EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb0725*
SENATE BILL 725
J5, J4 2lr2237
CF 2lr1861
By: Senator McCray
Introduced and read first time: February 7, 2022
Assigned to: Finance
A BILL ENTITLED
AN ACT concerning 1
Health Insurance – Physical Therapy – Copayments, Coinsurance, and 2
Deductibles 3
FOR the purpose of prohibiting insurers, nonprofit health service plans, and health 4
maintenance organizations from imposing a copayment, coinsurance, or deductible 5
for covered physical therapy services that is greater than the copayment, 6
coinsurance, or deductible imposed for a primary care visit under the same plan or 7
contract; requiring insurers, nonprofit health service plans, and health maintenance 8
organizations to state in each plan or contract the coverage requirements, 9
limitations, conditions, and exclusions for the provision of physical therapy services; 10
and generally relating to health insurance and physical therapy services. 11
BY adding to 12
Article – Insurance 13
Section 15–856 14
Annotated Code of Maryland 15
(2017 Replacement Volume and 2021 Supplement) 16
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 17
That the Laws of Maryland read as follows: 18
Article – Insurance 19
15–856. 20
(A) IN THIS SECTION, “PHYSICAL THERAPY SER VICES” MEANS SERVICES 21
PROVIDED TO A PATIEN T WITHIN THE SCOPE O F PRACTICE OF A PHYS ICAL 22
THERAPIST WHO IS LIC ENSED BY THE STATE BOARD OF PHYSICAL THERAPY 23
EXAMINERS TO PRACTICE PHYSICAL THERAPY UND ER THE HEALTH OCCUPATIONS 24
ARTICLE. 25 2 SENATE BILL 725
(B) THIS SECTION APPLIES TO: 1
(1) INSURERS AND NONPROF IT HEALTH SERVICE PL ANS THAT 2
PROVIDE COVERAGE FOR BOTH PHYSICAL THERAP Y AND PRIMARY CARE S ERVICES 3
UNDER INDIVIDUAL , GROUP, OR BLANKET HEALTH IN SURANCE POLICIES OR 4
CONTRACTS THAT ARE I SSUED OR DEL IVERED IN THE STATE; AND 5
(2) HEALTH MAINTENANCE O RGANIZATIONS THAT PR OVIDE 6
COVERAGE FOR BOTH PH YSICAL THERAPY AND P RIMARY CARE SERVICES UNDER 7
INDIVIDUAL OR GROUP CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE. 8
(C) FOR EACH DATE COVERED PHYSICAL THERAPY SERVICES ARE 9
PROVIDED, AN ENTITY SUBJECT TO THIS SECTION MAY NOT IMPOSE A COPAYMENT , 10
COINSURANCE , OR DEDUCTIBLE AMOUNT FOR THE PHYSICAL THE RAPY SERVICES 11
THAT IS GREATER THAN THE COPAYMENT , COINSURANCE , OR DEDUCTIBLE AMOUNT 12
IMPOSED FOR A PRIMAR Y CARE VISIT UNDER THE SA ME PLAN OR CONTRACT . 13
(D) AN ENTITY SUBJECT TO THIS SECTION SHALL C LEARLY STATE IN EACH 14
PLAN OR CONTRACT THE COVERAGE REQUIREMENT S, LIMITATIONS, CONDITIONS, 15
AND EXCLUSIONS FOR T HE PROVISION OF PHYS ICAL THERAPY SERVICE S. 16
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all 17
policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 18
after January 1, 2023. 19
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 20
January 1, 2023. 21