HB 1863 would create a new public health insurance plan, called the Public Option, available to state residents as an alternative to private insurance. It establishes a dedicated Public Option Program Fund to support the plan and requires the Insurance Department to administer the program, including setting up enrollment and oversight. Health insurers would be obligated to participate in the Public Option Program. This bill directly affects residents seeking health coverage and insurers operating in the state.
HB 117 requires insurers to include a clear, separate notice with reimbursement payments for emergency medical services provided by non-network EMS agencies. This notice must explain the service details (date, agency), clarify that the recipient is responsible for the EMS bill, and detail payment options - including whether the insurer already paid the agency or if the recipient owes copays/deductibles. The notice must be printed on red paper with "STOP" in 24-point bold and "Read this notice before depositing payment" in 18-point bold, using at least 10-point font size. The bill directly affects insurers sending such payments and the covered persons receiving them, ensuring transparency about billing responsibilities.
HB 444 requires most health insurance policies covering hospital or medical/surgical services to include coverage for postacute neurorehabilitation following an acquired brain injury. This includes specific therapies like cognitive rehabilitation, neurobehavioral treatment, and community reintegration services, with no arbitrary limits on the number of covered days if medically necessary. Insurers must verify providers are accredited through recognized programs (e.g., Commission on Accreditation of Rehabilitation Facilities) and cannot apply stricter deductibles or copays than other covered benefits. The requirement does not apply to policies like dental, vision, workers’ compensation, or accident-only coverage.
HB 2011 establishes a state program to reimburse Pennsylvania National Guard members for their TRICARE health insurance premiums. This directly affects current and future Pennsylvania National Guard members who pay for TRICARE coverage. The key provision creates a reimbursement mechanism where the state would refund members' monthly TRICARE premiums, reducing their out-of-pocket healthcare costs. The bill amends Pennsylvania's military affairs statutes to implement this financial assistance program.
HB 1828 requires health insurance plans in Pennsylvania to cover all recommended vaccines without requiring patients to pay out-of-pocket costs like copays or deductibles. It directly affects insurance companies by mandating this coverage and patients who rely on insurance for routine immunizations (e.g., childhood vaccines, flu shots). The bill adds penalties for insurers that fail to comply with the coverage requirement. This policy change ensures broader access to vaccines by removing financial barriers under insurance plans.
HB 1802 requires all health insurance policies issued in Pennsylvania to cover FDA-approved COVID-19 vaccines with no cost-sharing for enrollees. This applies to insurers offering policies covering medical care (excluding accident-only, dental, or Medicare supplement plans), and mandates that government programs like Medicaid must also provide this coverage without deductibles, copays, or coinsurance. The bill defines "cost-sharing" to exclude premiums but includes standard out-of-pocket expenses, ensuring vaccines remain fully covered. It takes immediate effect and prevents insurers from reducing or eliminating this coverage for existing policies. This directly affects Pennsylvania residents with health insurance and the insurers providing those plans.
SB 610 requires health insurers in Pennsylvania to protect the confidentiality of health care information for "protected enrolled dependents" (individuals covered under another person's insurance policy). It mandates insurers to provide a standardized form allowing dependents to request confidential communication methods - such as paper mail to a different address, electronic delivery to a new email, or withholding communications - covering specific items like explanations of benefits, appointment details, and claim denials. The bill also requires insurers to implement these requests within three business days and educates providers about dependents' rights. This law directly affects millions of people covered under family health insurance plans who seek privacy for their medical care.
This bill requires Medicaid programs and private health insurance plans to cover bone density screenings, preventive care, and treatments for osteoporosis specifically linked to menopause. It directly affects postmenopausal women, particularly those with low income who rely on Medicaid, by ensuring access to these services without cost barriers. The key provision mandates that both public medical assistance programs and private insurers include these osteoporosis-related services in standard coverage. This expands existing coverage to explicitly address menopause-related bone health needs.
SB 51, the Health Insurance Core Benefits Coverage Act, requires Pennsylvania health insurance companies to cover specific core health benefits in both individual and group plans. It mandates coverage for 10 essential categories, including emergency services, mental health care, prescription drugs, hospitalization, preventive care, and pediatric services (like dental/vision for children). The law ensures plans are at least as comprehensive as those offered in 2018, with the Insurance Department allowed to adjust requirements through regulations. This directly affects insurers and policyholders by standardizing minimum coverage across the state.
HB 1266 requires Pennsylvania hospitals to publicly post detailed pricing information for standard medical services on their websites within six months of the law taking effect. Hospitals must list the full price (gross charge), negotiated prices for each insurance company (with the insurer's name), the minimum and maximum negotiated prices across all insurers, and the cash price for self-pay patients, along with service descriptions and standard billing codes. This transparency requirement applies to all hospitals and hospital systems in Pennsylvania and mandates ongoing disclosure even if federal pricing rules are repealed or no longer enforced.
