Healthcare (Prescription Drugs)

in committee · Pennsylvania · House Jul 20, 2026

HB 2708: An Act providing for insurance coverage for epinephrine delivery systems; and imposing duties on the Insurance Department.

This bill requires health insurance policies in Pennsylvania to cover at least two epinephrine delivery systems, such as EpiPens, for an annual maximum cost of $35 regardless of deductibles or copayments. It applies to standard medical insurance plans but excludes limited coverage types like dental-only or accident policies. Additionally, the state Insurance Department must investigate manufacturer pricing practices and submit a public report with recommendations to control costs within one year. Insurance companies are also permitted to offer lower out-of-pocket costs than the $35 cap if they choose.

Topics ✓ HealthcareSupports HealthcareBill mandates insurance coverage for epinephrine devices, expanding patient access to life-saving treatments and protecting public health.95% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · Pennsylvania · House Jun 24, 2026

HB 2652: 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.

Topics ✓ HealthcareSupports HealthcareBill reduces prescription drug costs by crediting out-of-pocket spending, improving patient access and financial protection.95% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · Pennsylvania · House Jun 23, 2026

HB 2648: An Act amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, in regulation of insurers and related persons generally, providing for health insurance alteration prohibitions.

This bill prohibits licensed health insurers in Pennsylvania from increasing costs such as premiums, copayments, coinsurance, or deductibles for specific health care services that were already covered under a policy. The law applies to individual and group health insurance plans but excludes self-funded employer plans and other limited benefit policies. Insurers may still raise costs if a service was obtained through fraud or if the U.S. Food and Drug Administration issues a warning about safety or if a drug manufacturer announces a discontinuance. Violations of these rules would be treated as unfair trade practices and could result in a civil penalty of up to $1,000 for the insurer.

Topics ✓ HealthcareSupports HealthcareBill prevents insurers from raising costs for covered services, protecting patient access and financial stability.90% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · Pennsylvania · House Jun 17, 2026

HB 2646: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in quality health care accountability and protection, further providing for medical policies and clinical review criteria.

This bill amends Pennsylvania's Insurance Company Law to require health insurers and managed care plans to include specific clinical review criteria in their medical policies. The key provision mandates that these policies cannot exclude, restrict, or delay coverage for prescription drugs solely because they received expedited FDA approval for serious or life-threatening conditions. Directly affecting insurance companies and managed care organizations, the law aims to ensure access to newly approved treatments without artificial barriers based on the speed of regulatory approval. The changes become effective 60 days after the bill is enacted.

Topics ✓ HealthcareSupports HealthcareBill mandates insurers cannot delay coverage for FDA-approved drugs for serious conditions, improving patient access and protecting rights.95% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · Pennsylvania · House Apr 21, 2026

HB 2431: An Act amending the act of November 21, 2016 (P.L.1318, No.169), known as the Pharmacy Audit Integrity and Transparency Act, in enforcements, further providing for scope of enforcement authority.

This bill expands the enforcement powers of Pennsylvania's Pharmacy Audit Integrity and Transparency Act to address how Pharmacy Benefit Managers handle Medicaid prescriptions. It directly affects PBMs, pharmacies, and pharmacists by requiring PBMs to accept and process prescriptions from any pharmacy or pharmacist that is in good standing with state regulators. The law prohibits PBMs from limiting patient access to specific pharmacies based on the PBM's own private contracting choices. These changes are designed to ensure that Medicaid patients can use any qualified pharmacy without facing artificial restrictions imposed by their benefit manager.

Topics ✓ HealthcareSupports HealthcareBill expands enforcement to ensure PBMs accept prescriptions from any pharmacy, directly improving patient access to healthcare services.85% confidence

Sub-Topics Medicaid Prescription Drugs

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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

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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

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in committee · Pennsylvania · House Mar 18, 2026

HB 2270: An Act amending the act of November 21, 2016 (P.L.1318, No.169), known as the Pharmacy Audit Integrity and Transparency Act, in preliminary provisions, further providing for definitions; and, in pharmacy benefits manager contracts, providing for State pharmacy benefits manager.

This bill amends Pennsylvania's Pharmacy Audit Integrity and Transparency Act to update definitions for "specialty drug" and "spread pricing" while establishing a new role for a State pharmacy benefits manager. The updated definitions clarify which prescription medications qualify as specialty drugs based on cost, handling requirements, and patient needs, while defining spread pricing as when a pharmacy benefits manager charges more than it pays pharmacists. The bill requires the Department of Human Services to select a single third-party administrator to manage all pharmacy benefits for Medicaid recipients by July 2026, ensuring all managed care organizations contract with this designated manager. The procurement process mandates competitive selection with strict conflict-of-interest disclosures to prevent conflicts between the manager and other healthcare entities like pharmacies, drug distributors, or managed care organizations.

Topics ✓ HealthcareSupports HealthcareBill strengthens pharmacy audit transparency and defines spread pricing to protect patients from overcharges, improving healthcare integrity and access.85% confidence

Sub-Topics Medicaid Prescription Drugs

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in committee · Pennsylvania · Senate Mar 12, 2026

SB 1186: An Act amending the act of November 21, 2016 (P.L.1318, No.169), known as the Pharmacy Audit Integrity and Transparency Act, in preliminary provisions, further providing for definitions; and, in pharmacy benefits manager contracts, providing for State pharmacy benefits manager.

This bill amends Pennsylvania's Pharmacy Audit Integrity and Transparency Act to update definitions for specialty drugs and spread pricing, while establishing a new requirement for a single state-run pharmacy benefits manager. The legislation directs the Department of Human Services to select one third-party administrator by July 2026 to manage all pharmacy benefits for Medicaid recipients, replacing the current system where multiple pharmacy benefits managers may handle these services. Managed care organizations receiving Medicaid contracts will be required to use this state pharmacy benefits manager, and the selection process must include competitive bidding and strict conflict-of-interest disclosures to prevent financial entanglements between the manager and other healthcare entities.

Topics ✓ HealthcareSupports HealthcareBill establishes single state-run pharmacy benefits manager to improve transparency and reduce spread pricing, enhancing patient access and protecting against excessive costs.85% confidence

Sub-Topics Medicaid Prescription Drugs

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in committee · Pennsylvania · Senate Dec 29, 2025

SB 1126: 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 epinephrine delivery systems.

SB 1126 requires most health insurance plans in Pennsylvania to cover at least two epinephrine delivery systems (such as EpiPens for severe allergic reactions) per year at a maximum annual cost of $35, regardless of the insured's deductible or other cost-sharing. This applies to individual and group health insurance policies, as well as certain nonprofit health plans. The Attorney General must investigate epinephrine drug pricing and submit a public report to the legislature within one year. The bill also allows plans to reduce cost-sharing below $35 and applies to high deductible and catastrophic health plans where permitted by federal law.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for epinephrine delivery systems at low cost, expanding access to critical allergy treatment and reducing patient financial barriers.95% confidence

Sub-Topics Insurance Prescription Drugs

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