Limits copays, coinsurance or office deductibles for services of a physical therapist to the amount authorized for the services of a primary care physician or osteopath on or after January 1, 2026.
S0051 would require most individual and group health insurance plans and policies delivered, issued for delivery, or renewed in Rhode Island on or after January 1, 2026, to treat physical therapy cost-sharing the same as primary care cost-sharing. Specifically, the bill prohibits insurers from charging a copayment, coinsurance, or office visit deductible for services provided by a licensed physical therapist that is higher than the amount charged for services from a primary care physician or osteopath. The bill applies this requirement across several insurance categories, including accident and sickness policies, nonprofit hospital service corporations, nonprofit medical service corporations, and health maintenance organizations.
The bill also requires insurers to clearly disclose the availability of physical therapy coverage and any related limitations, conditions, or exclusions. The act would take effect upon passage, but the cost-sharing parity requirement would apply only to plans renewed or issued on or after January 1, 2026. In practical terms, the measure would amend multiple chapters of Rhode Island insurance law to create a uniform rule for physical therapy benefits across regulated health plans.
S0051 would add new sections to four separate insurance chapters in the Rhode Island General Laws, creating a statewide standard for physical therapy cost-sharing in regulated health plans. It would limit out-of-pocket charges for covered physical therapy services to no more than the amount charged for primary care physician or osteopath visits, and it would require clearer insurer disclosure of physical therapy coverage terms. The bill would affect insurers, health plans, and insured patients who use licensed physical therapists, while leaving the underlying coverage decision and plan exclusions otherwise intact.
Based on the bill text and available context, the measure appears to be framed as a consumer- and access-oriented health insurance reform, with no recorded committee debate or votes indicating opposition or controversy. The sponsors include multiple senators, suggesting at least some legislative support for reducing financial barriers to physical therapy. The overall sentiment in the available record is neutral to favorable toward improving affordability and transparency for insured patients seeking physical therapy services.
The main policy issue raised by the bill is whether physical therapy should receive the same cost-sharing treatment as primary care, which could increase insurer costs or affect premium pricing, though no specific objections are recorded in the available materials. Potential points of contention would likely involve insurers and plan administrators concerned about mandated benefit design, while physical therapists and patients would likely support the change because it lowers out-of-pocket costs and may improve access to care. No committee testimony, amendments, or votes are available to show a formal dispute in the legislative record provided.