An Act amending the act of December 29, 1972 (P.L.1701, No.364), known as the Health Maintenance Organization Act, further providing for rules and regulations.

This bill amends Pennsylvania's Health Maintenance Organization Act to require health plans to cover basic services when referrals come from direct primary care providers who are not part of the plan's network. It defines direct primary care providers as licensed doctors or advanced practitioners who offer direct care through personal agreements with patients. The rule must be established within one year of the bill's effective date and applies to all health maintenance organizations operating in the state.