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NY S05045
Bill
Status
2/18/2025
Primary Sponsor
Jamaal Bailey
Click for details
AI Summary
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Caps copayments and coinsurance for physical therapy and occupational therapy services at no more than 25% higher than what the insurer charges for a primary care physician or osteopath office visit for the same or similar condition
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Applies to physical therapists licensed under Article 136 of the education law and occupational therapists licensed under Article 156 of the education law
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Amends multiple sections of the insurance law (sections 3216, 4235, 4301, and 4322) to ensure the copayment cap applies across different types of insurance policies
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Preserves existing requirements that physical and occupational therapy services be performed pursuant to a medical order or physician prescription
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Takes effect January 1, 2027
Legislative Description
Provides that any copayment or coinsurance amount charged by an insurer to the insured for services rendered by a physical therapist or an occupational therapist shall not be more than twenty-five percent greater than the copayment or coinsurance amount imposed for an office visit to a licensed primary care physician or osteopath for the same or a similar diagnosed condition.
Last Action
REFERRED TO INSURANCE
1/7/2026