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A BILL TO BE ENTITLED
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AN ACT
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relating to copayments required by a health maintenance |
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organization or preferred provider benefit plan for visiting |
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physical therapists. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter F, Chapter 843, Insurance Code, is |
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amended by adding Section 843.212 to read as follows: |
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Sec. 843.212. PHYSICAL THERAPIST COPAYMENT LIMIT. A health |
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care plan that requires an enrollee to pay a copayment for an office |
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visit with the enrollee's primary care physician or provider may |
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not charge a higher copayment amount to that enrollee for an office |
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visit with a physical therapist if that visit did not require a |
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referral from a physician or provider. |
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SECTION 2. Subchapter D, Chapter 1301, Insurance Code, is |
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amended by adding Section 1301.166 to read as follows: |
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Sec. 1301.166. PHYSICAL THERAPIST COPAYMENT LIMIT. A |
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preferred provider benefit plan that requires an insured to pay a |
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copayment for an office visit with the insured's primary care |
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physician or provider may not charge a higher copayment amount to |
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that insured for an office visit with a physical therapist if that |
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visit did not require a referral from a physician or health care |
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provider. |
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SECTION 3. The changes in law made by this Act apply only to |
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a health benefit plan delivered, issued for delivery, or renewed on |
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or after January 1, 2024. |
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SECTION 4. This Act takes effect September 1, 2023. |