Bill Text: PA HB414 | 2011-2012 | Regular Session | Introduced

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Bill Title: In health and accident insurance, providing for coverage for prescription contraceptive drugs and devices.

Spectrum: Strong Partisan Bill (Democrat 15-1)

Status: (Introduced - Dead) 2011-02-03 - Referred to INSURANCE [HB414 Detail]

Download: Pennsylvania-2011-HB414-Introduced.html

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PRINTER'S NO. 380
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 414 Session of2011
INTRODUCED BY WAGNER, BUXTON, CALTAGIRONE, CURRY, DePASQUALE, FRANKEL, JOHNSON, JOSEPHS, MAHONEY, MANN, MUNDY, M. O'BRIEN, PAYTON, ROSS, STURLA AND YOUNGBLOOD, FEBRUARY 3, 2011
REFERRED TO COMMITTEE ON INSURANCE, FEBRUARY 3, 2011
AN ACT
Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
act relating to insurance; amending, revising, and
consolidating the law providing for the incorporation of
insurance companies, and the regulation, supervision, and
protection of home and foreign insurance companies, Lloyds
associations, reciprocal and inter-insurance exchanges, and
fire insurance rating bureaus, and the regulation and
supervision of insurance carried by such companies,
associations, and exchanges, including insurance carried by
the State Workmen's Insurance Fund; providing penalties; and
repealing existing laws," in health and accident insurance,
providing for coverage for prescription contraceptive drugs
and devices.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of May 17, 1921 (P.L.682, No.284), known
as The Insurance Company Law of 1921, is amended by adding a
section to read:
Section 633.1. Coverage for Prescription Contraceptive Drugs
and Devices and for Outpatient Medical or Counseling Services
Necessary for the Effective Use of Contraception.--(a) Every
health insurance policy delivered, issued, executed or renewed
in this Commonwealth on or after the effective date of this
section shall provide coverage for the expenses of:
(1) Any prescription contraceptive drug.
(2) Any prescription contraceptive device.
(3) Any outpatient medical or counseling service necessary
for the effective use of contraception.
(b) Nothing in this act shall be construed to prevent a
health insurance policy from imposing any copayment, deductible
or other cost-sharing mechanism or premium differential in
relation to any of the following coverage, provided that the
limitation for the coverage is not greater than or different
from all other copayments, deductibles or other cost-sharing
mechanisms or premium differentials imposed under general terms
and conditions under the policy: coverage for prescription
contraceptive drugs, prescription contraceptive devices and
outpatient medical or counseling services necessary for the
effective use of contraception.
(c) As used in this section, the following words and phrases
shall have the meanings given to them in this subsection:
"Health insurance policy."
(1) Any individual or group health insurance policy,
contract or plan which provides medical or health care coverage
by any 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:
(i) This act.
(ii) Subdivision (f) of Article IV of the act of June 13,
1967 (P.L.31, No.21), known as the "Public Welfare Code."
(iii) The act of December 29, 1972 (P.L.1701, No.364), known
as the "Health Maintenance Organization Act."
(iv) The act of May 18, 1976 (P.L.123, No.54), known as the
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"Individual Accident and Sickness Insurance Minimum Standards
Act."
(v) A nonprofit corporation subject to 40 Pa.C.S. Ch. 61
(relating to hospital plan corporations) or 63 (relating to
professional health services plan corporations).
(2) The term does not include any of the following types of
insurance or a combination of any of the following types of
insurance:
(i) Short-term travel.
(ii) Accident-only.
(iii) Workers' compensation.
(iv) Short-term nonrenewable policies of not more than six
(6) months' duration.
(v) Hospital indemnity.
(vi) Specified disease.
(vii) Disability income.
(viii) Dental.
(ix) Vision.
(x) Civilian Health and Medical Program of the Uniformed
Services (CHAMPUS) supplement.
(xi) Medicare or Medicaid supplemental contract.
(xii) Long-term care.
(xiii) Limited coverage accident and sickness policy.
This subparagraph includes cancer insurance, polio insurance
and any similar policy identified as exempt from this section by
the Insurance Commissioner.
"Outpatient medical or counseling service necessary for the
effective use of contraception." The term includes, but is not
limited to, examinations, procedures and medical and counseling
services provided on an outpatient basis and services for
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initial and periodic comprehensive physical examinations,
medical, laboratory and radiology services warranted by the
initial and periodic examinations or by the history, physical
findings or risk factors, including medical services necessary
for the insertion and removal of any contraceptive drug or
device and individual or group family planning counseling.
"Prescription contraceptive device." Any regimen of a
prescription contraceptive device approved by the Food and Drug
Administration, as well as any generic equivalent approved as
substitutable by the Food and Drug Administration.
"Prescription contraceptive drug." Any regimen of a
prescription contraceptive drug approved by the Food and Drug
Administration, as well as any generic equivalent approved as
substitutable by the Food and Drug Administration.
Section 2. This act shall take effect in 60 days.
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