PRINTER'S NO. 1466
No. 1067 Session of 2006
INTRODUCED BY ORIE, GREENLEAF, PILEGGI, STACK, BROWNE, O'PAKE,
MELLOW, MUSTO, C. WILLIAMS, RAFFERTY, WOZNIAK, BOSCOLA,
WONDERLING AND COSTA, JANUARY 24, 2006
REFERRED TO PUBLIC HEALTH AND WELFARE, JANUARY 24, 2006
AN ACT
1 Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
2 act to consolidate, editorially revise, and codify the public
3 welfare laws of the Commonwealth," further providing for
4 medical assistance benefit packages, coverages, copayments
5 and rates.
6 The General Assembly of the Commonwealth of Pennsylvania
7 hereby enacts as follows:
8 Section 1. Section 454 of the act of June 13, 1967 (P.L.31,
9 No.21), known as the Public Welfare Code, added July 7, 2005
10 (P.L.177, No.42), is amended to read:
11 Section 454. Medical Assistance Benefit Packages; Coverage,
12 Copayments[, Premiums] and Rates.--(a) Notwithstanding any
13 other provision of law to the contrary, the department shall
14 promulgate regulations as provided in subsection (b) to
15 establish provider payment rates[;] and the benefit packages and
16 any copayments for adults eligible for medical assistance under
17 Title XIX of the Social Security Act (49 Stat 620, 42 U.S.C. §
18 1396 et seq.) and adults eligible for medical assistance in
19 general assistance-related categories.[; and the premium
1 requirements for disabled children whose family income is above
2 two hundred percent of the Federal poverty income limit.] The
3 regulations shall authorize and describe the available benefit
4 packages and any copayments [and premiums.] The regulations
5 shall also specify the effective date for provider payment
6 rates.
7 (b) For purposes of implementing this section, and
8 notwithstanding any other provision of law, including section
9 814-A of this act, the secretary shall promulgate regulations
10 pursuant to section 204(1)(iv) of the act of July 31, 1968
11 (P.L.769, No.240), referred to as the Commonwealth Documents
12 Law, which shall, until December 31, 2005, be exempt from all of
13 the following acts:
14 (1) Section 205 of the Commonwealth Documents Law.
15 (2) Section 204(b) of the act of October 15, 1980 (P.L.950,
16 No.164), known as the "Commonwealth Attorneys Act."
17 (3) The act of June 25, 1982 (P.L.633, No.181), known as the
18 "Regulatory Review Act."
19 (c) The department is authorized to grant exceptions to any
20 limits specified in the benefit packages adopted under this
21 section or when any of the following circumstances applies:
22 (1) The department determines the recipient has a serious
23 chronic systemic illness or other serious health condition and
24 denial of the exception will jeopardize the life of or result in
25 the rapid, serious deterioration of the health of the recipient.
26 (2) The department determines that granting a specific
27 exception to a limit is a cost-effective alternative for the
28 medical assistance program.
29 (3) The department determines that granting an exception to
30 a limit is necessary in order to comply with Federal law.
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1 (d) As used in this section:
2 "Adult" means recipients twenty-one years of age or older,
3 except when in relation to copayments, for which the term means
4 recipients eighteen years of age or older.
5 "Benefit packages" means the list of items and services
6 covered by medical assistance, including any limitations on
7 covered items and services.
8 Section 2. This act shall take effect immediately.
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