Bill > S01198

This bill limits co-payments for physical and occupational therapy services across various types of health insurance policies in New York State. Specifically, the bill amends multiple sections of the state insurance law to ensure that insurance policies cannot impose co-payments exceeding 20 percent of the total reimbursement to the healthcare provider for physical and occupational therapy services. These services must be performed by a licensed physical or occupational therapist and typically require a physician's prescription or referral. The changes apply to individual health insurance policies, group health insurance plans, and other types of health coverage. The bill maintains existing requirements for utilization review and medical orders while providing more predictable and potentially more affordable out-of-pocket costs for patients seeking physical and occupational therapy. The provisions will take effect 180 days after the bill becomes law, giving insurance providers time to adjust their policies to comply with the new co-payment limitations.

Business and Industry

https://www.nysenate.gov/legislation/bills/2025/S1198