2023 -- H 5012

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LC000322

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2023

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A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES --

PHYSICAL THERAPY COPAY

     

     Introduced By: Representatives Bennett, Baginski, McGaw, Fenton-Fung, Corvese, and
Solomon

     Date Introduced: January 06, 2023

     Referred To: House 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 Insurance

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

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     27-18-91. Physical therapists.

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

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renewed in this state on or after January 1, 2024, shall not impose a copayment, coinsurance, or

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

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

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

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under chapter 37 of title 5.

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

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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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     27-19-83. Physical therapists.

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

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renewed in this state on or after January 1, 2024, shall not impose a copayment, coinsurance, or

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

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

 

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

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under chapter 37 of title 5.

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

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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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     27-20-79. Physical therapists.

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

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renewed in this state on or after January 1, 2024, shall not impose a copayment, coinsurance, or

10

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

11

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

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

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under chapter 37 of title 5.

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

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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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     27-41-96. Physical therapists.

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

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renewed in this state on or after January 1, 2024, shall not impose a copayment, coinsurance, or

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

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

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

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under chapter 37 of title 5.

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

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and all related limitations, conditions, and exclusions.

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     SECTION 5. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES --

PHYSICAL THERAPY COPAY

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

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therapist to the amount authorized for the services of a primary care physician or osteopath.

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     This act would take effect upon passage.

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