This bill amends the Insurance Company Law of 1921 to mandate that health insurance policies and government programs provide coverage for medically necessary physical therapy, occupational therapy, and speech therapy for individuals under the age of twenty-one. The new section, designated as Section 635.11, specifies that such coverage cannot be subject to deductibles, maximum benefit amounts, or limits on the number of visits, although copayments or coinsurance may apply. Additionally, the bill clarifies that coverage is not contingent upon coordination with individualized education programs, ensuring that therapies can be accessed independently of educational services.

Furthermore, the bill establishes the Children's Therapies Medical Assistance Savings Account within the General Fund, which will receive savings realized by the medical assistance program. These funds are appropriated to the Department of Human Services to enhance access to therapy services for eligible individuals and to increase reimbursement rates for providers. The Department is also tasked with developing a formula to calculate the savings from reduced capitation rates for therapy services. The provisions of this act will take effect 90 days after its passage, with specific implementation timelines based on the filing of health insurance policies.

Statutes/Laws affected:
Printer's No. 2284 (Sep 09, 2025): P.L.682, No.284