Healthcare (Insurance)

signed · Pennsylvania · Senate Jul 7, 2025

SB 95: An Act amending the act of September 27, 1961 (P.L.1700, No.699), known as the Pharmacy Act, further providing for definitions, for licensing of pharmacists and for unlawful acts; and providing for price disclosure.

SB 95 amends Pennsylvania's Pharmacy Act to create a 180-day provisional license for pharmacists moving from other states, allowing them to practice without demonstrating competency under Pennsylvania's requirements. It also permits emergency medical services providers to distribute naloxone dose packages for opioid overdose reversal under specific conditions, including a Department of Health standing order and voluntary distribution without liability. Additionally, the bill requires pharmacies to disclose prescription drug prices (brand vs. generic), cost-sharing amounts, and health insurance options upon customer request. These changes aim to improve pharmacist mobility, expand naloxone access, and increase price transparency for consumers.

Topics ✓ HealthcareSupports HealthcareCreates provisional pharmacist licenses to improve access and enables naloxone distribution for opioid overdose reversal, directly advancing public health and patient access.90% confidence

Sub-Topics Insurance Prescription Drugs Substance Abuse

in committee · Pennsylvania · Senate May 22, 2025

SB 447: 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, providing for coverage for prostate cancer screening.

SB 447 requires health insurance policies in Pennsylvania to cover annual prostate cancer screenings with no out-of-pocket costs for men aged 40+ who are high-risk. High-risk status includes genetic factors, family history of prostate cancer (a first-degree relative diagnosed), or physician determination of medical need. The law mandates coverage for screenings like PSA tests and digital rectal exams, applying to policies filed or renewed 180 days after the law takes effect. It directly affects insured men meeting these criteria and insurance companies offering health coverage in Pennsylvania.

Topics ✓ HealthcareSupports HealthcareMandates no-cost prostate cancer screenings for high-risk men, expanding insurance coverage and improving access to preventive care.95% confidence

Sub-Topics Insurance

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in committee · Pennsylvania · House Feb 12, 2025

HB 565: An Act amending the act of March 4, 1971 (P.L.6, No.2), known as the Tax Reform Code of 1971, providing for employer health insurance contribution tax credit; and promulgating regulations.

HB 565 creates a new tax credit for Pennsylvania employers who pay for their employees' health insurance. It allows businesses to reduce their state tax bill by up to 100% of their contributions toward employee health insurance premiums, but only the first $500 per employee counts toward the credit. The credit percentage decreases as the number of covered employees increases: 100% for fewer than 50 employees, 75% for 50-99 employees, and 50% for 100+ employees. Employers must submit specific employee and insurance provider details to the Department of Revenue to claim the credit, which cannot be carried over, refunded, or sold.

Topics ✓ Budget & TaxesSupports Budget & TaxesCreates tax credit reducing employer state tax burden for health insurance, aligning with tax relief indicators for businesses under Budget & Taxes.95% confidence ✓ HealthcareSupports HealthcareTax credit incentivizes employers to provide health insurance, expanding coverage access for employees through reduced business costs.85% confidence ✓ Labor & EmploymentSupports Labor & EmploymentIncentivizes employer-provided health insurance via tax credit, expanding worker benefits without mandating coverage.95% confidence

Sub-Topics Business Taxes Tax Credits Insurance

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in committee · Pennsylvania · Senate Feb 25, 2025

SB 301: An Act amending the act of September 27, 1961 (P.L.1700, No.699), known as the Pharmacy Act, providing for price disclosure.

SB 301 requires Pennsylvania pharmacies to disclose specific pricing information to consumers upon request for prescription medications. This includes the current retail price for brand-name and generic drugs, the consumer's cost-sharing amount under their insurance, and details about subsidized health coverage through Pennsylvania's health insurance exchange. Pharmacies must keep records of this information, post clear notices about the disclosure right, and present details in simple terms. Failure to comply results in a $500 fine per violation. The law applies to all retail pharmacies and directly affects consumers making prescription purchasing decisions.

Topics ✓ HealthcareSupports HealthcareRequires pharmacies to disclose drug pricing and insurance costs, improving patient access to cost information for informed healthcare decisions.90% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · Pennsylvania · House Nov 17, 2025

HB 2041: An Act amending the act of November 3, 2022 (P.L.2135, No.150), known as the Childhood Blood Lead Test Act, further providing for title of act, for legislative purpose, for definitions, for lead poisoning prevention, assessment and testing, for duties of department and for blood lead assessment and testing coverage.

