BILL ANALYSIS H.B. 625 By: Harris, Cody Insurance Committee Report (Unamended) BACKGROUND AND PURPOSE During the 86th Regular Session, the Texas Legislature enacted legislation providing direct access to physical therapy services, which afforded Texans the ability to see a physical therapist without a referral from a primary care physician. Unfortunately, patients are still paying too much for these services because physical therapists are still categorized as "specialists" and not "primary" providers. H.B. 625 seeks ensure that patients receiving physical therapy services without a referral are not burdened with unnecessarily high copayments. CRIMINAL JUSTICE IMPACT It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision. RULEMAKING AUTHORITY It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution. ANALYSIS H.B. 625 amends the Insurance Code to prohibit a health care plan offered by a health maintenance organization or a preferred provider benefit plan that requires an enrollee or an insured, as applicable, to pay a copayment for an office visit with the enrollee's or the insured's primary care physician or provider from charging a higher copayment amount to that enrollee or insured for an office visit with a physical therapist. The bill applies only to a health benefit plan delivered, issued for delivery, or renewed on or after January 1, 2024. EFFECTIVE DATE September 1, 2023.
BILL ANALYSIS
# BILL ANALYSIS
H.B. 625
By: Harris, Cody
Insurance
Committee Report (Unamended)
H.B. 625
By: Harris, Cody
Insurance
Committee Report (Unamended)
BACKGROUND AND PURPOSE During the 86th Regular Session, the Texas Legislature enacted legislation providing direct access to physical therapy services, which afforded Texans the ability to see a physical therapist without a referral from a primary care physician. Unfortunately, patients are still paying too much for these services because physical therapists are still categorized as "specialists" and not "primary" providers. H.B. 625 seeks ensure that patients receiving physical therapy services without a referral are not burdened with unnecessarily high copayments.
CRIMINAL JUSTICE IMPACT It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.
RULEMAKING AUTHORITY It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.
ANALYSIS H.B. 625 amends the Insurance Code to prohibit a health care plan offered by a health maintenance organization or a preferred provider benefit plan that requires an enrollee or an insured, as applicable, to pay a copayment for an office visit with the enrollee's or the insured's primary care physician or provider from charging a higher copayment amount to that enrollee or insured for an office visit with a physical therapist. The bill applies only to a health benefit plan delivered, issued for delivery, or renewed on or after January 1, 2024.
EFFECTIVE DATE September 1, 2023.
BACKGROUND AND PURPOSE
During the 86th Regular Session, the Texas Legislature enacted legislation providing direct access to physical therapy services, which afforded Texans the ability to see a physical therapist without a referral from a primary care physician. Unfortunately, patients are still paying too much for these services because physical therapists are still categorized as "specialists" and not "primary" providers. H.B. 625 seeks ensure that patients receiving physical therapy services without a referral are not burdened with unnecessarily high copayments.
CRIMINAL JUSTICE IMPACT
It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.
RULEMAKING AUTHORITY
It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.
ANALYSIS
H.B. 625 amends the Insurance Code to prohibit a health care plan offered by a health maintenance organization or a preferred provider benefit plan that requires an enrollee or an insured, as applicable, to pay a copayment for an office visit with the enrollee's or the insured's primary care physician or provider from charging a higher copayment amount to that enrollee or insured for an office visit with a physical therapist. The bill applies only to a health benefit plan delivered, issued for delivery, or renewed on or after January 1, 2024.
EFFECTIVE DATE
September 1, 2023.