Healthcare (Insurance)

passed · Pennsylvania · House Jun 22, 2026

HB 2464: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in benefits for alcohol abuse and dependence, further providing for definitions, for inpatient detoxification, for nonhospital residential alcohol or other drug services, for outpatient alcohol or other drug services and for rules and regulations; and making editorial changes.

This bill amends Pennsylvania's Insurance Company Law to update definitions and provisions related to health insurance coverage. It clarifies how certain government health programs are defined for insurance policies, specifically regarding prescription drug coverage and continuation of coverage for employees who lose their jobs. The legislation also updates the legal definition of a hospital to include facilities operating alcoholism or drug addiction treatment programs and establishes a Long-Term Care Partnership Program to help individuals manage future long-term care costs.

Topics ✓ HealthcareSupports HealthcareBill expands prescription drug coverage and clarifies definitions to improve access to health services and government programs.85% confidence

Sub-Topics Insurance Long-Term Care Prescription Drugs

Track

in committee · Pennsylvania · House Apr 29, 2026

HB 2477: An Act amending Titles 40 (Insurance) and 42 (Judiciary and Judicial Procedure) of the Pennsylvania Consolidated Statutes, providing for behavioral health benefits for justice-involved children; and, in juvenile matters, further providing for definitions and for costs and expenses of care of child, providing for mandatory intake conference and screening in cases alleging delinquency and further providing for informal adjustment and for powers and duties.

This bill requires health insurance policies and government programs in Pennsylvania to cover behavioral health services for children involved in the juvenile justice system. It mandates that insurers provide funding for screenings, assessments, and treatments related to mental health conditions and substance use disorders during specific legal proceedings, such as mandatory intake conferences and informal adjustments. The legislation also establishes clear definitions for terms like "behavioral health provider" and "screening" to ensure consistent application of these coverage requirements. By integrating mental health support into the juvenile justice process, the bill aims to address the needs of youth facing delinquency charges while maintaining a neutral focus on policy implementation.

Topics ✓ Criminal JusticeSupports Criminal JusticeBill mandates behavioral health funding and services for justice-involved children, promoting rehabilitation and addressing root causes of delinquency.90% confidence ✓ HealthcareSupports HealthcareBill mandates health insurance coverage for behavioral health services for justice-involved children, expanding access and funding.90% confidence

Sub-Topics Juvenile Justice Insurance Mental Health

Track

in committee · Pennsylvania · Senate Apr 17, 2026

SB 1289: An Act providing for patient access to clear health care information; and requiring plain-language summaries of coverage, prior authorization and appeal rights.

This bill, known as the Patient Right-to-Understand Act, requires health care entities in Pennsylvania to provide patients with clear, plain-language summaries of their insurance coverage, prior authorization rules, and appeal rights. These summaries must be written at a sixth-grade reading level, limited to two pages, and include details on costs, network restrictions, and payment options like cash pricing or health savings accounts. The law also mandates that providers clearly distinguish between what insurance covers and medical decisions made solely between a patient and their doctor. As an enforcement measure, health care entities that fail to comply with these disclosure requirements are prohibited from collecting debts from patients who dispute the care they received.

Topics ✓ HealthcareSupports HealthcareBill improves patient access to clear health information and protects patient rights by mandating plain-language summaries of coverage and appeal rights.95% confidence

Sub-Topics Insurance

Track

in committee · Pennsylvania · House Apr 16, 2026

HB 2393: An Act amending the act of September 30, 1983 (P.L.160, No.39), known as the Public Official Compensation Law, further providing for the compensation of members of the General Assembly.

This bill amends Pennsylvania's Public Official Compensation Law to establish health insurance benefits for members of the House of Representatives. The legislation defines these benefits to include medical, dental, vision, prescription drug, and long-term care coverage, which the state will pay for on behalf of the representative and their eligible dependents. Coverage is limited to the time a member serves in office and includes a specific period between legislative sessions if the representative is reelected. The changes apply only to House members elected after the law takes effect, which is set for 60 days from its passage.

Topics ✓ HealthcareSupports HealthcareBill establishes health insurance benefits for state representatives, expanding coverage for medical, dental, and other services.90% confidence

Sub-Topics Insurance Long-Term Care Prescription Drugs

Track

passed · Pennsylvania · Senate Mar 24, 2026

SB 1211: 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 coverage for biomarker testing.

SB 1211 amends Pennsylvania's Insurance Company Law of 1921 to require casualty insurance policies to cover biomarker testing for medical assistance and Children's Health Insurance Program enrollees. The bill defines medical assistance and CHIP managed care plans as health care plans that use gatekeepers to manage services, explicitly including biomarker testing in this definition. This change ensures that insurance coverage for these specific health services is standardized under state law, subject to necessary federal approval. The legislation takes effect 60 days after passage.

