Bill Text: WV HB3534 | 2023 | Regular Session | Introduced
Bill Title: Relating to insurance copayments for certain services
Spectrum: Partisan Bill (Republican 3-0)
Status: (Introduced - Dead) 2023-02-14 - To House Health and Human Resources [HB3534 Detail]
Download: West_Virginia-2023-HB3534-Introduced.html
WEST VIRGINIA LEGISLATURE
2023 REGULAR SESSION
Introduced
House Bill 3534
By Delegates Worrell, Ferrell, and Rohrbach
[Introduced February 14, 2023; Referred
to the Committee on Health and Human Resources then Finance]
A BILL to amend the Code of West Virginia, 1931, as amended, by adding thereto a new section, designated §5-16-7h; to amend said code by adding thereto a new section, designated §33-15-23; to amend said code by adding thereto a new section designated §33-16-19; to amend said code by adding thereto a new section, designated §33-16D-17; to amend said code by adding thereto a new section designated §33-24-7x; to amend said code by adding thereto a new section designated §33-25-8u; and to amend said code by adding thereto a new section designated §33-25A-8x, all relating to prohibiting an insurer from imposing a copayment, for services rendered by a licensed occupational therapist, licensed occupational therapist assistant, licensed speech-language pathologist, licensed speech-language pathologist assistant, licensed physical therapist or a licensed physical therapist assistant, that is more than a copayment imposed for the services of a primary care physician or an osteopathic physician.
Be it enacted by the Legislature of West Virginia:
CHAPTER 5. GENERAL POWERS AND AUTHORITY OF THE GOVERNOR, SECRETARY OF STATE AND ATTORNEY GENERAL; BOARD OF PUBLIC WORKS; MISCELLANEOUS AGENCIES, COMMISSIONS, OFFICES, PROGRAMS, ETC.
ARTICLE 16. WEST VIRGINIA PUBLIC EMPLOYEES INSURANCE ACT.
§5-16-7h. Copayments for certain services.
(a) A policy, provision, contract, plan, or agreement subject to this article may not impose a copayment, coinsurance, or office visit deductible amount charged to the individual participating in or receiving coverage under the policy, provision, contract, plan, or agreement subject to this article for services rendered for each date of service by a licensed occupational therapist, licensed occupational therapist assistant, licensed speech-language pathologist, licensed speech-language pathologist assistant, licensed physical therapist, or a licensed physical therapist assistant that is greater than the copayment, coinsurance, or office visit deductible amount charged to the individual participating in or receiving coverage under the policy, provision, contract, plan, or agreement subject to this article for the services of a primary care physician or an osteopathic physician.
(b) The policy, provision, contract, plan, or agreement shall clearly state the availability of occupational therapy, speech-language therapy and physical therapy coverage and all related limitations, conditions, and exclusions.
CHAPTER 33. INSURANCE.
ARTICLE 15. ACCIDENT AND SICKNESS INSURANCE.
§33-15-23. Copayments for certain services.
(a) A policy, provision, contract, plan, or agreement subject to this article may not impose a copayment, coinsurance, or office visit deductible amount charged to the insured for services rendered for each date of service by a licensed occupational therapist, licensed occupational therapist assistant, licensed speech-language pathologist, licensed speech-language pathologist assistant, licensed physical therapist, or a licensed physical therapist assistant that is greater than the copayment, coinsurance, or office visit deductible amount charged to the insured for the services of a primary care physician or an osteopathic physician.
(b) The policy, provision, contract, plan, or agreement shall clearly state the availability of occupational therapy, speech-language therapy and physical therapy coverage and all related limitations, conditions, and exclusions.
ARTICLE 16. GROUP ACCIDENT AND SICKNESS INSURANCE.
§33-16-19. Copayments for certain services.
(a) A group health plan, health benefit plan or network plan subject to this article may not impose a copayment, coinsurance, or office visit deductible amount charged to the insured for services rendered for each date of service by a licensed occupational therapist, licensed occupational therapist assistant, licensed speech-language pathologist, licensed speech-language pathologist assistant, licensed physical therapist, or a licensed physical therapist assistant that is greater than the copayment, coinsurance, or office visit deductible amount charged to the insured for the services of a primary care physician or an osteopathic physician.
