SB 159 – Requires parity between the out-of-pocket expenses charged for physical therapist services and the out-of-pocket expenses charged for similar services provided by primary care physicians

• Sponsor: Schmitt
• LR Number: 0202S.04T
• Committee: Small Business, Insurance and Industry
• Last Action: 6/25/2013 - Signed by Governor
• Journal Page: S2466
• Title: SS SCS SB 159
• Effective Date: August 28, 2013
• House Handler: Scharnhorst

Current Bill Summary

SS/SCS/SB 159 - This act prohibits health carriers from imposing greater copayments or coinsurance percentages to insureds for prescribed covered services provided by a licensed physical therapist than those charged for the same covered services provided by licensed primary care physicians. Under the act, health carriers must clearly state the availability of physical therapy coverage under its plan and all related limitations, conditions, and exclusions.

This act requires the Oversight Division of the Joint Committee on Legislative Research to perform an actuarial analysis of the cost impact of the new mandate. By December 31, 2013, the director of the oversight division shall submit a report of the actuarial findings prescribed by the act to the Speaker, the President Pro Tem, and the chairpersons of both the House and Senate standing committees having jurisdiction over health insurance matters. If the fiscal note cost estimation is less than the cost of an actuarial analysis, the actuarial analysis requirement shall be waived.

This act is similar to HB 30 (2013), SB 687 (2012), and HB 1134 (2012).

STEPHEN WITTE