senate Bill S4870A

2011-2012 Legislative Session

No policy of group accident, group health or group accident and health shall impose copayments in excess of 20 percent of total reimbursement to the provider of care

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Sponsored By

Archive: Last Bill Status - In Senate Insurance Committee


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor

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Actions

view actions (4)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 05, 2012 print number 4870a
Jan 05, 2012 amend and recommit to insurance
Jan 04, 2012 referred to insurance
Apr 27, 2011 referred to insurance

Co-Sponsors

view additional co-sponsors

S4870 - Details

See Assembly Version of this Bill:
A187A
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 4235, 4301 & 4322, Ins L
Versions Introduced in 2009-2010 Legislative Session:
S4321A, A8171A

S4870 - Summary

Provides that no policy of group accident, group health or group accident and health shall impose co-payments in excess of twenty percent of total reimbursement to the provider of care.

S4870 - Sponsor Memo

S4870 - Bill Text download pdf

                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  4870

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             April 27, 2011
                               ___________

Introduced  by  Sen.  DeFRANCISCO -- read twice and ordered printed, and
  when printed to be committed to the Committee on Insurance

AN ACT to amend the insurance  law,  in  relation  to  physical  therapy
  services

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Paragraph 23 of subsection  (i)  of  section  3216  of  the
insurance  law,  as added by chapter 593 of the laws of 2000, is amended
to read as follows:
  (23) If a policy provides for reimbursement for physical  and  occupa-
tional therapy service which is within the lawful scope of practice of a
duly  licensed  physical  or occupational therapist, an insured shall be
entitled to reimbursement for such service whether the said  service  is
performed  by a physician or through a duly licensed physical or occupa-
tional therapist, provided however, that nothing contained herein  shall
be  construed  to  impair any terms of such policy including appropriate
utilization review and the requirement that said  service  be  performed
pursuant to a medical order, or a similar or related service of a physi-
cian  PROVIDED THAT SUCH TERMS SHALL NOT IMPOSE CO-PAYMENTS IN EXCESS OF
TWENTY PERCENT OF THE TOTAL REIMBURSEMENT TO THE PROVIDER OF CARE.
  S 2. Subparagraph (A) of paragraph 1 of subsection (f) of section 4235
of the insurance law, as amended by chapter 240 of the laws of 2009,  is
amended to read as follows:
  (A)  Any  policy of group accident, group health or group accident and
health insurance may include provisions for the payment by  the  insurer
of  benefits  for  expenses  incurred on account of hospital, medical or
surgical care or physical and occupational therapy by licensed  physical
and  occupational  therapists  upon  the  prescription  or referral of a
physician for the employee or other member of  the  insured  group,  his
spouse,  his  child or children, or other persons chiefly dependent upon
him for support and maintenance; provided  that  a  policy  under  which

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00680-01-1

Co-Sponsors

view additional co-sponsors

S4870A (ACTIVE) - Details

See Assembly Version of this Bill:
A187A
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 4235, 4301 & 4322, Ins L
Versions Introduced in 2009-2010 Legislative Session:
S4321A, A8171A

S4870A (ACTIVE) - Summary

Provides that no policy of group accident, group health or group accident and health shall impose co-payments in excess of twenty percent of total reimbursement to the provider of care.

S4870A (ACTIVE) - Sponsor Memo

S4870A (ACTIVE) - Bill Text download pdf

                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 4870--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             April 27, 2011
                               ___________

Introduced  by  Sens.  DeFRANCISCO,  AVELLA,  BRESLIN,  GOLDEN, HUNTLEY,
  LANZA, MAZIARZ -- read twice and ordered printed, and when printed  to
  be  committed  to  the  Committee  on  Insurance -- recommitted to the
  Committee on Insurance in accordance with Senate Rule  6,  sec.  8  --
  committee  discharged,  bill amended, ordered reprinted as amended and
  recommitted to said committee

AN ACT to amend the insurance  law,  in  relation  to  physical  therapy
  services

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Paragraph 23 of subsection  (i)  of  section  3216  of  the
insurance  law,  as added by chapter 593 of the laws of 2000, is amended
to read as follows:
  (23) If a policy provides for reimbursement for physical  and  occupa-
tional therapy service which is within the lawful scope of practice of a
duly  licensed  physical  or occupational therapist, an insured shall be
entitled to reimbursement for such service whether the said  service  is
performed  by a physician or through a duly licensed physical or occupa-
tional therapist, provided however, that nothing contained herein  shall
be  construed  to  impair any terms of such policy including appropriate
utilization review and the requirement that said  service  be  performed
pursuant to a medical order, or a similar or related service of a physi-
cian  PROVIDED THAT SUCH TERMS SHALL NOT IMPOSE CO-PAYMENTS IN EXCESS OF
TWENTY PERCENT OF THE TOTAL REIMBURSEMENT TO THE PROVIDER OF CARE.
  S 2. Subparagraph (A) of paragraph 1 of subsection (f) of section 4235
of the insurance law, as amended by chapter 219 of the laws of 2011,  is
amended to read as follows:
  (A)  Any  policy of group accident, group health or group accident and
health insurance may include provisions for the payment by  the  insurer
of  benefits  for  expenses  incurred on account of hospital, medical or
surgical care or physical and occupational therapy by licensed  physical

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00680-02-2

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