Assembly limits co‑payments for physical and occupational therapy in insurance plans
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Summary
A bill that caps physical and occupational therapy co‑payments at primary‑care copay plus 25% passed the Assembly; sponsors argued it would keep rehab affordable while opponents warned of premium effects and urged DFS oversight.
The Assembly approved A.6484‑A on March 24, a measure that limits co‑payments for physical and occupational therapy services to the primary‑care co‑payment plus 25 percent.
Sponsor Assemblymember Weprin (label 16) said specialty co‑pay rates for therapy can make prolonged rehabilitation unaffordable, and the bill would keep therapy accessible. Members asked whether existing Affordable Care Act and state caps on out‑of‑pocket expenses already address this and whether the change might shift costs into premiums.
Weprin said the intent is to improve access without materially affecting premiums and noted Department of Financial Services oversight of cost‑sharing arrangements. The bill will take effect January 1, 2027. The Assembly recorded Ayes 135, Nays 7.
What happens next: insurers and DFS will review plan designs to implement the new co‑payment limits before the effective date.
