Healthcare (Insurance)

in committee · Pennsylvania · House Feb 21, 2025

HB 695: An Act providing for vaccination schedule for pediatric patients and for coverage, compensation and reimbursement for vaccinations; and imposing penalties.

HB 695 requires health insurance plans to cover vaccinations administered on schedules chosen by parents or guardians that differ from CDC recommendations, provided at least one vaccine is given annually. It prohibits insurers from offering financial incentives to providers based on per-member vaccination rates. Health care practitioners must continue providing pediatric care for patients on non-CDC schedules and cannot bill for discussions about alternative schedules. Violations by practitioners could result in disciplinary action from their licensing board.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for non-CDC vaccination schedules, expands patient choice, prohibits financial incentives limiting provider options, and protects access to pediatric care on alternative schedules.95% confidence

Sub-Topics Children's Health Insurance Medical Licensing

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in committee · Pennsylvania · Senate Sep 4, 2025

SB 989: An Act amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, providing for immunization coverage; and imposing penalties.

SB 989 would require health insurance plans in Pennsylvania to cover immunizations (such as vaccines) without out-of-pocket costs for policyholders. The bill applies to all health insurance providers operating in the state and mandates that they include immunization coverage in their plans. It also imposes penalties on insurers that fail to provide this coverage. This change would directly affect insurance companies and ensure Pennsylvanians with health insurance have guaranteed access to immunization services.

Topics ✓ HealthcareSupports HealthcareMandates no-cost vaccine coverage in insurance plans, removing financial barriers and expanding access to preventive healthcare services.95% confidence

Sub-Topics Insurance

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in committee · Pennsylvania · House Oct 29, 2025

HB 305: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, providing for coverage for insulin.

HB 305 requires health insurance policies to cover insulin, directly affecting people with diabetes who rely on this medication. It amends the 1921 Insurance Company Law to mandate that casualty insurance plans include insulin coverage without excessive cost-sharing. The key provision eliminates gaps where insulin might previously have been excluded or subject to high out-of-pocket costs. This policy change applies to all insurers offering casualty coverage under the amended law. The bill is currently pending before the Insurance committee.

Topics ✓ HealthcareSupports HealthcareMandates insulin coverage in insurance policies, eliminating cost barriers for diabetes patients, directly expanding essential medication access under healthcare coverage.95% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · Pennsylvania · House Mar 17, 2025

HR 124: A Resolution designating the month of September 2025 as "Prostate Cancer Awareness Month" in Pennsylvania.

This resolution designates September 2025 as "Prostate Cancer Awareness Month" in Pennsylvania. It symbolically raises public attention to prostate cancer, highlighting statistics like an estimated 13,000 new cases and 1,500 deaths in Pennsylvania during 2025. The resolution also urges Congress to support federal legislation (H.R. 1300) that would require health insurance coverage for prostate cancer screenings without cost-sharing for at-risk men. It does not create new laws or funding but aims to promote awareness and encourage preventive care.

Topics ✓ HealthcareSupports HealthcareUrges support for H.R. 1300 requiring insurance coverage of prostate cancer screenings without cost-sharing, expanding patient access to preventive care.92% confidence

Sub-Topics Insurance Primary Care

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in committee · Pennsylvania · House May 5, 2025

HB 1391: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, providing for reimbursement for custom-fabricated devices, custom-fitted devices, orthosis, orthotics, over-the-counter prostheses, orthoses and pedorthic devices, prefabricated orthoses, prostheses, prosthetics and components of such devices.

House Bill 1391 amends The Insurance Company Law of 1921 to mandate that individual and group health insurance policies provide coverage for various custom-fabricated, custom-fitted, orthotic, prosthetic, and pedorthic devices. This applies when these devices are prescribed by an authorized medical professional, directly affecting individuals who require such medical aids and the health insurance companies providing their coverage. The bill requires coverage for the fitting, repair, or replacement of these devices, including those used for recreational, organized, or adaptive sports, and allows insurers to require preauthorization while applying standard cost-sharing. Additionally, Medicaid and contracted insurers would reimburse for these devices at Federal Medicare rates.

