Utah 2025 Regular Session

Utah Senate Bill SB0196 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	Enrolled Copy S.B. 196
	1	+	02-04 07:26 1st Sub. (Green) S.B. 196
	2	+	Calvin R. Musselman proposes the following substitute bill:
2	3		1
3	4		Physical Therapist Practice Amendments
4	5		2025 GENERAL SESSION
5	6		STATE OF UTAH
6	7		Chief Sponsor: Calvin R. Musselman
7		-	House Sponsor: ~~Norman K Thurston~~
	8	+	House Sponsor:
8	9		2
9	10
10	11		3
11	12		LONG TITLE
12	13		4
13	14		General Description:
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15	16		This bill addresses physical therapists and primary care providers.
16	17		6
17	18		Highlighted Provisions:
18	19		7
19	20		This bill:
20	21		8
21	22		▸ expands the definition of primary health care to include the services of physical
22	23		9
23	24		therapists;
24	25		10
25	26		▸ recognizes that a health insurance policy has discretion to allow an insured to select a
26	27		11
27	28		physical therapist as the insured's primary care provider for a neuromusculoskeletal
28	29		12
29	30		condition; and
30	31		13
31	32		▸ makes conforming and technical changes.
32	33		14
33	34		Money Appropriated in this Bill:
34	35		15
35	36		None
36	37		16
37	38		Other Special Clauses:
38	39		17
39	40		None
40	41		18
41	42		Utah Code Sections Affected:
42	43		19
43	44		AMENDS:
44	45		20
45	46		26B-4-301, as last amended by Laws of Utah 2024, Chapter 261
46	47		21
47	48		31A-22-624, as last amended by Laws of Utah 2019, Chapter 349
48	49		22
49	50
50	51		23
51	52		Be it enacted by the Legislature of the state of Utah:
52	53		24
53	54		Section 1. Section 26B-4-301 is amended to read:
54	55		25
55	56		26B-4-301 . Definitions.
56	57		26
57	58		As used in this part:
58	59		27
59	60		(1) "Committee" means the Primary Care Grant Committee described in Section 26B-1-410.
60	61		28
61		-	(2) "Community based organization": ~~S.B. 196 Enrolled Copy~~
	62	+	(2) "Community based organization":
62	63		29
63	64		(a) means a private entity; and
	65	+	1st Sub. S.B. 196 1st Sub. (Green) S.B. 196 02-04 07:26
64	66		30
65	67		(b) includes for profit and not for profit entities.
66	68		31
67	69		(3) "Cultural competence" means a set of congruent behaviors, attitudes, and policies that
68	70		32
69	71		come together in a system, agency, or profession and enables that system, agency, or
70	72		33
71	73		profession to work effectively in cross-cultural situations.
72	74		34
73	75		(4) "Emergency medical dispatch center" means a public safety answering point, as defined
74	76		35
75	77		in Section 63H-7a-103, that is designated as an emergency medical dispatch center by
76	78		36
77	79		the office.
78	80		37
79	81		(5) "Health literacy" means the degree to which an individual has the capacity to obtain,
80	82		38
81	83		process, and understand health information and services needed to make appropriate
82	84		39
83	85		health decisions.
84	86		40
85	87		(6) "Institutional capacity" means the ability of a community based organization to
86	88		41
87	89		implement public and private contracts.
88	90		42
89	91		(7) "Medically underserved population" means the population of an urban or rural area or a
90	92		43
91	93		population group that the committee determines has a shortage of primary health care.
92	94		44
93	95		(8) "Office" means the Office of Emergency Medical Services and Preparedness within the
94	96		45
95	97		department.
96	98		46
97	99		(9) "Pregnancy support services" means services that:
98	100		47
99	101		(a) encourage childbirth instead of voluntary termination of pregnancy; and
100	102		48
101	103		(b) assist pregnant women, or women who may become pregnant, to choose childbirth
102	104		49
103	105		whether they intend to parent or select adoption for the child.
104	106		50
105	107		(10) "Primary care grant" means a grant awarded by the department under Subsection
106	108		51
107	109		26B-4-310(1).
108	110		52
109	111		(11)(a) "Primary health care" means:
110	112		53
111	113		(i) basic and general health care services given when a person seeks assistance to
112	114		54
113	115		screen for or to prevent illness and disease, or for simple and common illnesses
114	116		55
115	117		and injuries; and
116	118		56
117	119		(ii) care given for the management of chronic diseases.
