senate Bill S5764A

2017-2018 Legislative Session

Provides that no policy of group accident, group health or group accident and health shall impose copayments for physical or occupational therapy greater than copays for similar services provided by a physician

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Archive: Last Bill Status - In Senate Committee 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 03, 2018 referred to insurance
May 09, 2017 print number 5764a
May 09, 2017 amend and recommit to insurance
Apr 28, 2017 referred to insurance

S5764 (ACTIVE) - Details

See Assembly Version of this Bill:
A569
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 4235, 4301 & 4322, Ins L
Versions Introduced in Other Legislative Sessions:
2009-2010: S4321, A8171
2011-2012: S4870, A187
2013-2014: S2319, A1666
2015-2016: S28, A1063
2019-2020: S3751, A405

S5764 (ACTIVE) - Summary

Provides that no policy of group accident, group health or group accident and health shall impose copayments for physical or occupational therapy greater than the copay for similar services provided by a physician.

S5764 (ACTIVE) - Sponsor Memo

S5764 (ACTIVE) - Bill Text download pdf


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

                                  5764

                       2017-2018 Regular Sessions

                            I N  S E N A T E

                             April 28, 2017
                               ___________

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  OR
DIFFERENT  DEDUCTIBLES, CO-PAYMENTS OR CO-INSURANCE AMOUNTS ON THE BASIS
OF THE SETTING IN WHICH SUCH PHYSICAL THERAPY SERVICES ARE  RENDERED  OR
WHETHER THE SERVICES ARE PERFORMED BY A PHYSICAL THERAPIST OR PHYSICIAN.
  § 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
and occupational therapists upon  the  prescription  or  referral  of  a

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

Co-Sponsors

view additional co-sponsors

S5764A (ACTIVE) - Details

See Assembly Version of this Bill:
A569
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 4235, 4301 & 4322, Ins L
Versions Introduced in Other Legislative Sessions:
2009-2010: S4321, A8171
2011-2012: S4870, A187
2013-2014: S2319, A1666
2015-2016: S28, A1063
2019-2020: S3751, A405

S5764A (ACTIVE) - Summary

Provides that no policy of group accident, group health or group accident and health shall impose copayments for physical or occupational therapy greater than the copay for similar services provided by a physician.

S5764A (ACTIVE) - Sponsor Memo

S5764A (ACTIVE) - Bill Text download pdf


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

                                 5764--A

                       2017-2018 Regular Sessions

                            I N  S E N A T E

                             April 28, 2017
                               ___________

Introduced  by  Sen.  DeFRANCISCO -- read twice and ordered printed, and
  when printed to be committed to the Committee on Insurance --  commit-
  tee  discharged, bill amended, ordered reprinted as amended and recom-
  mitted 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.    AN  INSURER  SHALL NOT IMPOSE A COPAYMENT OR COINSURANCE AMOUNT
CHARGED TO THE INSURED FOR SERVICES RENDERED FOR EACH DATE OF SERVICE BY
A PHYSICAL THERAPIST LICENSED UNDER ARTICLE ONE  HUNDRED  THIRTY-SIX  OF
THE  EDUCATION  LAW  OR AN OCCUPATIONAL THERAPIST LICENSED UNDER ARTICLE
ONE HUNDRED FIFTY-SIX OF THE EDUCATION LAW  THAT  IS  GREATER  THAN  THE
COPAYMENT  OR  COINSURANCE  AMOUNT  IMPOSED  ON THE INSURED FOR SERVICES
PROVIDED TO THE INSURED FOR  AN  OFFICE  VISIT  FOR  THE  SERVICE  OF  A
LICENSED  PRIMARY  CARE PHYSICIAN OR OSTEOPATH FOR THE SAME OR A SIMILAR
DIAGNOSED CONDITION EVEN IF A DIFFERENT NOMENCLATURE IS USED TO DESCRIBE
THE CONDITION FOR WHICH THE SERVICES ARE PROVIDED.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01314-02-7

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