HB 1848 — An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, providing for coverage for physical therapy, occupational therapy and speech therapy; and establishing the Children's Therapies Medical Assistance Savings Account.

Summary

Expanding Access to Therapies

Bill Text

• Printer's No. 2284 View text Current

AI-generated reading aid from the bill's amendatory text — verify against the official bill.

This bill mandates insurance coverage for physical, occupational, and speech therapy for individuals under 21, establishing a funding mechanism through a designated savings account for medical assistance.

• Section 635.11

  Coverage for Physical Therapy, Occupational Therapy and Speech Therapy.--(a) A health insurance policy or government program shall provide coverage for medically necessary physical therapy, occupational therapy and speech therapy for covered individuals under twenty-one (21) years of age. The following shall apply: (1) Coverage provided under this section may not be subject to any deductible, maximum benefit amount or limit on the number of visits. (2) Coverage provided under this section may be subject to copayments or coinsurance requirements imposed by a health insurance policy or government program for similar coverage under the same health insurance policy. (3) This section shall not be construed as limiting benefits which are otherwise available to an individual under a health insurance policy or government program. (4) This section shall not be construed as requiring coverage by an insurer of any service based solely on its inclusion in an individualized education program. Consistent with Federal or State law and upon consent of the parent or guardian of the covered individual, the physical, occupational or speech therapies available under this section may be coordinated with any service included in an individualized education program. Coverage of physical, occupational or speech therapies shall not be contingent upon a coordination of services with an individualized education program.

  This introduces mandatory coverage for physical, occupational, and speech therapies for minors without limits on visits or maximum benefits.

• Section 635.11

  (b) (1) A restricted account is established within the General Fund to be known as the Children's Therapies Medical Assistance Savings Account. (2) Savings realized by the medical assistance program, as determined under subsection (c), shall be deposited into the account. (3) Money in the account is appropriated to the Department of Human Services on a continuing basis to increase access to physical therapy, occupational therapy and speech therapy services for individuals in the Early Intervention Program or for individuals under twenty-one (21) years of age covered under a government program. (4) Money in the account shall be used by the department to increase reimbursement rates paid to providers of physical therapy, occupational therapy and speech therapy or to offset increased costs in the Children's Health Insurance Program due to expanded coverage required under subsection (a).

  This establishes a designated savings account to fund increased access to therapy services and provider reimbursements.

• Section 635.11

  (c) (1) The Department of Human Services shall, as necessary, develop a formula for calculating savings realized by the medical assistance program due to a decrease in the capitation rate paid to a managed care organization for physical therapy, occupational therapy and speech therapy services for children under twenty-one (21) years of age.

  This requires the Department of Human Services to calculate savings from changes in reimbursement rates and determine funds for the therapy account.

Action History

1. September 09, 2025

   Referred to HUMAN SERVICES, Sept. 9, 2025

Sponsors

• Lisa A. Borowski · Primary
• Tim Brennan · Cosponsor
• Jose Giral · Cosponsor
• Nikki Rivera · Cosponsor
• Benjamin V. Sanchez · Cosponsor
• Brandon J. Markosek · Cosponsor
• Melissa Cerrato · Cosponsor
• Joseph C. Hohenstein · Cosponsor
• Maureen E. Madden · Cosponsor
• Tarah Probst · Cosponsor
• Patrick J. Harkins · Cosponsor
• Melissa L. Shusterman · Cosponsor
• Mandy Steele · Cosponsor
• Heather Boyd · Cosponsor
• Robert Freeman · Cosponsor
• Ben Waxman · Cosponsor
• Johanny Cepeda-Freytiz · Cosponsor
• Dan K. Williams · Cosponsor
• Keith S. Harris · Cosponsor

Subjects