Rhode Island House Bill H5082

Rhode Island 2025 Regular Session

• Introduced: 1/16/25
• Refer: 1/16/25

Caption

Limits copays, coinsurance or office deductibles for services of a physical therapist to the amount authorized for the services of a primary care physician or osteopath on or after January 1, 2026.

Impact

This bill will amend existing statutes concerning Accident and Sickness Insurance Policies by establishing clear financial limits on the amount insurers can charge for physical therapy. It will mandate that insurers must explicitly communicate the coverage details—limitations, conditions, and exclusions—related to physical therapy services. If enacted, this would represent a significant change in how physical therapy is covered in insurance policies, potentially encouraging more individuals to seek necessary treatments without the burden of excessive out-of-pocket costs.

Summary

House Bill 5082, introduced in January 2025, seeks to regulate the financial obligations of insured individuals when receiving services from licensed physical therapists. The bill stipulates that, effective January 1, 2026, any individual or group health insurance plan within the state must not impose a copayment, coinsurance, or office visit deductible for physical therapy services that exceeds those required for primary care physician or osteopathic services. This legislative initiative aims to ensure that physical therapy services are more affordable and accessible to insured individuals in Rhode Island, providing parity with primary care services.

Contention

While the bill aims to improve access to healthcare, there may be resistance from insurance providers who might argue that such regulations could impact their cost structures and revenue models. They may express concerns that mandating specific copayment amounts could lead to increased premiums or changes in coverage. Furthermore, discussions around this bill may revolve around the broader implications of healthcare policy changes—balancing cost controls with the need to ensure adequate funding for services like physical therapy, which play an essential role in rehabilitation and health maintenance.