Healthcare

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 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 111 prohibits life insurance companies in Pennsylvania from denying coverage, limiting benefits, or charging higher rates to applicants or policyholders solely because they have been prescribed an opioid overdose reversal agent (like naloxone). The bill directly affects individuals who use these medications, including those with opioid use disorder or at risk of overdose. It defines "adverse action" to include these discriminatory practices and makes such actions violations of existing laws against unfair insurance practices. The law takes effect 60 days after enactment.