This bill mandates that all health insurance plans in the state provide coverage for pelvic health therapy, specifically pelvic-floor physical therapy (PFPT), as a rehabilitative benefit. Insurers are required to cover initial evaluations without prior authorization, allow direct access to PFPT, and ensure that co-pays and deductibles for these services are comparable to those for other physical therapy services. The bill also outlines specific diagnoses for which coverage must be provided, including various forms of urinary and fecal incontinence, pelvic organ prolapse, and pelvic pain syndromes. Additionally, it establishes guidelines for prehabilitation and post-surgical rehabilitation coverage, ensuring that patients receive necessary therapy before and after pelvic surgeries.

Furthermore, the bill requires insurers to report data on PFPT utilization and outcomes to the insurance department and the Department of Health and Human Services, which will publish an annual report evaluating access, utilization, and cost offsets related to PFPT. The insurance department is also authorized to adopt rules regarding provider credentialing and education about the new coverage requirements. The act is set to take effect on July 1, 2027, and while the fiscal impact is currently indeterminable, it may lead to increased insurance premiums and administrative costs for insurers.