House of Representatives

SB 1229

health insurance; physical therapists

(now: physical therapists; insurance)

Sponsors: Senator Cirillo

 

DP

Committee on Financial Institutions and Insurance

DP

Committee on Appropriations

DP

Caucus and COW

X

Third Read

 

 

As Passed the House
 

SB 1229 allows individuals who have medical insurance that provides coverage for physical therapy to obtain services from a physical therapist with the assurance of reimbursement from the insurance carrier.

 

Current Status

SB 1229 passed out of the Appropriations and  Financial Institutions and Insurance Committees unamended.

 

History

In 1983, legislation was passed which removed the requirement for a doctor’s prescription giving physical therapists direct access.  Following that legislation there has been difficulty in the reimbursement process for covered services with regards to physician referrals.  SB 1229 contains provisions similar to Titles 20 and 23 regarding other professions such as psychologists and chiropractors who also have direct access.  If passed, this legislation would prohibit individual and group indemnity insurance contracts, hospital and medical services corporation subscription contracts and workers’ compensation insurance contracts from denying claims for physical therapy based solely on the fact that the insured was not referred by a physician.

 

Provisions

·          Prohibits hospital service corporations, medical service corporations, group disability, or blanket disability insurance providers from denying a claim for covered physical therapy services obtained out of network based solely on the fact that the insured was not referred by a physician.

·          Permits the insurance provider to impose coinsurance, copayments, deductibles, dollar caps, and limitations on the number of visits or other cost containment measures as a condition of physical therapy coverage.

·          Provides an effective date of December 31, 2002. 

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·          45th Legislature                 

·          Second Regular Session      2          April 25, 2002

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