introduced: March 01, 2018

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness

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Insurance Policies" is hereby amended by adding thereto the following section:

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     27-18-84. Physical therapists.

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     (a) An individual or group health insurance plan or policy delivered, issued for delivery,

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or renewed in this state on or after January 1, 2019, shall not impose a copayment, coinsurance,

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or office visit deductible amount charged to the insured for services rendered by a physical

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therapist licensed under § 5-40-7 that is greater than the copayment, coinsurance or office visit

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deductible amount charged to the insured for the services of a primary care physician or osteopath

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licensed under chapters 36 and 37 of title 5.

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     (b) An insurer shall state clearly the availability of physical therapy coverage under its

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plan and all related limitations, conditions, and exclusions.

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     SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service

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Corporations" is hereby amended by adding thereto the following section:

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     27-19-76. Physical therapists.

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     (a) An individual or group health insurance plan or policy delivered, issued for delivery,

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or renewed in this state on or after January 1, 2019, shall not impose a copayment, coinsurance,

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or office visit deductible amount charged to the insured for services rendered by a physical

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therapist licensed under § 5-40-7 that is greater than the copayment, coinsurance or office visit

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deductible amount charged to the insured for the services of a primary care physician or osteopath

 

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licensed under chapters 36 and 37 of title 5.

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     (b) An insurer shall state clearly the availability of physical therapy coverage under its

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plan and all related limitations, conditions, and exclusions.

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     SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service

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Corporations" is hereby amended by adding thereto the following section:

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     27-20-72. Physical therapists.

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     (a) An individual or group health insurance plan or policy delivered, issued for delivery,

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or renewed in this state on or after January 1, 2019, shall not impose a copayment, coinsurance,

9

or office visit deductible amount charged to the insured for services rendered by a physical

10

therapist licensed under § 5-40-7 that is greater than the copayment, coinsurance or office visit

11

deductible amount charged to the insured for the services of a primary care physician or osteopath

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licensed under chapters 36 and 37 of title 5.

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     (b) An insurer shall state clearly the availability of physical therapy coverage under its

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plan and all related limitations, conditions, and exclusions.

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     SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance

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Organizations" is hereby amended by adding thereto the following section:

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     27-41-89. Physical therapists.

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     (a) An individual or group health insurance plan or policy delivered, issued for delivery,

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or renewed in this state on or after January 1, 2019, shall not impose a copayment, coinsurance,

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or office visit deductible amount charged to the insured for services rendered by a physical

21

therapist licensed under § 5-40-7 that is greater than the copayment, coinsurance or office visit

22

deductible amount charged to the insured for the services of a primary care physician or osteopath

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licensed under chapters 36 and 37 of title 5.

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     (b) An insurer shall state clearly the availability of physical therapy coverage under its

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plan and all related limitations, conditions, and exclusions.

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     SECTION 5. This act shall take effect upon passage.

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LC004881

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- PHYSICAL THERAPY COPAY

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     This act would limit copays, coinsurance or office deductible for services of a physical

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therapist to the amount authorized for medical osteopathic physician office visits.

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     This act would take effect upon passage.

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LC004881

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LC004881 - Page 3 of 3