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Kentucky Co-pay Law 'Victory' for PTs

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Kentucky Gov. Steve Beshear signed legislation March 16 that limits copays for physical therapy and occupational therapy visits.

Senate Bill 112 was sponsored by State Senator Tom Buford (R) and supported by the Kentucky Physical Therapy Association (KPTA) and the Kentucky Occupational Therapy Association.

SB 112 limits a copayment or coinsurance amount for a physical therapist or occupational therapist visit to no greater than the copayment or coinsurance amount charged to a patient for a physician or osteopath office visit.

SB 112 also requires insurers to clearly state the availability of therapies under their plans, and all related limitations.

"The Kentucky Physical Therapy Association pushed hard for this legislation because for too long we saw the detrimental effects that excessively high copays were having on patient care," said Ramona Carper, PT, DPT, president of KPTA. "The financial implication of excessive copay amounts results in disincentives for patients to participate in physical therapy, contributing to a lack of compliance for their care. This can result in significant recurrence and downstream costs including further surgery, imaging, and pharmacy."

Access to physical therapy services was restricted by managed care companies imposing "specialty" copays of $50 and sometimes as high as $75 per physical therapy or occupational therapy visit, according to an APTA release. Since physical therapist services often require multiple visits over an extended period of time, many consumers are forced to pay nearly $600 per month in out-of-pocket expenses to receive physical therapist services, the release states.

"We hope that SB 112 will provide the patients we serve with some financial relief for their copays and allow them to focus on their most important priority -- getting better, faster," Carper said. "We believe that SB 112 will lead to better outcomes as well as increased savings in the long run."

"This truly was a team effort," said Dave Pariser, PT, PhD, legislative chair for KPTA. "Physical therapists, patients, and occupational therapists came together to advocate for this important legislation. It just goes to show what we can accomplish when we put our patients first."


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