An Act amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, providing for prescription drug cost credits in health insurance; and imposing penalties.
This bill requires health insurance plans in Pennsylvania to credit money that policyholders spend on prescription drugs toward their annual out-of-pocket maximums. The law applies to anyone enrolled in a health benefit plan who pays directly for medications at a pharmacy or through a discount program, regardless of whether the pharmacy has a contract with the insurer. To receive this credit, individuals must submit proof of purchase, and the credit counts toward deductibles, copayments, and coinsurance for the year the expense was incurred. The legislation also establishes a process for insurers to submit regulations and outlines penalties for failing to comply with these new requirements.
Bill status
in committee
3 of 5 stages cleared
Introduction
Jun 2026
Committee Review
Jun 2026
House Passage
Jun 2026
Senate Passage
Governor
Introduced Jun 22, 2026
Last action Jun 24, 2026
Maddy AI version diff · 1 comparison
What changed between versions
Printer's No. PN3661
→
Printer's No. PN3707
·
5 edits
MODERATE
This bill update reorganizes the chapter structure by adding new sections for exemptions, regulations, and enforcement while removing a standalone exemption section. It clarifies the definition of a 'health care provider' to include those regulated by law, not just licensed ones. The most significant policy addition is a new requirement for administrators who lose their exemption status to comply with all chapter rules within 60 days. The text also updates the list of referenced laws to include the Pennsylvania Health Care Insurance Portability Act.
Scope change
The bill's scope was expanded by adding a specific compliance timeline for entities that lose their exemption status and by broadening the definition of who qualifies as a health care provider.
REQUIREMENT
Added a new requirement that prescription drug coverage administrators must comply with all chapter provisions within 60 days if they no longer qualify for an exemption.
Added a requirement for the purchasing entity to make a transparent pricing model available to covered persons.
DEFINITION
Modified the definition of 'health care provider' to include persons who are licensed, certified, or otherwise regulated to provide health care services.
STRUCTURE
Added new sections for Exemption (5208), Regulations (5209), and Enforcement (5210) and removed the standalone Exemption section.
TECHNICAL
Updated the list of referenced acts to include the Pennsylvania Health Care Insurance Portability Act.
Floor votes · House Jun 24, 2026
How they voted
26–0
Passed
Total votes 26
Jun 24, 2026
D
Democratic14
100% Yea
R
Republican12
100% Yea
Vote distribution
All Yea
All Nay
Mixed
No data
Full legislative history
Actions timeline
Total actions
5
Key actions
2
Committee
2
Amendments
1
Jun 24, 2026
House · Passed
House Vote: pass (26-0)
house
Jun 24, 2026
Committee
Re-committed to Rules
lower
Jun 24, 2026
Lower · Passed
Reported as amended
lower
Jun 22, 2026
Committee
Referred to Insurance
lower
1 primary · 12 co-sponsors
Sponsors
Role
Legislator
Party
State
District
P
Emily Kinkead
DDemocratic
Co
Ben Sanchez
DDemocratic
Co
Chris Pielli
DDemocratic
Co
Dan Deasy
DDemocratic
Co
Dan Williams
DDemocratic
Co
Danielle Otten
DDemocratic
Co
Jeanne McNeill
DDemocratic
Co
Joe Ciresi
DDemocratic
Co
Joe Hohenstein
DDemocratic
Co
Kristine Howard
DDemocratic
Co
Manny Guzman
DDemocratic
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