The Kentucky Blueprint for Legislative Success

Building on the 2011 successful Kentucky Physical Therapy Association (KPTA) copayment legislation, Dave Pariser, PT, PhD KPTA Legislative Chair and Leigh Ann Thacker, Chapter Lobbyist gave a breakout demonstration at the American Physical Therapy Association (APTA) State Payment and Policy Forum in Austin, Texas on the process physical therapists can follow to successfully implement co-payment legislation in your state.

Here is the actual bill language that KPTA passed in the Kentucky Senate.

1. An insurer shall not impose a copayment or coinsurance amount charged to the insured for services rendered for each date of service by an occupational therapist licensed under KRS Chapter 319A or a physical therapist licensed under KRS Chapter 327 that is greater than the copayment or coinsurance amount charged to the insured for the services of a physician or an osteopath licensed under KRS Chapter 311 for an office visit.
2. An insurer shall state clearly the availability of occupational and physical therapy coverage under its plan and all related limitations, conditions, and exclusions.

Here is how the actual vote went down in Kenucky:

Date	Venue	Yes	No
Feb. 23, 2011	Kentucky Senate	30	6
March 13,2011	Kentucky House	98	0

However, when you go to implement YOUR state physical therapy copayment bill the KPTA recommends this ideal language for your state's legislation: 

1. An insurer shall not impose a copayment, coinsurance OR DEDUCTIBLE amount charged to the insured for services rendered for each date of service by an occupational therapist licensed under KRS Chapter 319A or a physical therapist licensed under KRS Chapter 327 that is greater than the copayment or coinsurance amount charged to the insured for the services of a PRIMARY CARE physician or an osteopath licensed under KRS Chapter 311 for an office visit.
2. An insurer shall state clearly the availability of occupational and physical therapy coverage under its plan and all related limitations, conditions, and exclusions.

Physical therapists can help move their copayment legislation forward by doing the following:

• Survey your state membership FIRST to see if MOST of the membership perceive copayment legislation important enough to get behind - believe it or not you may encounter opposition, either overt or covert.
• Collecting copayment information for your patients' PT, MD and medical sub-specialty co-payments.
• Collecting insurance company remisions, especially those amounts that are for $1 or $2.
• Talking to patients and collecting stories about patient hardships related to difficulty accessing necessary physical therapy services due to high co-pays.
• Talking to friends and neighbors about hardships related to difficulty accessing necessary physical therapy services due to high co-pays.