Maryland 2022 Regular Session

Maryland House Bill HB974 Compare Versions

Only one version of the bill is available at this time.
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33 EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
44 [Brackets] indicate matter deleted from existing law.
55 *hb0974*
66
77 HOUSE BILL 974
88 J5, J4 2lr1861
99 CF SB 725
1010 By: Delegate Kipke
1111 Introduced and read first time: February 10, 2022
1212 Assigned to: Health and Government Operations
1313
1414 A BILL ENTITLED
1515
1616 AN ACT concerning 1
1717
1818 Health Insurance – Physical Therapy – Copayments, Coinsurance, and 2
1919 Deductibles 3
2020
2121 FOR the purpose of prohibiting insurers, nonprofit health service plans, and health 4
2222 maintenance organizations from imposing a copayment, coinsurance, or deductible 5
2323 for covered physical therapy services that is greater than the copayment, 6
2424 coinsurance, or deductible imposed for a primary care visit under the same plan or 7
2525 contract; requiring insurers, nonprofit health service plans, and health maintenance 8
2626 organizations to state in each plan or contract the coverage requirements, 9
2727 limitations, conditions, and exclusions for the provision of physical therapy services; 10
2828 and generally relating to health insurance and physical therapy services. 11
2929
3030 BY adding to 12
3131 Article – Insurance 13
3232 Section 15–856 14
3333 Annotated Code of Maryland 15
3434 (2017 Replacement Volume and 2021 Supplement) 16
3535
3636 SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 17
3737 That the Laws of Maryland read as follows: 18
3838
3939 Article – Insurance 19
4040
4141 15–856. 20
4242
4343 (A) IN THIS SECTION , “PHYSICAL THERAPY SER VICES” MEANS SERVICES 21
4444 PROVIDED TO A PATIEN T WITHIN THE SCOPE O F PRACTICE OF A PHYSICAL 22
4545 THERAPIST WHO IS LIC ENSED BY THE STATE BOARD OF PHYSICAL THERAPY 23
4646 EXAMINERS TO PRACTICE PHYSICAL THERAPY UNDER THE HEALTH OCCUPATIONS 24
4747 ARTICLE. 25 2 HOUSE BILL 974
4848
4949
5050
5151 (B) THIS SECTION APPLIES TO: 1
5252
5353 (1) INSURERS AND NONPROFI T HEALTH SERVICE PLA NS THAT 2
5454 PROVIDE COVERAGE FOR BOTH PH YSICAL THERAPY AND P RIMARY CARE SERVICES 3
5555 UNDER INDIVIDUAL, GROUP, OR BLANKET HEALTH INSURANCE POL ICIES OR 4
5656 CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE; AND 5
5757
5858 (2) HEALTH MAINTENANCE O RGANIZATIONS THAT PROVIDE 6
5959 COVERAGE FOR BOTH PH YSICAL THERAPY AND P RIMARY CARE SERVICES UNDER 7
6060 INDIVIDUAL OR GROUP CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE. 8
6161
6262 (C) FOR EACH DATE COVERED PHYSICAL THERAPY SERVICES ARE 9
6363 PROVIDED, AN ENTITY SUBJECT TO TH IS SECTION MAY NOT IMPOSE A COPAYME NT, 10
6464 COINSURANCE , OR DEDUCTIBLE AMOUNT FOR THE PHYSICAL THERAPY SER VICES 11
6565 THAT IS GREATER THAN THE COPAYMENT , COINSURANCE , OR DEDUCTIBLE AMOUNT 12
6666 IMPOSED FOR A PRIMARY CARE V ISIT UNDER THE SAME PLAN OR CONTRACT . 13
6767
6868 (D) AN ENTITY SUBJECT TO THIS SECTION SHALL CLEARLY STATE IN EAC H 14
6969 PLAN OR CONTRACT THE COVERAGE REQUIREMENTS , LIMITATIONS, CONDITIONS, 15
7070 AND EXCLUSIONS FOR THE PROVISION OF PHYSICAL THERAPY SERVICE S. 16
7171
7272 SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all 17
7373 policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 18
7474 after January 1, 2023. 19
7575
7676 SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 20
7777 January 1, 2023. 21