Healthcare (Medicare)

in committee · Pennsylvania · Senate May 21, 2026

SB 1342: 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 billing.

This bill amends Pennsylvania's Insurance Company Law to establish a direct billing system for nonnetwork emergency medical services (EMS) agencies. It requires insurers to directly reimburse these agencies for dispatched 911 services at a rate of 350% of the Centers for Medicare and Medicaid Services published rate, rather than billing patients directly. The legislation mandates that insurers pay these agencies within 45 days and prohibits them from forcing EMS agencies to sign contracts to receive this reimbursement. Additionally, the bill creates a public registry to track which EMS agencies are eligible for direct payment and restricts how these agencies can solicit donations related to billing practices.

Topics ✓ HealthcareSupports HealthcareBill mandates insurers to directly reimburse EMS agencies, preventing patient billing and improving access to emergency services.85% confidence

Sub-Topics Medicaid Medicare Tags Public Safety

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in committee · Pennsylvania · House Mar 31, 2026

HB 2342: An Act amending the act of December 15, 1982 (P.L.1291, No.292), known as the Medicare Supplement Insurance Act, providing for applications for medicare supplement policies.

This bill amends Pennsylvania's Medicare Supplement Insurance Act to allow individuals to switch insurance companies without being denied coverage or facing higher prices due to their health status or medical history. It specifically applies to people aged 65 or older who are already enrolled in Medicare and wish to change their current supplement plan within 60 days of their birthday while keeping the same type of coverage. Under the new rules, a new policy issued under these conditions must take effect on the first day of the month that is at least 30 days after the application is signed, and the changes will become effective on January 1, 2027.

Topics ✓ HealthcareSupports HealthcareBill protects patient rights by allowing seniors to switch Medicare supplement plans without coverage denial or price hikes due to health status.90% confidence

Sub-Topics Medicare

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in committee · Pennsylvania · House Apr 27, 2026

HB 2456: An Act amending the act of June 13, 1967 (P.L.31, No.21), known as the Human Services Code, in public assistance, providing for payments for extraordinary personal care services.

This bill proposes allowing Pennsylvania to pay for special personal care services provided by a family member to a recipient of Medical Assistance. To make this possible, the state would need to request permission from the federal Centers for Medicare and Medicaid Services to cover these costs. The law specifies that the state cannot begin paying for these services until it receives approval from the federal government. The changes would take effect 180 days after the bill is signed into law.

Topics ✓ HealthcareSupports HealthcareBill expands health coverage by enabling state funding for personal care services provided by family members to Medical Assistance recipients.85% confidence

Sub-Topics Medicaid Medicare

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in committee · Pennsylvania · Senate Feb 27, 2026

SB 1185: An Act amending the act of December 15, 1982 (P.L.1291, No.292), known as the Medicare Supplement Insurance Act, providing for annual open enrollment period; and abrogating a regulation.

SB 1185 creates an annual open enrollment period for Pennsylvania Medicare supplement insurance policyholders. Starting on each policyholder's birthday, insurers must offer a 90-day window during which individuals can switch to any comparable Medicare supplement policy without being denied coverage or charged more based on health status. Insurers must also notify policyholders 15-30 days before the enrollment period about dates, rights, and policy changes. This amendment modifies Pennsylvania's 1982 Medicare Supplement Insurance Act and replaces an inconsistent existing regulation. The bill directly affects Medicare supplement policyholders in Pennsylvania.

Topics ✓ HealthcareSupports HealthcareCreates annual open enrollment for Medicare supplements, allowing policyholders to switch plans without health-based denials or higher premiums, improving access and protecting patient rights in insurance coverage.95% confidence

Sub-Topics Medicare

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in committee · Pennsylvania · Senate Jan 20, 2026

SB 1147: An Act amending the act of June 13, 1967 (P.L.31, No.21), known as the Human Services Code, in public assistance, further providing for emergency transportation services.

SB 1147 amends Pennsylvania's Human Services Code to update reimbursement rates for emergency ambulance services under Medicaid programs (Fee-for-Service, Capitation, and Community HealthChoices). It requires reimbursement for every loaded mile based on the higher of 2023 Medicare ambulance rates or current Medicaid fees, effective January 1, 2024. For cases where patients refused transport, it sets new rates starting July 1, 2025, using 2025 Medicare rates or updated Medicaid fees. The bill applies retroactively to July 1, 2025, directly affecting licensed ambulance providers serving Medicaid enrollees.

