HB 1140 requires health insurers and Medicaid/CHIP managed care plans in Pennsylvania to cover all FDA-approved contraceptives - including prescription drugs, devices, emergency contraception (like levonorgestrel), and oral contraceptives - without any out-of-pocket costs for enrollees. It specifically prohibits prior authorization or step therapy for emergency and oral contraceptives, and mandates coverage for sterilization procedures and related services like counseling. The bill directly affects health insurers, managed care plans, and their enrollees by expanding contraceptive coverage under state insurance regulations. It exempts male condoms from coverage requirements but ensures no cost-sharing for covered contraceptive methods.
This bill updates Pennsylvania's pilot program for non-narcotic medication-assisted treatment (MAT) in prisons and parole settings. It removes outdated rules about the program's establishment, clarifies requirements for county participation, and specifies how grant funds can be used for treatment services. The Pennsylvania Commission on Crime and Delinquency gains new duties to oversee the program, and the bill includes administrative updates to the state statutes governing it. The changes directly affect counties administering the pilot program and individuals in prison or parole under the MAT initiative.
HB 79 requires hospitals to establish clear financial assistance programs for patients who cannot afford care, including standardized forms and easily accessible information about eligibility and coverage. It mandates that hospitals publicly share details about their financial aid policies and report their program rules to the Department of Health. These requirements directly affect hospitals operating in the state and patients seeking financial help with medical bills. The bill aims to standardize and increase transparency in hospital financial aid offerings.
HB 433 requires health insurance plans to cover mammograms and breast imaging services without cost-sharing (like copays or deductibles) for policyholders. It directly affects women needing preventive breast cancer screenings and the insurance companies providing health coverage. The bill amends Pennsylvania’s 1921 Insurance Company Law to mandate this coverage for mammographic examinations and breast imaging under casualty insurance policies. This policy change ensures these essential preventive services are fully covered at no additional cost to patients.
HB 526 protects mothers' right to breastfeed their children in any public or private location where they are otherwise permitted to be, without being considered indecent exposure, a nuisance, or obscenity. It defines "breastfeeding" to include both direct feeding and expressing milk for bottle-feeding, and creates a private right to sue for violations, allowing recovery of $1,000 per incident plus attorney fees. The law applies broadly across Pennsylvania, ensuring mothers can feed their children without legal interference while maintaining existing protections from the repealed 2007 Freedom to Breastfeed Act.
HB 535 bans Pennsylvania health insurers from setting annual or lifetime dollar limits on core health benefits for enrollees, whether services are provided by in-network or out-of-network providers. It applies to all individual and group health insurance policies (excluding specific types like Medicare supplements or dental/vision-only plans) and prohibits limits on benefits that were already covered without such caps in 2025 policies. The Insurance Department can enforce this through fines up to $5,000 per violation (or $10,000 for willful violations), with annual caps of $500,000 for insurers. The law does not require coverage of specific benefits but eliminates existing dollar limit practices for covered services.
HB 618, the Health Insurance Access Protection Act, prohibits health insurers from denying coverage or charging higher premiums based on a person's health condition, including preexisting conditions. This law applies to both individual and group health insurance policies, protecting enrollees and their dependents from discrimination in enrollment or pricing. The Insurance Department and Commissioner are tasked with enforcing these rules, and the bill includes penalties for insurers that violate the prohibitions.
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.
HB 404 amends Pennsylvania's Insurance Company Law to extend health insurance coverage for children under family policies. It requires policies to cover dependent children up to age 26 (previously 19) and prohibits insurers from denying or restricting coverage based on a child's financial dependency, residency, marital status, school enrollment, or employment. The bill also allows group health plans to extend coverage for adult children up to age 29 if they meet specific conditions, such as not being married, having no dependents, and residing in Pennsylvania or attending school full-time. This affects all health insurance policies sold in Pennsylvania that provide dependent child coverage.
HB 111 prohibits life insurance companies in Pennsylvania from denying coverage, limiting benefits, or charging higher rates to applicants or policyholders solely because they have been prescribed an opioid overdose reversal agent (like naloxone). The bill directly affects individuals who use these medications, including those with opioid use disorder or at risk of overdose. It defines "adverse action" to include these discriminatory practices and makes such actions violations of existing laws against unfair insurance practices. The law takes effect 60 days after enactment.
