PRINTER'S NO. 3853
No. 2580 Session of 2008
INTRODUCED BY CAPPELLI, DeLUCA, BIANCUCCI AND MICOZZIE,
JUNE 4, 2008
REFERRED TO COMMITTEE ON INSURANCE, JUNE 4, 2008
AN ACT
1 Requiring health insurance policies issued by professional
2 health services plan corporations to reimburse for
3 occupational therapy services provided by licensed
4 occupational therapists.
5 The General Assembly of the Commonwealth of Pennsylvania
6 hereby enacts as follows:
7 Section 1. Short title.
8 This act shall be known and may be cited as the Occupational
9 Therapy Reimbursement Act.
10 Section 2. Definitions.
11 The following words and phrases when used in this act shall
12 have the meanings given to them in this section unless the
13 context clearly indicates otherwise:
14 "Health insurance policy." Any individual or group health
15 insurance policy, subscriber contract, certificate or plan which
16 provides medical or health care coverage which is offered by or
17 is governed under any professional health services plan
18 corporation as defined under 40 Pa.C.S. Ch. 63 (relating to
1 professional health services plan corporations).
2 "Occupational therapy services." The general and usual
3 services rendered and care administered by licensed occupational
4 therapists, as defined as "occupational therapy" under the act
5 of June 15, 1982 (P.L.502, No.140), known as the Occupational
6 Therapy Practice Act.
7 Section 3. Reimbursement for services provided by occupational
8 therapists.
9 (a) Reimbursement.--The insured or any other person covered
10 by a health insurance policy shall be entitled to reimbursement
11 for occupational therapy services.
12 (b) Licensed occupational therapist's rights.-- Whenever
13 occupational therapy services are reimbursed by a professional
14 health services plan corporation, the licensed occupational
15 therapist providing such occupational therapy services shall be
16 granted such rights of participation, plan admission and
17 registration as may be granted by the professional health
18 services plan corporation under 40 Pa.C.S. Ch. 63 (relating to
19 professional health services plan corporations).
20 Section 4. Rules and regulations.
21 The Insurance Commissioner may promulgate such rules and
22 regulations as are deemed necessary for the effective
23 implementation and operation of this act.
24 Section 5. Effective date.
25 This act shall take effect in 60 days.
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