118	120		57
119	121		(b) "Primary health care" includes:
120	122		58
121	123		(i) services of physicians, nurses, physician's assistants, physical therapists, and
122	124		59
123	125		dentists licensed to practice in this state under Title 58, Occupations and
124	126		60
125	127		Professions;
126	128		61
127	129		(ii) diagnostic and radiologic services;
128	130		62
129	131		(iii) preventive health services including perinatal services, well-child services, and
130		-	- 2 - Enrolled Copy S.B. 196
131	132		63
132	133		other services that seek to prevent injury, disease, or [its] the consequences of
	134	+	- 2 - 02-04 07:26 1st Sub. (Green) S.B. 196
133	135		64
134	136		injury or disease;
135	137		65
136	138		(iv) emergency medical services;
137	139		66
138	140		(v) preventive dental services; and
139	141		67
140	142		(vi) pharmaceutical services.
141	143		68
142	144		Section 2. Section 31A-22-624 is amended to read:
143	145		69
144	146		31A-22-624 . Primary care physician, physician assistant, or physical therapist.
145	147		70
146	148		(1) An accident and health insurance policy that requires an insured to select a primary
147	149		71
148		-	care ~~provider or~~ physician to receive optimum coverage shall permit an insured to select
	150	+	care physician to receive optimum coverage shall permit an insured to select a
149	151		72
150		-	a participating provider who is:
	152	+	participating provider who is:
151	153		73
152	154		[(1) shall permit an insured to select a participating provider who:]
153	155		74
154	156		[(a) is an:]
155	157		75
156	158		[(i)] (a)(i) an obstetrician;
157	159		76
158	160		(ii) a gynecologist;
159	161		77
160	162		(iii) a pediatrician; or
161	163		78
162	164		(iv) a physician assistant who works with a physician:
163	165		79
164	166		(A) providing primary care; or
165	167		80
166	168		(B) described in [Subsections] Subsection (1)(a)(i), (ii), or (iii); and
167	169		81
168	170		(b) [is ]qualified and willing to provide primary care services, as defined by the health
169	171		82
170	172		care plan, as the insured's provider from whom primary care services are received[;] .
171	173		83
172	174		(2) Subject to Subsection (5), an accident and health insurance policy that requires an
173	175		84
174		-	insured to select a primary care ~~provider or~~ physician to receive optimum coverage may
	176	+	insured to select a primary care physician to receive optimum coverage may permit an
175	177		85
176		-	~~permit an~~ insured to select a participating provider who is a physical therapist ~~to provide~~
	178	+	insured to select a participating provider who is a physical therapist, if:
177	179		86
178		-	~~physical therapy services.~~
	180	+	(a) the insurance coverage for which the selection is made is for a neuromusculoskeletal
179	181		87
	182	+	condition; and
	183	+	88
	184	+	(b) the physical therapist meets the requirements of Subsection (1)(b).
	185	+	89
180	186		[(2)] (3) An accident and health insurance policy shall clearly state in literature explaining
181		-	88
	187	+	90
182	188		the policy the [option] options available to insureds under [Subsection (1); and]
183		-	89
	189	+	91
184	190		Subsections (1) and (2).
185		-	90
	191	+	92
186	192		[(3)] (4) An accident and health insurance policy may not impose a higher premium, higher
187		-	91
	193	+	93
188	194		copayment requirement, or any other additional expense on an insured because the
189		-	92
	195	+	94
190	196		insured selected a primary care physician in accordance with [Subsection (1)] this section.
191		-	93
	197	+	95
192	198		(5) Notwithstanding Subsection (2), nothing in this section permits a physical therapist to
193		-	94
	199	+	96
194	200		practice physical therapy outside of the physical therapist's scope of practice under Title
195		-	95
	201	+	97
196	202		58, Chapter 24b, Physical Therapy Practice Act.
197		-	96
	203	+	- 3 - 1st Sub. (Green) S.B. 196 02-04 07:26
	204	+	98
198	205		Section 3. Effective Date.
199		-	- 3 - S.B. 196 Enrolled Copy
200		-	97
	206	+	99
201	207		This bill takes effect on May 7, 2025.
202	208		- 4 -