Topics ✓ HealthcareSupports HealthcareMandates health insurance coverage for prescribed medical devices, expanding patient access to essential orthotics/prosthetics under healthcare policy.95% confidence

Sub-Topics Insurance Medicaid Medicare

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in committee · Pennsylvania · House Mar 19, 2025

HB 966: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in quality health care accountability and protection, further providing for departmental powers and duties and providing for additional penalties.

HB 966 amends Pennsylvania's Insurance Company Law of 1921 to strengthen consumer protections in health insurance. It requires insurance companies to pay penalties if over 50% of their denied health claims (excluding administrative denials) are later overturned through internal or external review processes. Penalties start at $50,000 for the first overturned claim and increase to $250,000 per claim for subsequent violations. Collected penalties must fund consumer protection activities, in addition to any other existing penalties. This directly affects health insurers operating in Pennsylvania.

Topics ✓ HealthcareSupports HealthcareStrengthens consumer protections in health insurance by penalizing insurers for unjust claim denials, funding consumer protection activities per bill summary.95% confidence

Sub-Topics Insurance

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in committee · Pennsylvania · House Apr 4, 2025

HB 1152: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, further providing for billing.

HB 1152 requires insurance companies to directly reimburse non-network emergency medical services (EMS) agencies for 911 emergency calls within 45 days at 350% of the Medicare ambulance rate for the same service in the same area. EMS agencies must register with the state annually to qualify for direct payments, and insurers cannot demand contracts to facilitate this reimbursement. The insurer's payment covers the full service cost (excluding the patient's copay, coinsurance, or deductible), so EMS agencies cannot bill patients for the remaining amount. This law applies only to non-network EMS providers offering 911 emergency medical services, unless preempted by federal law.

Topics ✓ HealthcareSupports HealthcareMandates insurers to reimburse non-network EMS at 350% of Medicare rate within 45 days, ensuring emergency service coverage without patient cost shifting, strengthening access to critical healthcare services.95% confidence

Sub-Topics Insurance Medicare

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passed · Pennsylvania · House Mar 25, 2025

HB 755: An Act providing for health care insurance preventive services coverage protections; conferring authority on the Insurance Department and the Insurance Commissioner; and providing for regulations, for enforcement and for penalties.

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.

Topics ✓ HealthcareSupports HealthcareMandates insurers to cover preventive services without cost-sharing, expanding access to vaccinations and screenings at no extra cost.95% confidence

Sub-Topics Insurance Primary Care

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in committee · Pennsylvania · Senate Jun 24, 2025

SB 884: An Act amending the act of March 20, 2002 (P.L.154, No.13), known as the Medical Care Availability and Reduction of Error (Mcare) Act, in insurance, prohibiting certain adverse actions against legal reproductive health care.

SB 884 amends Pennsylvania's MCare Act to prohibit health insurance companies from taking negative actions against healthcare providers who offer legal reproductive health services, including telemedicine prescriptions for pregnancy termination to out-of-state patients. The bill specifically bans insurers from refusing to renew policies, raising premiums, or making other unfavorable changes solely because a provider offers such services permitted under Pennsylvania law. It defines "adverse actions" to include contract terminations, negative reporting to authorities, and coverage changes. This directly affects medical liability insurers and providers offering reproductive care, ensuring they cannot face financial penalties for serving patients from other states legally. The law takes effect 60 days after enactment.

Topics ✓ HealthcareSupports HealthcareProhibits insurers from taking adverse actions against providers offering legal reproductive health services, protecting patient access to care under Pennsylvania law.95% confidence

Sub-Topics Insurance Telehealth Women's Health

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in committee · Pennsylvania · House May 29, 2025

HB 1519: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, further providing for mental illness coverage.

HB 1519 amends Pennsylvania's 1921 Insurance Company Law to require casualty insurance policies to cover mental illness treatments. This directly affects insurance companies writing casualty policies and policyholders seeking mental health services. The key provision mandates that insurers include mental health coverage in standard casualty policies, aligning it with other health coverage requirements. The bill focuses on expanding access to mental health care by ensuring it is covered under these specific insurance policies.

Topics ✓ HealthcareSupports HealthcareMandates mental illness coverage in casualty insurance policies, expanding access to mental health services per healthcare policy requirements.95% confidence

Sub-Topics Insurance Mental Health

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