HB 440 Pennsylvania House · 2025-2026 Regular Session

An Act amending the act of June 13, 1967 (P.L.31, No.21), known as the Human Services Code, in public assistance, providing for prohibition on medical assistance managed care payment for provider-preventable conditions.

HB 440 prohibits Pennsylvania's Medicaid managed care organizations from paying for "provider-preventable conditions" as defined by federal regulations. This directly affects Medicaid managed care plans (like those providing physical or behavioral health services) and healthcare providers who cause these avoidable errors. The bill adopts federal standards, requiring conditions to meet specific criteria: they must be reasonably preventable through evidence-based guidelines, cause patient harm, be auditable, and include examples like wrong-site surgeries, wrong-patient procedures, or incorrect invasive treatments. The law takes effect 60 days after enactment, changing payment rules for these specific preventable incidents.
Bill status in committee 1 of 4 stages cleared
Introduction
Jan 2025
Committee Review
Floor Vote
Governor
Introduced Jan 31, 2025 Last action Jan 31, 2025
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Total actions
1
Key actions
0
Committee
1
Jan 31, 2025
Committee
Referred to Human Services
lower
1 primary · 2 co-sponsors

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