Bill Text: PA HB2261 | 2011-2012 | Regular Session | Introduced

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Bill Title: Limiting copayments and coinsurances for insured medical services.

Spectrum: Moderate Partisan Bill (Democrat 11-2)

Status: (Introduced - Dead) 2012-03-19 - Referred to INSURANCE [HB2261 Detail]

Download: Pennsylvania-2011-HB2261-Introduced.html

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PRINTER'S NO. 3237
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 2261 Session of2012
INTRODUCED BY WHITE, THOMAS, BARRAR, CALTAGIRONE, COHEN, GEORGE, GIBBONS, HORNAMAN, JOSEPHS, READSHAW, YOUNGBLOOD AND M. O'BRIEN, MARCH 19, 2012
REFERRED TO COMMITTEE ON INSURANCE, MARCH 19, 2012
AN ACT
Limiting copayments and coinsurances for insured medical
services.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as the Fairness in
Copayment Act.
Section 2. Declaration of intent.
This act is intended to limit the imposition of copayments
and coinsurances for insured medical services to no more than
30% of the total cost of medical services per visit.
Section 3. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Health insurance policy." An individual or group health
insurance policy, contract or plan which provides medical or
health care coverage by a health care facility or licensed
health care provider on an expense-incurred service or prepaid
basis and which is offered by or is governed under any of the
following:
(1) Section 630 of the act of May 17, 1921 (P.L.682,
No.284), known as The Insurance Company Law of 1921.
(2) The act of December 29, 1972 (P.L.1701, No.364),
known as the Health Maintenance Organization Act.
(3) 40 Pa.C.S. Ch. 61 (relating to hospital plan
corporations).
(4) 40 Pa.C.S. Ch. 63 (relating to professional health
services plan corporations).
(5) 40 Pa.C.S. Ch. 67 (relating to beneficial
societies).
Section 4. Mandated coverage.
A health insurance policy which is delivered, issued for
delivery, renewed, extended or modified in this Commonwealth by
a health care insurer shall not impose a copayment or
coinsurance that exceeds 30% of the total reimbursement to the
care provider for medical services to the covered person per
visit.
Section 5. Applicability.
This act shall apply to:
(1) Insurance policies.
(2) Subscriber contracts and group certificates issued
under any group master policy delivered or issued for
delivery on or after the effective date of this act.
(3) Renewals of contracts on a renewal date which is on
or after the effective date of this act.
Section 6. Effective date.
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This act shall take effect in 60 days.
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