HB 1445 requires health insurers in Pennsylvania to cover medically necessary health services provided in schools - such as mental health care, behavioral health services, and speech therapy - without denying coverage solely because the service occurs in a school setting. It prohibits insurers from excluding coverage based on location (e.g., through "school setting" or "place of service" exclusions), applying to public, charter, cyber charter, and private schools. Exceptions allow denials if services are provided by unlicensed individuals, are not medically necessary per insurer policies, or conflict with existing legal obligations (like IEPs). This law directly affects students receiving school-based care, insurers, and school entities, ensuring coverage parity for services delivered on school premises.
HB 27 amends the Health Care Facilities Act to require hospitals and surgical clinics to install systems that remove smoke generated during certain medical procedures. This directly affects healthcare facilities performing surgeries where smoke is produced, such as those using lasers or electrosurgery. The bill mandates these evacuation systems as part of facility licensing standards under the existing 1979 law. The change focuses on improving air quality and safety for both patients and medical staff during operations.
HB 1088 amends Pennsylvania's 1921 Insurance Company Law to require casualty insurance policies to cover blood pressure monitors. This directly affects policyholders who rely on these devices for managing health conditions like hypertension, ensuring they are not excluded from standard coverage. The bill adds a specific provision mandating insurers to include blood pressure monitors as covered items under casualty insurance policies. It changes insurer obligations without altering broader policy terms, focusing on making a common medical device accessible through existing insurance frameworks.
HB 282 amends Pennsylvania's Human Services Code (1967) to clarify eligibility rules for individuals receiving medical assistance under public assistance programs. The bill directly affects current and prospective recipients of medical assistance, ensuring consistent application of qualification standards. Key provisions update how eligibility is determined for medical assistance, though specific changes are not detailed in the provided context. The bill passed the House on June 3, 2025, and was referred to the Health & Human Services committee for further review.
HB 1140 requires health insurers and Medicaid/CHIP managed care plans in Pennsylvania to cover all FDA-approved contraceptives - including prescription drugs, devices, emergency contraception (like levonorgestrel), and oral contraceptives - without any out-of-pocket costs for enrollees. It specifically prohibits prior authorization or step therapy for emergency and oral contraceptives, and mandates coverage for sterilization procedures and related services like counseling. The bill directly affects health insurers, managed care plans, and their enrollees by expanding contraceptive coverage under state insurance regulations. It exempts male condoms from coverage requirements but ensures no cost-sharing for covered contraceptive methods.
HB 79 requires hospitals to establish clear financial assistance programs for patients who cannot afford care, including standardized forms and easily accessible information about eligibility and coverage. It mandates that hospitals publicly share details about their financial aid policies and report their program rules to the Department of Health. These requirements directly affect hospitals operating in the state and patients seeking financial help with medical bills. The bill aims to standardize and increase transparency in hospital financial aid offerings.
HB 526 protects mothers' right to breastfeed their children in any public or private location where they are otherwise permitted to be, without being considered indecent exposure, a nuisance, or obscenity. It defines "breastfeeding" to include both direct feeding and expressing milk for bottle-feeding, and creates a private right to sue for violations, allowing recovery of $1,000 per incident plus attorney fees. The law applies broadly across Pennsylvania, ensuring mothers can feed their children without legal interference while maintaining existing protections from the repealed 2007 Freedom to Breastfeed Act.
HB 535 bans Pennsylvania health insurers from setting annual or lifetime dollar limits on core health benefits for enrollees, whether services are provided by in-network or out-of-network providers. It applies to all individual and group health insurance policies (excluding specific types like Medicare supplements or dental/vision-only plans) and prohibits limits on benefits that were already covered without such caps in 2025 policies. The Insurance Department can enforce this through fines up to $5,000 per violation (or $10,000 for willful violations), with annual caps of $500,000 for insurers. The law does not require coverage of specific benefits but eliminates existing dollar limit practices for covered services.
HB 618, the Health Insurance Access Protection Act, prohibits health insurers from denying coverage or charging higher premiums based on a person's health condition, including preexisting conditions. This law applies to both individual and group health insurance policies, protecting enrollees and their dependents from discrimination in enrollment or pricing. The Insurance Department and Commissioner are tasked with enforcing these rules, and the bill includes penalties for insurers that violate the prohibitions.
HB 755 requires health insurers in Pennsylvania (excluding grandfathered plans) to cover all preventive health services listed by the Insurance Department without cost-sharing, such as copays or deductibles. This directly affects insurers who must comply with the coverage rules and enrollees who gain access to preventive care like vaccinations and screenings at no extra cost. The bill empowers the Insurance Department to create and update the preventive services list through a public comment process (15+ business days) and enforce compliance with penalties for violations. It aligns with federal preventive care standards but allows Pennsylvania to adjust the list based on public input and evidence-based guidelines.
