HB 3695
AN ACT relating to copayments required by a health maintenance
89th Regular Session
Jan 14, 2025 - Jun 2, 2025 • Session ended
Awaiting Committee Assignment
Bill filed, pending referral to House committee
Committee
Not yet assigned
Fiscal Note
Not available
What This Bill Does
Prevents health insurance plans from charging higher copayments for physical therapist visits compared to primary care physician visits when no referral is required. It applies to health maintenance organizations and preferred provider benefit plans, ensuring patients will pay the same copayment rate for direct physical therapy visits as they would for standard primary care appointments. The legislation aims to make physical therapy more accessible and affordable by removing financial barriers to treatment.
Subject Areas
Bill Text
relating to copayments required by a health maintenance organization or preferred provider benefit plan for visiting BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Subchapter F, Chapter 843, Insurance Code, is amended by adding Section 843.212 to read as follows: Sec. 843.212. PHYSICAL THERAPIST COPAYMENT LIMIT. A health care plan that requires an enrollee to pay a copayment for an office visit with the enrollee's primary care physician or provider may not charge a higher copayment amount to that enrollee for an office visit with a physical therapist if that visit did not require a referral from a physician or provider. SECTION 2. Subchapter D, Chapter 1301, Insurance Code, is amended by adding Section 1301.167 to read as follows: Sec. 1301.167. PHYSICAL THERAPIST COPAYMENT LIMIT. A preferred provider benefit plan that requires an insured to pay a copayment for an office visit with the insured's primary care physician or provider may not charge a higher copayment amount to that insured for an office visit with a physical therapist if that visit did not require a referral from a physician or health care SECTION 3. The changes in law made by this Act apply only to a health benefit plan delivered, issued for delivery, or renewed on SECTION 4. This Act takes effect September 1, 2025.
Bill History
Bill filed: AN ACT relating to copayments required by a health maintenance
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