Senate Bill S2134

2017-2018 Legislative Session

Expands health insurance coverage of physical and occupational therapy services

download bill text pdf

Sponsored By

Archive: Last Bill Status - In Senate Committee Insurance Committee


  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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2017-S2134 (ACTIVE) - Details

See Assembly Version of this Bill:
A298
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3235-a, 4235, 4301, 4322, 4803, 4901, 4902 & 4905, Ins L; amd §§4406-d, 4901, 4902 & 4905, Pub Health L
Versions Introduced in Other Legislative Sessions:
2015-2016: A9384
2019-2020: S964, S5760, A3757
2021-2022: S3569

2017-S2134 (ACTIVE) - Summary

Expands health insurance coverage of physical and occupational therapy services by limiting co-payments and regulating visit limitations; expands coverage of early intervention services; expands utilization review of health insurance coverage for medically necessary care.

2017-S2134 (ACTIVE) - Sponsor Memo

2017-S2134 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2134
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                             January 12, 2017
                                ___________
 
 Introduced  by  Sen.  YOUNG  -- 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  health  insurance
   coverage of physical and occupational therapy services and payment for
   early  intervention  services;  and to amend the insurance law and the
   public health law, in relation to the provision of medically necessary
   care and utilization review
 
   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, FURTHER, THAT SUCH TERMS SHALL NOT IMPOSE CO-PAYMENTS  IN
 EXCESS  OF  TWENTY PERCENT OF THE TOTAL REIMBURSEMENT TO THE PROVIDER OF
 CARE. VISIT LIMITS FOR PHYSICAL AND OCCUPATIONAL THERAPY SERVICES  SHALL
 BE  SUBJECT  TO  AN EXCEPTIONS PROCESS, THAT SHALL INCLUDE THE INSURED'S
 PHYSICIAN CERTIFYING THAT THE CESSATION OF SERVICES  WOULD  MOST  LIKELY
 RESULT  IN  FURTHER  DISABILITY  OR  HARM TO THE INSURED. ANY EXCEPTIONS
 PROCESS SHALL BE FURTHER DETERMINED BY THE SUPERINTENDENT.
   § 2. Subsection (b) of section 3235-a of the insurance law,  as  added
 by  section  3 of part C of chapter 1 of the laws of 2002, is amended to
 read as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

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