Senate Bill S28A

2015-2016 Legislative Session

Provides that no policy of group accident, group health or group accident and health shall impose copayments in excess of 20 percent of total reimbursement to the provider of care

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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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Bill Amendments

co-Sponsors

2015-S28 - Details

See Assembly Version of this Bill:
A1063
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
2017-2018: S5764, A569
2019-2020: S3751, A405
2021-2022: S3562, A594
2023-2024: S1470, A6345

2015-S28 - Summary

Provides that no policy of group accident, group health or group accident and health shall impose co-payments in excess of twenty percent of total reimbursement to the provider of care.

2015-S28 - Sponsor Memo

2015-S28 - Bill Text download pdf

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

                                   28

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 7, 2015
                               ___________

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.
  S 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
physician for the employee or other member of  the  insured  group,  the
employee's or member's spouse, the employee's or member's child or chil-

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

co-Sponsors

2015-S28A (ACTIVE) - Details

See Assembly Version of this Bill:
A1063
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
2017-2018: S5764, A569
2019-2020: S3751, A405
2021-2022: S3562, A594
2023-2024: S1470, A6345

2015-S28A (ACTIVE) - Summary

Provides that no policy of group accident, group health or group accident and health shall impose co-payments in excess of twenty percent of total reimbursement to the provider of care.

2015-S28A (ACTIVE) - Sponsor Memo

2015-S28A (ACTIVE) - Bill Text download pdf

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

                                  28--A

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 7, 2015
                               ___________

Introduced  by  Sens.  DeFRANCISCO,  AVELLA,  BOYLE, MARCHIONE, MARTINS,
  PANEPINTO, YOUNG -- read twice and ordered printed, and  when  printed
  to be committed to the Committee on Insurance -- committee discharged,
  bill  amended,  ordered  reprinted  as amended and recommitted 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  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.
  S 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:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01104-02-5
              

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