HB3695 - Relating to copayments required by a health maintenance organization or preferred provider benefit plan for visiting physical therapists.

  89R239 CJD-D     By: Orr, Harris, Howard, Jones of Dallas, H.B. No. 3695       et al.       A BILL TO BE ENTITLED   AN ACT   relating to copayments required by a health maintenance   organization or preferred provider benefit plan for visiting   physical therapists.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Subchapter F, Chapter 843, Insurance Code, is   amended by adding Section 843.212 to read as follows:           Sec.   843.212.     PHYSICAL THERAPIST COPAYMENT LIMIT. A health   care plan that requires an enrollee to pay a copayment for an office   visit with the enrollee's primary care physician or provider may   not charge a higher copayment amount to that enrollee for an office   visit with a physical therapist if that visit did not require a   referral from a physician or provider.          SECTION 2.  Subchapter D, Chapter 1301, Insurance Code, is   amended by adding Section 1301.167 to read as follows:           Sec.   1301.167.     PHYSICAL THERAPIST COPAYMENT LIMIT. A   preferred provider benefit plan that requires an insured to pay a   copayment for an office visit with the insured's primary care   physician or provider may not charge a higher copayment amount to   that insured for an office visit with a physical therapist if that   visit did not require a referral from a physician or health care   provider.          SECTION 3.  The changes in law made by this Act apply only to   a health benefit plan delivered, issued for delivery, or renewed on   or after January 1, 2026.          SECTION 4.  This Act takes effect September 1, 2025.