PRINTER'S NO. 3597
No. 2669 Session of 1982
INTRODUCED BY ARTY AND ZWIKL, SEPTEMBER 20, 1982
REFERRED TO COMMITTEE ON INSURANCE, SEPTEMBER 20, 1982
AN ACT
1 Providing reimbursement by insurance companies, professional
2 health service plan corporations, fraternal benefit societies
3 and voluntary nonprofit health service plans for services
4 performed by a registered nurse.
5 The General Assembly of the Commonwealth of Pennsylvania
6 hereby enacts as follows:
7 Section 1. Policies, contracts or certificates covered.
8 (a) This act shall apply to every group or individual
9 policy, contract or certificate issued thereunder, of health,
10 sickness or accident insurance delivered or issued for delivery
11 within the Commonwealth including, but not limited to, policies,
12 contracts or certificates issued by:
13 (1) Any stock insurance company as defined in section
14 202(c)(4) and (11) and any mutual insurance company as
15 defined in section 202(d)(1), act of May 17, 1921 (P.L.682,
16 No.284), known as "The Insurance Company Law of 1921."
17 (2) Any hospital plan corporation as defined in 40
18 Pa.C.S. Ch. 61 (relating to hospital plan corporations).
1 (3) Any professional health services plan corporation as
2 defined in 40 Pa.C.S. Ch. 63 (relating to professional health
3 services plan corporations).
4 (4) Any fraternal benefit society as defined in 40
5 Pa.C.S. Ch. 65 (relating to fraternal benefit societies).
6 (5) Any voluntary nonprofit health service plan as
7 defined in the act of December 29, 1972 (P.L.1701, No.364),
8 known as the "Health Maintenance Organization Act."
9 (6) Any person who sells or issues contracts or
10 certificates of insurance which meet the requirements of this
11 act.
12 (b) This act shall apply to all such policies, contracts or
13 certificates issued, renewed, modified, altered, amended or
14 reissued on or after the effective date of this act.
15 Section 2. Scope of coverage.
16 Whenever a policy, contract or certificate provides for
17 reimbursement for any service which is within the scope of
18 practice for which registered professional nurses are licensed
19 pursuant to the act of May 22, 1951 (P.L.317, No.69), known as
20 "The Professional Nursing Law," the insured or any other person
21 covered by the policy, contract or certificate shall be entitled
22 to reimbursement either directly to the insured or to the
23 provider of the service, when the service is performed by a
24 registered nurse permitted by law to perform such service. When
25 services may legally be performed by a licensed registered
26 professional nurse, without the intervention, supervision,
27 prescription or order of a physician, reimbursement for such
28 services may not be conditioned upon the intervention,
29 supervision, prescription or order of a physician.
30 Section 3. Rules and regulations.
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1 The Insurance Commissioner shall promulgate such rules and
2 regulations as are deemed necessary for the effective
3 implementation and operation of this act. Public hearings shall
4 be held prior to the promulgation of any such regulations,
5 including a verbatim transcript and cross-examination of all
6 witnesses in accordance with applicable rules of procedure,
7 unless such regulation or amendment is insubstantial.
8 Section 4. Effective date.
9 This act shall take effect in 90 days.
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