New York S 5045: Relates to copayment and coinsurance charged for physical and occupational therapy services

Bill Text

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S05045 Summary:

BILL NOS05045A

&nbsp

SAME ASSAME AS A06484-A

&nbsp

SPONSORBAILEY

&nbsp

COSPNSRASHBY, COMRIE, GALLIVAN, GRIFFO, HELMING, MAY, PARKER, SCARCELLA-SPANTON, SEPULVEDA, STEC

&nbsp

MLTSPNSR

&nbsp

Amd §§3216, 4235, 4301 & 4322, Ins L

&nbsp

Provides that any copayment or coinsurance amount charged by an insurer to the insured for services rendered by a physical therapist or an occupational therapist shall not be more than twenty-five percent greater than the copayment or coinsurance amount imposed for an office visit to a licensed primary care physician or osteopath for the same or a similar diagnosed condition.

Go to top S05045 Actions:

BILL NOS05045A

&nbsp

02/18/2025REFERRED TO INSURANCE

03/24/20251ST REPORT CAL.584

03/25/20252ND REPORT CAL.

03/26/2025ADVANCED TO THIRD READING 

05/19/2025AMENDED ON THIRD READING (T) 5045A

06/13/2025COMMITTED TO RULES

01/07/2026REFERRED TO INSURANCE

04/20/20261ST REPORT CAL.701

04/21/20262ND REPORT CAL.

04/22/2026ADVANCED TO THIRD READING 

05/29/2026SUBSTITUTED BY A6484A

&nbspA06484 AMEND=A Weprin

&nbsp03/05/2025referred to insurance

&nbsp05/05/2025amend (t) and recommit to insurance

&nbsp05/05/2025print number 6484a

&nbsp05/20/2025reported referred to rules

&nbsp06/10/2025reported 

&nbsp06/10/2025rules report cal.569

&nbsp06/10/2025ordered to third reading rules cal.569

&nbsp01/07/2026ordered to third reading cal.161

&nbsp03/25/2026passed assembly

&nbsp03/25/2026delivered to senate

&nbsp03/25/2026REFERRED TO INSURANCE

&nbsp05/29/2026SUBSTITUTED FOR S5045A

&nbsp05/29/20263RD READING CAL.701

&nbsp05/29/2026PASSED SENATE

&nbsp05/29/2026RETURNED TO ASSEMBLY

Go to topS05045 Committee&nbspVotes:

Go to topS05045 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topS05045 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 5045--A
 Cal. No. 584

 2025-2026 Regular Sessions

 IN SENATE

 February 18, 2025
 ___________

 Introduced by Sens. BAILEY, ASHBY, COMRIE, GALLIVAN, GRIFFO, HELMING,
 MAY, PARKER, SEPULVEDA, STEC -- read twice and ordered printed, and
 when printed to be committed to the Committee on Insurance -- reported
 favorably from said committee, ordered to first and second report,
 ordered to a third reading, amended and ordered reprinted, retaining
 its place in the order of third reading

 AN ACT to amend the insurance law, in relation to physical and occupa-
 tional therapy services

 The People of the State of New York, represented in Senate and Assem-
 bly, do enact as follows:

 1 Section 1. Paragraph 23 of subsection (i) of section 3216 of the
 2 insurance law, as added by chapter 593 of the laws of 2000, is amended
 3 to read as follows:
 4 (23) If a policy provides for reimbursement for physical and occupa-
 5 tional therapy service which is within the lawful scope of practice of a
 6 duly licensed physical or occupational therapist, an insured shall be
 7 entitled to reimbursement for such service whether the said service is
 8 performed by a physician or through a duly licensed physical or occupa-
 9 tional therapist, provided however, that nothing contained herein shall
 10 be construed to impair any terms of such policy including appropriate
 11 utilization review and the requirement that said service be performed
 12 pursuant to a medical order, or a similar or related service of a physi-
 13 cian. Any copayment or coinsurance amount charged by an insurer to the
 14 insured for services rendered by a physical therapist licensed under
 15 article one hundred thirty-six of the education law or an occupational
 16 therapist licensed under article one hundred fifty-six of the education
 17 law shall not be more than twenty-five percent greater than the copay-
 18 ment or coinsurance amount imposed for an office visit to a licensed
 19 primary care physician or osteopath for the same or a similar diagnosed
 20 condition.

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD09380-03-5

 S. 5045--A 2

 1 § 2. Subparagraph (A) of paragraph 1 of subsection (f) of section 4235
 2 of the insurance law is amended by adding a new clause (iii) to read as
 3 follows:
 4 (iii) a policy shall not impose a copayment or coins