OPTA Introduces HB 547 – Fair Co-pay Legislation

March 10, 2020. Rep. Jeff LaRe (R-77) introduced legislation that would create co-pay parity for physical and occupational therapy services. Currently, insurance carriers classify PTs and OTs as “specialists” and patients are often subjected to higher co-pays than they would be for seeing primary care providers. The goal of the bill is to remove the cost factor in choosing between physical and occupational therapy services or prescription opioids in treating pain management. Allowing therapy to be a more affordable option and removing this barrier to access is one means of addressing the opioid epidemic.

As defined in the bill, cost sharing is an out-of-pocket expense (i.e. copayment, coinsurance, deductible) made by an individual for services rendered by a physical or occupational therapist. Typically, the out-of-pocket expense for this type of therapy falls into the specialist category. The legislation will prohibit the cost sharing requirement for these services to not be greater than the cost sharing requirement for services provided by an individual’s primary care physician.

The OPTA and OOTA believe creating co-pay alignment with that of a primary care physician will allow more Ohioans to access the services of physical and occupational therapists. If passed Ohio would join other states such as Kentucky in enacting this policy.

1) Login at www.ohiopt.org
2) Click on the Advocacy tab
4) Click on HB 547 – Fair Co-Pay 

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We’ll continue to post updates on this legislation, and the PT Compact bill, as information becomes available. Thank you Rep. LaRe for your support of the physical and occupational therapy professions!

For more information, contact Executive Director Victoria Gresh.