Senate Bill S964

2019-2020 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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2019-S964 (ACTIVE) - Details

See other versions of this Bill:
A3757 ,
S5760 ,
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
2017-2018: S2134, A298
2021-2022: S3569

2019-S964 (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.

2019-S964 (ACTIVE) - Sponsor Memo

2019-S964 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    964
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                              January 9, 2019
                                ___________
 
 Introduced  by Sens. YOUNG, ADDABBO, KAMINSKY, KENNEDY -- 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.

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD00572-01-9

              

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