Bill > A07472

This bill limits co-payments for physical and occupational therapy services across various types of health insurance policies in New York State. Specifically, the legislation amends multiple sections of the state's insurance law to mandate that insurance policies cannot impose co-payments exceeding 20 percent of the total reimbursement to the healthcare provider for physical and occupational therapy services. The bill applies to individual and group health insurance policies, ensuring that patients seeking therapy from licensed physical or occupational therapists will have consistent and predictable out-of-pocket costs. These services must still be performed pursuant to a medical order or physician prescription, and the existing provisions regarding utilization review remain in place. The new co-payment limit aims to make therapy services more affordable and accessible for patients by preventing insurance companies from imposing higher cost-sharing requirements. The law will take effect 180 days after it is signed, giving insurance providers time to adjust their policies to comply with the new requirements.

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https://www.nysenate.gov/legislation/bills/2025/A7472