HB 2041 amends Pennsylvania's Childhood Blood Lead Test Act to require health care practitioners to ensure children receive at least one blood lead test by 12 months of age and a second test by 24 months of age, with additional testing mandated between 24 and 72 months if not tested by age 2. The bill also requires blood lead testing for pregnant women who have at least one identified lead exposure risk factor. It clarifies that health insurance must cover these tests without cost-sharing, as defined in the bill. This law directly affects children under 72 months, pregnant women, and health care providers in Pennsylvania.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage without cost-sharing for childhood blood lead tests and prenatal lead screening, expanding preventive care access per bill requirements.95% confidence

Sub-Topics Insurance

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in committee · Pennsylvania · Senate Jun 24, 2025

SB 888: An Act providing for the use of certain credentialing applications and for credentialing requirements for health insurers; imposing penalties; and conferring powers and imposing duties on the Insurance Department.

This bill, the Health Care Practitioner Credentialing Act, requires Pennsylvania health insurers to accept the CAQH credentialing application or a nationally recognized alternative for health care practitioners seeking to join provider networks. It sets clear timelines: insurers must notify practitioners within 10 business days if an application is incomplete and issue a credentialing decision within 45 business days for complete applications. Insurers failing to comply may face administrative penalties, though the bill does not guarantee practitioners a spot in any insurer's network. The law applies broadly to most health insurers (including Medicaid managed care organizations) but excludes certain coverage types like accident-only or vision insurance.

Topics ✓ HealthcareSupports HealthcareStreamlines insurer credentialing for healthcare practitioners, reducing delays in provider network access and improving patient access to care through mandated timelines and penalties for non-compliance.92% confidence

Sub-Topics Insurance Medicaid Medical Licensing

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in committee · Pennsylvania · House Oct 17, 2025

HB 1965: An Act amending Title 35 (Health and Safety) of the Pennsylvania Consolidated Statutes, providing for certification of community paramedicine providers, for community paramedicine service coverage by casualty insurance carriers and for medical assistance reimbursement.

HB 1965 establishes a certification process for community paramedicine providers in Pennsylvania, requiring them to meet state standards to deliver certain medical services. It mandates that casualty insurance carriers cover community paramedicine services in their policies and requires state medical assistance programs to reimburse providers for these services. The bill directly affects community paramedicine providers (who must certify), insurance companies (who must provide coverage), and state health programs (which must pay for covered services). These changes aim to formalize and expand access to community-based emergency medical care through standardized provider qualifications and insurance coverage.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage and reimbursement for community paramedicine services, expanding healthcare access and provider support.95% confidence

Sub-Topics Insurance

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passed · Pennsylvania · House May 22, 2025

HB 433: 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 mammographic examinations and breast imaging.

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.

Topics ✓ HealthcareSupports HealthcareMandates no-cost coverage for mammograms/breast imaging under insurance, removing financial barriers to preventive cancer screenings per bill summary.95% confidence

Sub-Topics Insurance

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passed · Pennsylvania · House Jul 17, 2025

HB 1527: An Act reenacting and amending the act of July 7, 2017 (P.L.285, No.14), entitled "An act establishing the Rare Disease Advisory Council and providing for its powers and duties; and providing for duties of the Department of Health, the Insurance Department, the Department of Human Services and the Department of Education."

HB 1527 updates the existing Rare Disease Advisory Council established in 2017, clarifying its structure and responsibilities. The bill directly affects patients with rare diseases and requires coordination among the Department of Health, Insurance Department, Department of Human Services, and Department of Education. Key provisions mandate the council to advise state agencies on rare disease research, treatment access, insurance coverage, and resource allocation. It also specifies how departments must collaborate on policies impacting rare disease patients, ensuring a unified state approach.

Topics ✓ HealthcareSupports HealthcareBill mandates council to advise on rare disease treatment access, insurance coverage, and resource allocation, directly advancing patient access and coordination across healthcare agencies.92% confidence

Sub-Topics Insurance

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in committee · Pennsylvania · House Mar 17, 2025

HB 922: 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, providing for fertility preservation coverage.

HB 922 requires health insurance plans in Pennsylvania to cover fertility preservation services, such as freezing eggs, sperm, or embryos, without cost-sharing (like deductibles or copays). This applies to individuals under 45 at risk of infertility due to medical treatments (e.g., cancer therapy), including covered spouses and dependents. The bill mandates coverage for specific services like storage, consultations, embryo transfers, and related diagnostics, while prohibiting preexisting condition exclusions or arbitrary limits on coverage. It also requires storage coverage for five years (or until age 18 for minors) and aligns with medical guidelines from the American Society for Reproductive Medicine.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for fertility preservation without cost-sharing, expanding access to reproductive health services for patients at risk of infertility.95% confidence

Sub-Topics Insurance

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