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High copays for physical therapy services

High copays for physical therapy services

Happy Spring...well sort of for those of us enduring the weather fluctuations upstate New York!  One of the events that occurs every spring is the New York Physical Therapy Association Lobby Day in Albany.  This is an event where physical therapists from around the state meet in Albany with legislators to discuss important legislation related to the practice and delivery of physical therapy services.  This event will take place on May 13 this year.

I posted a blog several months back regarding the problem of high copays for physical therapy services in New York State and the barrier to care that it creates with the consumer assuming the majority of the cost of the episode of care.  The high copay legislation will be a key issue on the legislative agenda this year at lobby day.  The high copay bill has been reintroduced and referred to the insurance committee as of January 2014.  Detailed information can be viewed at www.nypta.org but a summary of this bill is provided below:

“S2319/A1666 Cahill (MS) -- No policy of group accident, group health orgroup accident and health shall impose copayments in excess of 20percent of total reimbursement to the provider of care”

As I mentioned in my previous blog, an episode of physical therapy care often requires multiple sessions lasting many weeks, depending on the condition being treated, in order to achieve maximum benefit.  Physical therapy is classified in the specialist category and as a result the patient is responsible for a large proportion of the cost of treatment, despite the fact that their policy indicates coverage for physical therapy services.  This creates a larger burden of cost to the patient.

The strongest voice to the New York State legislators on this issue is from the consumers of health care services.  You can make a positive impact by letting your legislators know that you support this bill either in writing or by phone.  Its quick and easy to identify who your legislators are by following this link: http://capwiz.com/amerpta/state/main/?state=NY

Please visit www.nypta.org and follow the link to “Stop high copays” for further information.

Andrew J. Opett, PT, DPT, OCS


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