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PRINTER'S NO. 333
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
344
Session of
2017
INTRODUCED BY DeLUCA, READSHAW, ROZZI, MURT, D. COSTA,
CALTAGIRONE AND THOMAS, FEBRUARY 3, 2017
REFERRED TO COMMITTEE ON INSURANCE, FEBRUARY 3, 2017
AN ACT
Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
act relating to insurance; amending, revising, and
consolidating the law providing for the incorporation of
insurance companies, and the regulation, supervision, and
protection of home and foreign insurance companies, Lloyds
associations, reciprocal and inter-insurance exchanges, and
fire insurance rating bureaus, and the regulation and
supervision of insurance carried by such companies,
associations, and exchanges, including insurance carried by
the State Workmen's Insurance Fund; providing penalties; and
repealing existing laws," in casualty insurance, providing
for cranial hair vacuum prosthesis coverage standards for
health insurance policies.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of May 17, 1921 (P.L.682, No.284), known
as The Insurance Company Law of 1921, is amended by adding a
section to read:
Section 635.8. Cranial Hair Vacuum Prosthesis Insurance
Coverage.--(a) A health insurance policy shall provide that the
health insurance benefits applicable under the policy include
coverage for the cost of a medically necessary cranial hair
vacuum prosthesis when prescribed by a physician for an
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individual who sustains hair loss as a result of alopecia
totalis or alopecia universalis.
(b) If a health insurance policy provides coverage or
benefits to a resident of this Commonwealth, it shall be deemed
to be delivered in this Commonwealth within the meaning of this
section, regardless of whether the insurer issuing or delivering
the policy is located within or outside this Commonwealth.
(c) Benefits for a cranial hair vacuum prosthesis shall be
subject to any annual deductible, copayment and coinsurance
provisions of a health insurance policy to the extent that other
medical services covered by the policy are subject to those
provisions. A benefit limit of one thousand five hundred dollars
($1,500) once every three years shall apply to cranial hair
vacuum prostheses covered under this section.
(d) The department may promulgate regulations as may be
necessary and appropriate to carry out the provisions of this
act.
(e) This section shall apply as follows:
(1) For a health insurance policy for which either rates or
forms are required to be filed with the Federal Government or
the department, this section shall apply to any policy for which
a form or rate is first permitted to be used on or after 180
days following the effective date of this section.
(2) For a health insurance policy for which neither rates
nor forms are required to be filed with the Federal Government
or the department, this section shall apply to any policy issued
or renewed on or after 180 days following the effective date of
this section.
(f) As used in this section:
(1) " Alopecia totalis " means an autoimmune disease resulting
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in complete scalp hair loss.
(2) " Alopecia universalis " means an autoimmune disease
resulting in complete body hair loss.
(3) " Cranial hair vacuum prosthesis " means a custom designed
system utilizing specialized materials to replace hair loss due
to alopecia totalis or alopecia universalis.
(4) "Health insurance policy" means a policy, subscriber
contract, certificate or plan issued by an insurer that provides
medical or health care coverage. The term does not include any
of the following:
(i) An accident only policy.
(ii) A credit only policy.
(iii) A long-term care or disability income policy.
(iv) A specified disease policy.
(v) A Medicare supplement policy.
(vi) A TRICARE policy, including a Civilian Health and
Medical Program of the Uniformed Services (CHAMPUS) supplement
policy.
(vii) A fixed indemnity policy.
(viii) A dental only policy.
(ix) A vision only policy.
(x) A workers' compensation policy.
(xi) An automobile medical payment policy under 75 Pa.C.S.
(relating to vehicles).
(xii) Any other similar policies providing for limited
benefits.
(5) "Insurer" means an entity licensed by the department
with accident and health authority to issue a policy, subscriber
contract, certificate or plan that provides medical or health
care coverage that is offered or governed under any of the
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following:
(i) This act.
(ii) The act of December 29, 1972 (P.L.1701, No.364), known
as the "Health Maintenance Organization Act."
(iii) 40 Pa.C.S. Ch. 61 (relating to hospital plan
corporations) or 63 (relating to professional health services
plan corporations).
Section 2. This act shall take effect in 60 days.
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