Building on the 2011 successful Kentucky Physical Therapy Association (KPTA) copayment legislation, Dave Pariser, PT, PhD KPTA Legislative Chair and Leigh Ann Thacker, Chapter Lobbyist gave a breakout demonstration at the American Physical Therapy Association (APTA) State Payment and Policy Forum in Austin, Texas on the process physical therapists can follow to successfully implement co-payment legislation in your state.
Here is the actual bill language that KPTA passed in the Kentucky Senate.
Here is how the actual vote went down in Kenucky:
- An insurer shall not impose a copayment or coinsurance amount charged to the insured for services rendered for each date of service by an occupational therapist licensed under KRS Chapter 319A or a physical therapist licensed under KRS Chapter 327 that is greater than the copayment or coinsurance amount charged to the insured for the services of a physician or an osteopath licensed under KRS Chapter 311 for an office visit.
- An insurer shall state clearly the availability of occupational and physical therapy coverage under its plan and all related limitations, conditions, and exclusions.
Date | Venue | Yes | No |
Feb. 23, 2011 | Kentucky Senate | 30 | 6 |
March 13,2011 | Kentucky House | 98 | 0 |
However, when you go to implement YOUR state physical therapy copayment bill the KPTA recommends this ideal language for your state's legislation:
Physical therapists can help move their copayment legislation forward by doing the following:
- An insurer shall not impose a copayment, coinsurance OR DEDUCTIBLE amount charged to the insured for services rendered for each date of service by an occupational therapist licensed under KRS Chapter 319A or a physical therapist licensed under KRS Chapter 327 that is greater than the copayment or coinsurance amount charged to the insured for the services of a PRIMARY CARE physician or an osteopath licensed under KRS Chapter 311 for an office visit.
- An insurer shall state clearly the availability of occupational and physical therapy coverage under its plan and all related limitations, conditions, and exclusions.
- Survey your state membership FIRST to see if MOST of the membership perceive copayment legislation important enough to get behind - believe it or not you may encounter opposition, either overt or covert.
- Collecting copayment information for your patients' PT, MD and medical sub-specialty co-payments.
- Collecting insurance company remisions, especially those amounts that are for $1 or $2.
- Talking to patients and collecting stories about patient hardships related to difficulty accessing necessary physical therapy services due to high co-pays.
- Talking to friends and neighbors about hardships related to difficulty accessing necessary physical therapy services due to high co-pays.
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