H1013B1172A01180 AJB:JSL 05/09/17 #90 A01180
AMENDMENTS TO HOUSE BILL NO. 1013
Sponsor: REPRESENTATIVE BARRAR
Printer's No. 1172
Amend Bill, page 1, line 11, by inserting after "laws," "
in quality health care accountability and protection,
Amend Bill, page 1, line 11, by inserting after "providing"
for definitions and
Amend Bill, page 1, lines 15 through 17, by striking out all
of said lines and inserting
Section 1. The definition of "emergency service" in section
2102 of the act of May 17, 1921 (P.L.682, No.284), known as The
Insurance Company Law of 1921, is amended to read:
Section 2102. Definitions.--As used in this article, the
following words and phrases shall have the meanings given to
them in this section:
* * *
"Emergency service." Any health care service provided to an
enrollee after the sudden onset of a medical condition that
manifests itself by acute symptoms of sufficient severity or
severe pain such that a prudent layperson who possesses an
average knowledge of health and medicine could reasonably expect
the absence of immediate medical attention to result in:
(1) placing the health of the enrollee or, with respect to a
pregnant woman, the health of the woman or her unborn child in
serious jeopardy;
(2) serious impairment to bodily functions; or
(3) serious dysfunction of any bodily organ or part.
[Emergency transportation and related emergency service provided
by a licensed ambulance service shall constitute an emergency
service.] A health care service provided by a licensed ambulance
service, with or without emergency transportation, shall
constitute an emergency service.
* * *
Section 2. Section 2116 of the act is amended to read:
Amend Bill, page 2, line 18, by striking out "care" and
inserting
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services
Amend Bill, page 2, line 23, by inserting after "emergency."
The managed care plan may not make a determination that
emergency services were not medically necessary solely on the
basis that the enrollee did not require transport or refused to
be transported.
Amend Bill, page 2, line 24, by striking out "2" and
inserting
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See A01180 in
the context
of HB1013