THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY FRANKEL, VULAKOVICH, DeLUCA AND BARBIN, MAY 1, 2012

REFERRED TO COMMITTEE ON INSURANCE, MAY 1, 2012  

AN ACT

Providing for the Children's Access to Concurrent Care Act and

for applicability.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Short title.

This act shall be known and may be cited as the Children's

Access to Concurrent Care Act.

Section 2.  Definitions.

The following words and phrases when used in this act shall

have the meanings given to them in this section unless the

context clearly indicates otherwise:

"Child."  A person 18 years of age or younger.

"Health insurance policy."  An individual or group health,

sickness or accident policy, subscriber contract or certificate

issued by an entity subject to this act or the following:

(1)  The act of May 17, 1921 (P.L.682, No.284), known as

The Insurance Company Law of 1921.

(2)  The act of December 29, 1972 (P.L.1701, No.364),

known as the Health Maintenance Organization Act.

(3)  The act of May 18, 1976 (P.L.123, No.54), known as

the Individual Accident and Sickness Insurance Minimum

Standards Act.

(4)  40 Pa.C.S. Ch. 61 (relating to hospital plan

corporations) or 63 (relating to professional health services

plan corporations).

"Insurer."  A company or entity licensed in this Commonwealth

to issue health insurance policies.

"Life-prolonging treatment."  Treatment addressing the

underlying disease rather than alleviating symptoms.

Section 3.  Required coverage.

(a)  General rule.--

(1)  A voluntary election to seek payment for hospice

care for a child shall not preclude an insured from coverage

or payment for services related to the treatment of the

child's condition for which diagnosis of terminal illness has

been made.

(2)  A health insurance policy providing coverage for

life-prolonging treatments for children shall also provide

coverage for hospice care and shall not exclude concurrent

coverage for the life-prolonging treatment.

(b)  Coverage subject to annual deductible, copayment or

coinsurance requirements.--The coverage required under this act

shall be subject to the annual deductible, copayment or

coinsurance requirements imposed by an entity subject to this

act for similar coverages under the same health insurance policy

or contract.

Section 19.  Applicability.

This act shall apply to health insurance policies issued

under a group master policy or individual policy delivered or

issued for delivery on or after the effective date of this act

and to renewals of such policies on or after the effective date

of this act.

Section 20.  Effective date.

This act shall take effect simultaneously with the provision

for concurrent care for children under Medicaid and the

Children's Health Insurance Program as specified in section 2302

of the Patient Protection and Affordable Care Act (Public Law

111-148, 124 Stat. 119).