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PRINTER'S NO. 1172
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1013
Session of
2017
INTRODUCED BY BARRAR, BOBACK, R. BROWN, CHARLTON, D. COSTA, COX,
DAVIS, FARRY, GABLER, GILLEN, MASSER, O'NEILL, ORTITAY,
READSHAW, ROZZI, SACCONE, SNYDER AND WARD, MARCH 28, 2017
REFERRED TO COMMITTEE ON VETERANS AFFAIRS AND EMERGENCY
PREPAREDNESS, MARCH 28, 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," further providing for emergency
services.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 2116 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 2116. Emergency Services.--(a) If an enrollee seeks
emergency services and the emergency health care provider
determines that emergency services are necessary, the emergency
health care provider shall initiate necessary intervention to
evaluate and, if necessary, stabilize the condition of the
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enrollee without seeking or receiving authorization from the
managed care plan. The managed care plan shall pay all
reasonably necessary costs associated with the emergency
services provided during the period of the emergency. When
processing a reimbursement claim for emergency services, a
managed care plan shall consider both the presenting symptoms
and the services provided. The emergency health care provider
shall notify the enrollee's managed care plan of the provision
of emergency services and the condition of the enrollee. If an
enrollee's condition has stabilized and the enrollee can be
transported without suffering detrimental consequences or
aggravating the enrollee's condition, the enrollee may be
relocated to another facility to receive continued care and
treatment as necessary.
(b) If an emergency medical services agency is dispatched by
a public safety answering point, as defined in 35 Pa.C.S. ยง 5302
(relating to definitions) and provides medically necessary
emergency care, including advanced life support services under
35 Pa.C.S. Ch. 81 (relating to emergency medical services
system), to an enrollee and the enrollee does not require
transport or refuses to be transported, the managed care plan
shall pay all reasonably necessary costs associated with the
emergency services provided during the period of the emergency.
Section 2. This act shall take effect in 60 days.
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