1 | 1 | | |
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2 | 2 | | |
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3 | 3 | | EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW. |
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4 | 4 | | [Brackets] indicate matter deleted from existing law. |
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5 | 5 | | *hb0974* |
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6 | 6 | | |
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7 | 7 | | HOUSE BILL 974 |
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8 | 8 | | J5, J4 2lr1861 |
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9 | 9 | | CF SB 725 |
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10 | 10 | | By: Delegate Kipke |
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11 | 11 | | Introduced and read first time: February 10, 2022 |
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12 | 12 | | Assigned to: Health and Government Operations |
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13 | 13 | | |
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14 | 14 | | A BILL ENTITLED |
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15 | 15 | | |
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16 | 16 | | AN ACT concerning 1 |
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17 | 17 | | |
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18 | 18 | | Health Insurance – Physical Therapy – Copayments, Coinsurance, and 2 |
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19 | 19 | | Deductibles 3 |
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20 | 20 | | |
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21 | 21 | | FOR the purpose of prohibiting insurers, nonprofit health service plans, and health 4 |
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22 | 22 | | maintenance organizations from imposing a copayment, coinsurance, or deductible 5 |
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23 | 23 | | for covered physical therapy services that is greater than the copayment, 6 |
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24 | 24 | | coinsurance, or deductible imposed for a primary care visit under the same plan or 7 |
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25 | 25 | | contract; requiring insurers, nonprofit health service plans, and health maintenance 8 |
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26 | 26 | | organizations to state in each plan or contract the coverage requirements, 9 |
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27 | 27 | | limitations, conditions, and exclusions for the provision of physical therapy services; 10 |
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28 | 28 | | and generally relating to health insurance and physical therapy services. 11 |
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29 | 29 | | |
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30 | 30 | | BY adding to 12 |
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31 | 31 | | Article – Insurance 13 |
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32 | 32 | | Section 15–856 14 |
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33 | 33 | | Annotated Code of Maryland 15 |
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34 | 34 | | (2017 Replacement Volume and 2021 Supplement) 16 |
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35 | 35 | | |
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36 | 36 | | SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 17 |
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37 | 37 | | That the Laws of Maryland read as follows: 18 |
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38 | 38 | | |
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39 | 39 | | Article – Insurance 19 |
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40 | 40 | | |
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41 | 41 | | 15–856. 20 |
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42 | 42 | | |
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43 | 43 | | (A) IN THIS SECTION , “PHYSICAL THERAPY SER VICES” MEANS SERVICES 21 |
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44 | 44 | | PROVIDED TO A PATIEN T WITHIN THE SCOPE O F PRACTICE OF A PHYSICAL 22 |
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45 | 45 | | THERAPIST WHO IS LIC ENSED BY THE STATE BOARD OF PHYSICAL THERAPY 23 |
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46 | 46 | | EXAMINERS TO PRACTICE PHYSICAL THERAPY UNDER THE HEALTH OCCUPATIONS 24 |
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47 | 47 | | ARTICLE. 25 2 HOUSE BILL 974 |
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48 | 48 | | |
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49 | 49 | | |
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50 | 50 | | |
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51 | 51 | | (B) THIS SECTION APPLIES TO: 1 |
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52 | 52 | | |
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53 | 53 | | (1) INSURERS AND NONPROFI T HEALTH SERVICE PLA NS THAT 2 |
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54 | 54 | | PROVIDE COVERAGE FOR BOTH PH YSICAL THERAPY AND P RIMARY CARE SERVICES 3 |
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55 | 55 | | UNDER INDIVIDUAL, GROUP, OR BLANKET HEALTH INSURANCE POL ICIES OR 4 |
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56 | 56 | | CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE; AND 5 |
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57 | 57 | | |
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58 | 58 | | (2) HEALTH MAINTENANCE O RGANIZATIONS THAT PROVIDE 6 |
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59 | 59 | | COVERAGE FOR BOTH PH YSICAL THERAPY AND P RIMARY CARE SERVICES UNDER 7 |
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60 | 60 | | INDIVIDUAL OR GROUP CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE. 8 |
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61 | 61 | | |
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62 | 62 | | (C) FOR EACH DATE COVERED PHYSICAL THERAPY SERVICES ARE 9 |
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63 | 63 | | PROVIDED, AN ENTITY SUBJECT TO TH IS SECTION MAY NOT IMPOSE A COPAYME NT, 10 |
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64 | 64 | | COINSURANCE , OR DEDUCTIBLE AMOUNT FOR THE PHYSICAL THERAPY SER VICES 11 |
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65 | 65 | | THAT IS GREATER THAN THE COPAYMENT , COINSURANCE , OR DEDUCTIBLE AMOUNT 12 |
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66 | 66 | | IMPOSED FOR A PRIMARY CARE V ISIT UNDER THE SAME PLAN OR CONTRACT . 13 |
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67 | 67 | | |
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68 | 68 | | (D) AN ENTITY SUBJECT TO THIS SECTION SHALL CLEARLY STATE IN EAC H 14 |
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69 | 69 | | PLAN OR CONTRACT THE COVERAGE REQUIREMENTS , LIMITATIONS, CONDITIONS, 15 |
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70 | 70 | | AND EXCLUSIONS FOR THE PROVISION OF PHYSICAL THERAPY SERVICE S. 16 |
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71 | 71 | | |
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72 | 72 | | SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all 17 |
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73 | 73 | | policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 18 |
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74 | 74 | | after January 1, 2023. 19 |
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75 | 75 | | |
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76 | 76 | | SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 20 |
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77 | 77 | | January 1, 2023. 21 |
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