Plans could let members pick therapists for therapy services

Insurers whose plans require a primary care provider could let members choose a participating physical therapist for physical therapy or an occupational therapist for occupational therapy. This would apply to accident and sickness insurance policies that require a primary care provider; some policy and coverage types are excluded by state law. The policy would have to clearly explain these choices. It could not charge a higher premium, copayment, or other added expense because of the choice. Therapists would have to stay within their legally allowed work. These rules would apply to policies issued, delivered, amended, or renewed after June 30, 2026.

Health maintenance organizations that require a primary care provider could let members choose a participating physical therapist for physical therapy or an occupational therapist for occupational therapy. This would apply to individual and group HMO contracts that require members to choose a primary care provider. The contract would have to clearly explain these choices. The organization could not charge a higher premium, copayment, or other added expense because of the choice. Therapists would have to stay within their legally allowed work. These rules would apply to individual and group contracts entered into, delivered, amended, or renewed after June 30, 2026.