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South Dakota passes bill capping patients’ copays for physical therapy

On February 27 South Dakota Gov Dennis Daugaard signed House Bill 1183, legislation promoted by the South Dakota Physical Therapy Association (SDPTA) that reduces out-of-pocket expenses for patients.

HB 1183 limits the amount health insurers can charge patients for out-of-pocket copayments or coinsurance fees for physical therapist or occupational therapist visits. After the bill takes effect on July 1, copayment and coinsurance amounts cannot be higher than those charged when a patient visits a primary care physician. State Representative Mark Kirkeby (R) and State Senator Tom Hansen (R) were primary sponsors of the bill.

“Legislators saw that this bill was all about patient access and affordability,” said Ronald Van Dyke, PT, OCS, president of SDPTA. “They wanted to make sure the people of South Dakota could access the physical therapy and occupational therapy care they need at a fair cost.”

Health insurers often categorize physical therapy as a specialty service, and typically require higher copays than those for primary care services. Because physical therapy often requires multiple visits over an extended period, many patients pay hundreds of dollars per month out-of-pocket to get the care they need.

“The idea behind HB 1183 is that through reduction of financial barriers to care patients will be better able to access the care they need and focus on getting better,” said Van Dyke.

“We believe it will also save healthcare dollars in the long run by preventing unnecessary delays in care that might allow a patient’s problem to worsen, requiring higher-cost services like surgery and prescription medica­tion,” he said.

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