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Re: CoPay legislation

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This is the announcement that was sent to members of APTAnj: 

Beginning September 1, Horizon Blue Cross Blue Shield of New Jersey (Horizon)

is decreasing co-payment amounts for physical therapy to a maximum of $30 or

lower for members enrolled in some of Horizon's insured individual, small

employer, midsize standard (51 to 99 employees) and large group accounts.

 

In a letter to providers dated August 16, 2011, Horizon announced that this

change would occur in order to comply with New Jersey's Minimum Standards for

Health, Dental and Prescription Benefits (NJAC 11:22-5.1-11). Please refer to

the 8/16/11 Horizon letter or the July/August 2011 Blue Reviewnewsletter for

more details, such as how to determine the appropriate copayment amount

--OR call  to speak with a Horizon Physician Service

Representative.

 

Bernice Small, PT

Freehold, NJ

________________________________

To: ptmanager

Sent: Friday, August 26, 2011 3:34 PM

Subject: CoPay legislation

 

Does anyone have a copy of the recent copay legislation that went through in

New Jersey.

http://www.apta.org/PTinMotion/NewsNow/2011/8/23/NJBCBS/

The above link is from PT in Motion referencing the legislation, however I

could not find the original legislation from the administrative code link

given. Any help would be appreciated as we are attempting to get some

forward momentum in Florida regarding the same issue.

Thanks,

Adam Geril PT, DPT, MS,PT,OCS,ATC

Doctor of Physical Therapy

Geril Therapy

4901 East Silver Springs Blvd, Ste 305

Ocala, FL 34470

Office

Fax

Cell

ageril@... email

<http://www.geriltherapy.com> www.geriltherapy.com website

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Adam,

I had to drill down a bit into the New Jersey Administrative Code:

Network copayment shall not be applied to any service or supply to

which network coinsurance is applied.

It appears that Line 1, " Preventative Services " is how Physical Therapy is being

classified in New Jersey.

Perhaps a phone call to New Jersey Chapter President Mason, PT, DPT or to

New Jersey Chapter Payer Relations Specialist Dennis Marco at the APTA-NJ

offices at could better inform the Florida effort.

Tim , PT

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