(b) The group health plan, health benefit plan or network plan shall clearly state the availability of occupational therapy, speech-language therapy and physical therapy coverage and all related limitations, conditions, and exclusions.
ARTICLE 16D. MARKETING AND RATE PRACTICES FOR SMALL EMPLOYER ACCIDENT AND SICKNESS INSURANCE POLICIES.
§33-16D-17. Copayments for certain services.
(a) All policies issued pursuant to this article may not impose a copayment, coinsurance, or office visit deductible amount charged to the insured for services rendered for each date of service by a licensed occupational therapist, licensed occupational therapist assistant, licensed speech-language pathologist, licensed speech-language pathologist assistant, licensed physical therapist, or a licensed physical therapist assistant that is greater than the copayment, coinsurance, or office visit deductible amount charged to the insured for the services of a primary care physician or an osteopathic physician.
(b) All policies issued pursuant to this article shall clearly state the availability of occupational therapy, speech-language therapy and physical therapy coverage and all related limitations, conditions, and exclusions.
ARTICLE 24. HOSPITAL SERVICE CORPORATIONS, MEDICAL SERVICE CORPORATIONS, DENTAL SERVICE CORPORATIONS AND HEALTH SERVICE CORPORATIONS.
§33-24-7x. Copayments for certain services.
(a) A policy, provision, contract, plan or agreement subject to this article may not impose a copayment, coinsurance, or office visit deductible amount charged to a subscriber for services rendered for each date of service by a licensed occupational therapist, licensed occupational therapist assistant, licensed speech-language pathologist, licensed speech-language pathologist assistant, licensed physical therapist, or a licensed physical therapist assistant that is greater than the copayment, coinsurance, or office visit deductible amount charged to the subscriber for the services of a primary care physician or an osteopathic physician.
(b) The policy, provision, contract, plan, or agreement shall clearly state the availability of occupational therapy, speech-language therapy and physical therapy coverage and all related limitations, conditions, and exclusions.
ARTICLE 25. HEALTH CARE CORPORATIONS.
§33-25-8u. Copayments for certain services.
(a) A policy, provision, contract, plan, or agreement subject to this article may not impose a copayment, coinsurance, or office visit deductible amount charged to a subscriber or member for services rendered for each date of service by a licensed occupational therapist, licensed occupational therapist assistant, licensed speech-language pathologist, licensed speech-language pathologist assistant, licensed physical therapist, or a licensed physical therapist assistant that is greater than the copayment, coinsurance, or office visit deductible amount charged to the subscriber or member for the services of a primary care physician or an osteopathic physician.
(b) The policy, provision, contract, plan or agreement shall clearly state the availability of occupational therapy, speech-language therapy and physical therapy coverage and all related limitations, conditions, and exclusions.
ARTICLE 25A. HEALTH MAINTENANCE ORGANIZATION ACT.
§33-25A-8x. Copayments for certain services.
(a) A health maintenance organization issuing coverage in this state pursuant to the provisions of this article may not impose a copayment, coinsurance, or office visit deductible amount charged to a subscriber or member for services rendered for each date of service by a licensed occupational therapist, licensed occupational therapist assistant, licensed speech-language pathologist, licensed speech-pathologist assistant, licensed physical therapist, or a licensed physical therapist assistant that is greater than the copayment, coinsurance, or office visit deductible amount charged to the subscriber or member for the services of a primary care physician or an osteopathic physician.
(b) The policy, provision, contract, plan, or agreement subject to this article shall clearly state the availability of occupational therapy, speech-language therapy and physical therapy coverage and all related limitations, conditions, and exclusions.
NOTE: The purpose of this bill is to prohibit an insurer from imposing a copayment for services rendered by a licensed occupational therapist, licensed occupational therapist assistant, licensed speech-language pathologist, licensed speech-language pathologist assistant, licensed physical therapist or a licensed physical therapist assistant that is more than a copayment imposed for the services of a primary care physician or an osteopathic physician.
Strike-throughs indicate language that would be stricken from a heading or the present law and underscoring indicates new language that would be added.
