OLR Bill Analysis

sHB 6546 (as amended by House “A”)*

AN ACT CONCERNING COPAYMENTS FOR PHYSICAL THERAPY SERVICES.

SUMMARY:

This bill prohibits certain health insurance policies from imposing a copayment that is greater than $30 per visit for in-network physical therapy services performed by a state-licensed physical therapist.

The bill applies to individual and group policies delivered, issued, renewed, amended, or continued in Connecticut that cover (1) basic hospital expenses; (2) basic medical-surgical expenses; (3) major medical expenses; or (4) hospital or medical services, including coverage under an HMO plan. Due to the federal Employee Retirement Income Security Act (ERISA), state insurance benefit mandates do not apply to self-insured benefit plans.

*House Amendment “A” changes the permitted maximum copayment for physical therapy services from $25 a week to $30 per visit, limits the requirement to in-network services, and delays the effective date one year from January 1, 2014 to January 1, 2015.

EFFECTIVE DATE: January 1, 2015

COMMITTEE ACTION

Insurance and Real Estate Committee

Joint Favorable Substitute

Yea

18

Nay

0

(03/14/2013)

Appropriations Committee

Joint Favorable

Yea

38

Nay

10

(04/30/2013)