§ 2621. Physical therapists eligible for compensation from insurance [For application of this section, see 85 Del. Laws, c. 251, § 4].
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/de/title-24/chapter-26-physical-therapy-and-athletic-training/2621·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(a)For purposes of disability insurance, standard health and accident, sickness, and all other such insurance plans, whether or not they are considered insurance policies, and contracts issued by health service corporations and health maintenance organizations, if a physical therapist is authorized by law to perform a particular service, the physical therapist is entitled to compensation for that physical therapist’s services under such plans and contracts, and such plans and contracts are prohibited from placing annual or lifetime numerical limits on physical therapy visits for the treatment of the spine and other neuromusculoskeletal structures, including extremities.
(b)Nothing in this section prevents the operation of reasonable and nondiscriminatory cost containment or managed care provisions, including deductibles, coinsurance, allowable charge limitations, coordination of benefits, and utilization review. Any copayment or coinsurance amount must be equal to or less than 25% of the fee due or to be paid to the physical therapist under the policy, contract, or certificate for the treatment, therapy, or service provided.
(c)The Insurance Commissioner shall issue and administer regulations to aid the administration, effectuation, investigation, and enforcement of this section.