Topics ✓ HealthcareSupports HealthcareIncreases Medicaid reimbursement rates for ambulance services to higher Medicare rates, ensuring adequate funding and access to emergency transport under public health programs.95% confidence

Sub-Topics Medicaid Medicare

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in committee · Pennsylvania · Senate May 22, 2025

SB 754: An Act providing for hospital closure procedure requirements, for notice of proposed general hospital closure or significant impact closure, for health equity impact assessments, for closure plans and for enforcement actions.

SB 754 requires hospitals seeking to close major units (like emergency or maternity departments) or the entire facility to obtain approval from Pennsylvania's Department of Health or local health authorities. Before closing, hospitals must submit a detailed closure plan, hold two public hearings in the affected community, and provide a 60-day public comment period. The bill mandates a health equity impact assessment showing how the closure affects access for low-income, minority, senior, and Medicare patients, including nearby hospital options and transit times. This directly affects hospital authorities (parent companies or governing bodies) and communities relying on hospital services, ensuring transparency and community input before closures.

Topics ✓ HealthcareSupports HealthcareMandates health equity impact assessments and community input for hospital closures to protect access for vulnerable populations, improving patient access and equity in healthcare services.95% confidence

Sub-Topics Hospitals Medicare

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in committee · Pennsylvania · House Mar 11, 2025

HB 857: An Act amending the act of June 13, 1967 (P.L.31, No.21), known as the Human Services Code, in public assistance, further providing for emergency transportation services.

HB 857 amends Pennsylvania's Human Services Code to update reimbursement rates for emergency ambulance services under Medicaid programs. It requires the state to pay ambulance providers the higher of either Medicare's 2023 rates or current Medicaid ambulance fees (as updated in 2023) for services provided to Medicaid enrollees starting January 1, 2024. For services where patients declined transport, new rates based on 2025 Medicare data or updated Medicaid fees will apply beginning July 1, 2025. This directly affects licensed emergency medical services agencies that provide ambulance transport to Medicaid beneficiaries.

Topics ✓ HealthcareSupports HealthcareIncreases Medicaid ambulance reimbursement rates to higher Medicare benchmarks, improving provider payment and access to emergency services for Medicaid enrollees.95% confidence

Sub-Topics Medicaid Medicare

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passed · Pennsylvania · House Mar 25, 2025

HB 535: An Act providing for health care insurance coverage protections; imposing duties on the Insurance Department and the Insurance Commissioner; and imposing penalties.

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.

Topics ✓ HealthcareSupports HealthcareBans insurers from imposing annual/lifetime dollar limits on core health benefits, protecting patient access to essential care without financial caps.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentBans health insurers from capping core benefits, expanding worker health coverage protections under employment standards as a key benefit.90% confidence

Sub-Topics Insurance Medicare

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in committee · Pennsylvania · House Jun 25, 2025

HR 274: A Resolution urging the Congress of the United States to expand Medicare to include coverage of hearing aids.

This Pennsylvania House resolution urges Congress to expand Medicare to cover hearing aids. Currently, Medicare does not cover hearing aids or their fittings - only limited diagnostic exams under Part B. It specifically targets the gap affecting over 48 million Americans with hearing loss who rely on Medicare. The resolution requests Congressional action to amend Medicare policy but has no legal force.

Topics ✓ HealthcareSupports HealthcareUrges expanding Medicare coverage for hearing aids, directly advancing patient access to a previously excluded service under Medicare.95% confidence

Sub-Topics Medicare

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in committee · Pennsylvania · Senate Feb 26, 2025

SB 318: 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 postacute neurorehabilitation.

SB 318 requires most health insurance policies in Pennsylvania to cover postacute neurorehabilitation services for individuals with acquired brain injuries. This includes specific therapies like cognitive rehabilitation, neurobehavioral treatment, community reintegration, and day rehabilitation programs, as determined medically necessary by a patient's doctor. Insurers cannot impose arbitrary limits on the number of covered days or apply stricter deductibles/copays for these services than for other covered benefits. The law applies to group/individual health plans but excludes accident-only, dental, vision, Medicare supplements, and certain other limited policies.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for neurorehabilitation services, prevents arbitrary limits on days, and prohibits stricter copays, expanding patient access to necessary brain injury care.95% confidence

Sub-Topics Insurance Medicare

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