Provides that any copayment or coinsurance amount charged by an insurer to the insured for services rendered by a physical therapist or an occupational therapist shall not be more than twenty-five percent greater than the copayment or coinsurance amount imposed for an office visit to a licensed primary care physician or osteopath for the same or a similar diagnosed condition.
Impact
If enacted, A06484 would significantly impact healthcare policy in New York by ensuring that individuals seeking therapy services are not overburdened by high out-of-pocket costs compared to primary care visits. This legislation may lead to an expected increase in patients seeking such health services, ultimately contributing to better overall health outcomes. The bill is seen as a way to align the cost of therapy with more commonly sought medical care, thus supporting patients in their rehabilitation and recovery processes without financial strain.
Summary
Bill A06484 seeks to amend the New York insurance law concerning the copayment and coinsurance amounts charged by insurers for physical and occupational therapy services. The central tenet of the bill is that the copayment or coinsurance for services rendered by licensed physical or occupational therapists cannot exceed 25% more than what is charged for an office visit to a licensed primary care physician or osteopath under similar circumstances. This provision aims to make physical and occupational therapy more affordable for patients, promoting better access to necessary treatment that may be vital for recovery and health management.
Contention
While the bill has gained support from various stakeholders advocating for patient rights and affordable healthcare, it is not without contention. Critics have raised concerns regarding the potential financial impact on insurance companies and providers. Some argue that limiting the copayment structure might result in insurers adjusting their coverage models or raising premiums in other areas. Furthermore, there are considerations regarding appropriate utilization reviews and how the reimbursement process may be affected by such legislative changes. Thus, the bill has sparked discussions about balancing patient access to care with the financial sustainability of insurance practices.
Same As
Provides that any copayment or coinsurance amount charged by an insurer to the insured for services rendered by a physical therapist or an occupational therapist shall not be more than twenty-five percent greater than the copayment or coinsurance amount imposed for an office visit to a licensed primary care physician or osteopath for the same or a similar diagnosed condition.
Provides that any copayment or coinsurance amount charged by an insurer to the insured for services rendered by a physical therapist or an occupational therapist shall not be more than twenty-five percent greater than the copayment or coinsurance amount imposed for an office visit to a licensed primary care physician or osteopath for the same or a similar diagnosed condition.
Limits copays, coinsurance or office deductibles for services of a physical therapist to the amount authorized for the services of a primary care physician or osteopath on or after January 1, 2026.
Limits copays, coinsurance or office deductibles for services of a physical therapist to the amount authorized for the services of a primary care physician or osteopath on or after January 1, 2026.
Limits copays, coinsurance or office deductibles for services of a physical therapist to the amount authorized for the services of a primary care physician or osteopath on or after January 1, 2027.
Limits copays, coinsurance or office deductibles for services of a physical therapist to the amount authorized for the services of a primary care physician or osteopath on or after January 1, 2027.
Includes physical therapists, physical therapist assistants, occupational therapists, occupational therapy assistants, respiratory therapists, respiratory therapy technicians, and recreational therapists within the existing statutory staffing standards for nursing homes.
Changes the definition of continuous supervision in relation to physical therapist assistants in both the home care setting and school setting by eliminating the joint visit requirement with the patient by the supervising licensed physical therapist and the licensed physical therapist assistant.
Changes the definition of continuous supervision in relation to physical therapist assistants in both the home care setting and school setting by eliminating the joint visit requirement with the patient by the supervising licensed physical therapist and the licensed physical therapist assistant.