Topics ✓ HealthcareSupports HealthcareBill expands insurance coverage by requiring casualty policies to cover biomarker testing for medical assistance and CHIP enrollees, improving patient access to health services.90% confidence

Sub-Topics Children's Health Insurance Medicaid

Track

in committee · Pennsylvania · Senate Jun 30, 2025

SB 905: An Act amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, in regulation of insurers and related persons generally, providing for addiction treatment services information collection and reporting.

This Pennsylvania bill requires health insurance companies to collect and report detailed statistics on addiction treatment services provided under their plans. Insurers must submit annual reports to the state department by April 30, including data on the number of people receiving treatment, units of service authorized and paid for, average length of stay, and the percentage of treatment requests that were denied or limited. The reported information is broken down by treatment type, such as inpatient rehabilitation, outpatient services, and detoxification, while protecting individual patient privacy. The state Department of Drug and Alcohol Programs will review these reports to check compliance with federal parity laws and Pennsylvania regulations, then share findings with legislative committees.

Topics ✓ HealthcareSupports HealthcareBill requires insurers to collect and report addiction treatment data, improving transparency and oversight of mental health services access.85% confidence

Sub-Topics Insurance Substance Abuse

Track

in committee · Pennsylvania · Senate Jun 30, 2025

SB 904: An Act amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, in mental health parity and access to addiction treatment, further providing for scope of chapter, for definitions and for annual attestation.

This bill requires health insurance companies in Pennsylvania to annually certify that their mental health and addiction treatment coverage complies with federal and state parity laws. Insurers must submit sworn statements by January 1 each year confirming they have reviewed all their policies and plans for compliance, including those managed by third-party administrators. The law also clarifies which types of insurance policies are covered and establishes specific filing deadlines with the state insurance department. These changes aim to ensure consistent oversight of mental health and substance use disorder benefits across the state's health insurance market.

Topics ✓ HealthcareSupports HealthcareBill strengthens mental health and addiction treatment access by requiring insurers to certify compliance with parity laws, protecting patient rights and expanding coverage.95% confidence

Sub-Topics Insurance Mental Health Substance Abuse

Track

in committee · Pennsylvania · Senate Jul 8, 2025

SB 901: An Act amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, in regulation of insurers and related persons generally, providing for disclosure of addiction treatment coverage and for administrative penalties.

This bill requires health insurance companies in Pennsylvania to send their policyholders a clear, two-page notice twice each year explaining what addiction treatment services are covered under their plans. The notice must detail specific care levels like detoxification and rehabilitation, explain how long stays are available, describe how to access services, and outline appeal processes. Insurers must submit these notices to the Department of Drug and Alcohol Programs for review before sending them to customers, and the department has 45 days to approve or request changes. Companies that fail to provide this information as required could face administrative fines or penalties determined by the department.

Topics ✓ HealthcareSupports HealthcareBill requires insurers to disclose addiction treatment coverage details, improving patient access to mental health services and protecting patient rights.90% confidence

Sub-Topics Insurance Substance Abuse

Track

in committee · Pennsylvania · Senate Feb 24, 2026

SB 1195: 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.

SB 1195 requires most health insurance plans in Pennsylvania to cover preventive services listed by the Insurance Department without cost-sharing (like copays or deductibles). It directly affects health insurers and enrollees (people with health insurance), excluding grandfathered plans (existing before 2010) and limited policies like dental-only or vision-only coverage. The bill establishes a "preventive services list" maintained by the Insurance Department, which can add or remove services after a public comment period. Insurers must cover all listed services without out-of-pocket costs for enrollees, with the department enforcing compliance and imposing penalties for violations.

Topics ✓ HealthcareSupports HealthcareRequires most insurance plans to cover preventive services without cost-sharing, expanding access to essential health services like screenings and vaccinations.95% confidence

Sub-Topics Insurance

Track

in committee · Pennsylvania · House Feb 11, 2026

HB 2212: An Act amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, in regulation of insurers and related persons generally, providing for nondiscrimination by payers in health care benefit plans.

HB 2212 requires Pennsylvania health insurance companies and other health care payers (including health maintenance organizations and self-insured employers) to reimburse out-of-network medical facilities that meet specific criteria, such as having a four-star patient satisfaction rating, offering faster service than nearby in-network facilities, or being partially owned by physicians who are in-network with the payer. The bill mandates that payers use a "baseball-style arbitration" process for payment disputes, where an independent third party selects either the payer's or facility's proposed payment amount without modification. It defines key terms like "highest in-network rate" to standardize how payers determine fair reimbursement for services. This law directly affects health care benefit plans regulated under Pennsylvania insurance law, aiming to reduce discrimination against qualifying out-of-network providers.

Topics ✓ HealthcareSupports HealthcareMandates insurer reimbursement for out-of-network facilities meeting quality/service criteria, improving patient access to care options beyond in-network restrictions.92% confidence

Sub-Topics Insurance

Track