PRIOR PRINTER'S NO. 1905
PRINTER'S NO. 1981
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
1330
Session of
2022
INTRODUCED BY K. WARD, MENSCH, COLLETT, PHILLIPS-HILL, BROOKS,
TARTAGLIONE, SCHWANK, VOGEL, STEFANO, DILLON, COMITTA,
ARGALL, GEBHARD, CAPPELLETTI, SANTARSIERO, HUTCHINSON,
ROBINSON, YUDICHAK, BARTOLOTTA, LANGERHOLC, COSTA, BOSCOLA,
KEARNEY, CORMAN, MUTH, YAW, HUGHES, MASTRIANO, STREET, KANE,
L. WILLIAMS, BREWSTER AND DiSANTO, SEPTEMBER 15, 2022
AS AMENDED ON THIRD CONSIDERATION, OCTOBER 18, 2022
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 coverage for BRCA-related genetic counseling and testing.
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 633.1. Coverage for BRCA-related Genetic Counseling
and Testing.--(a) Any group or individual health, sickness or
accident insurance policy providing hospital or medical/surgical
coverage , group or individual subscriber contract or certificate
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issued by an entity subject to 40 Pa.C.S. Ch. 61 (relating to
hospital plan corporations) or 63 (relating to professional
health services plan corporations), the act of December 29, 1972
(P.L.1701, No.364), known as the "Health Maintenance
Organization Act" or this act or an employe welfare benefit plan
as defined in section 3 of the Employee Retirement Income
Security Act of 1974 (Public Law 93-406, 29 U.S.C. ยง 1001 et
seq.) providing hospital or medical/surgical coverage shall also
provide coverage for BRCA-related genetic counseling and
testing. The minimum coverage required shall include all costs
associated with genetic counseling and, if indicated after
genetic counseling, genetic testing for individuals believed to
be at an increased risk , based on a clinical risk assessment
tool, of potentially harmful mutations in the BRCA1 or BRCA2
genes due to personal or family history of breast or ovarian
cancer.
(b) This section shall not apply to the following types of
policies:
(1) Accident only.
(2) Limited benefit.
(3) Credit.
(4) Dental.
(5) Vision.
(6) Specified disease.
(7) Medicare supplement.
(8) Civilian Health and Medical Program of the Uniformed
Services (CHAMPUS) supplement.
(9) Long-term care or disability income.
(10) Workers' compensation.
(11) Automobile medical payment.
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(12) Fixed indemnity.
(13) Hospital indemnity.
SECTION 633.1. COVERAGE FOR BRCA-RELATED GENETIC COUNSELING
AND TESTING.--(A) A HEALTH INSURANCE POLICY OFFERED, ISSUED OR
RENEWED IN THIS COMMONWEALTH SHALL PROVIDE COVERAGE FOR BRCA-
RELATED GENETIC COUNSELING AND GENETIC TESTING PROVIDED BY AN
INDIVIDUAL LICENSED, CERTIFIED OR OTHERWISE REGULATED TO PROVIDE
GENETIC COUNSELING AND GENETIC TESTING UNDER THE LAWS OF THIS
COMMONWEALTH. THE MINIMUM COVERAGE REQUIRED SHALL INCLUDE ALL
COSTS ASSOCIATED WITH GENETIC COUNSELING AND, IF INDICATED AFTER
GENETIC COUNSELING, A GENETIC LABORATORY TEST OF THE BRCA1 AND
BRCA2 GENES FOR INDIVIDUALS ASSESSED TO BE AT AN INCREASED RISK,
BASED ON A CLINICAL RISK ASSESSMENT TOOL, OF POTENTIALLY HARMFUL
MUTATIONS IN THE BRCA1 OR BRCA2 GENES DUE TO A PERSONAL OR
FAMILY HISTORY OF BREAST OR OVARIAN CANCER.
(B) AS USED IN THIS SECTION:
"GENETIC COUNSELING" MEANS THE PROVISION OF SERVICES TO
INDIVIDUALS, COUPLES, FAMILIES AND ORGANIZATIONS BY ONE OR MORE
APPROPRIATELY TRAINED INDIVIDUALS TO ADDRESS THE PHYSICAL AND
PSYCHOLOGICAL ISSUES ASSOCIATED WITH THE OCCURRENCE OR RISK OF
OCCURRENCE OF A GENETIC DISORDER, BIRTH DEFECT OR GENETICALLY
INFLUENCED CONDITION OR DISEASE IN AN INDIVIDUAL OR A FAMILY.
"HEALTH INSURANCE POLICY" MEANS AN INDIVIDUAL OR GROUP
INSURANCE POLICY, SUBSCRIBER CONTRACT, CERTIFICATE OR PLAN
ISSUED BY AN INSURER THAT PROVIDES MEDICAL OR HEALTH CARE
COVERAGE, INCLUDING EMERGENCY SERVICES. THE TERM DOES NOT
INCLUDE ANY OF THE FOLLOWING:
(1) AN ACCIDENT ONLY POLICY.
(2) A CREDIT ONLY POLICY.
(3) A LONG-TERM CARE OR DISABILITY INCOME POLICY.
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(4) A SPECIFIED DISEASE POLICY.
(5) A MEDICARE SUPPLEMENT POLICY.
(6) A FIXED INDEMNITY POLICY.
(7) A HOSPITAL INDEMNITY POLICY.
(8) AN ADULT-ONLY DENTAL ONLY POLICY.
(9) A VISION ONLY POLICY.
(10) A WORKER'S COMPENSATION POLICY.
(11) AN AUTOMOBILE MEDICAL PAYMENT POLICY.
(12) A TRICARE POLICY, INCLUDING A CIVILIAN HEALTH AND
MEDICAL PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS) SUPPLEMENT
POLICY.
(13) ANY OTHER SIMILAR POLICY PROVIDING FOR LIMITED
BENEFITS.
"INSURER" MEANS AN ENTITY LICENSED BY THE INSURANCE
DEPARTMENT WITH ACCIDENT AND HEALTH AUTHORITY TO ISSUE A HEALTH
INSURANCE POLICY THAT IS OFFERED OR GOVERNED UNDER ANY OF THE
FOLLOWING:
(1) THIS ACT, INCLUDING SECTION 630 AND ARTICLE XXIV.
(2) THE ACT OF DECEMBER 29, 1972 (P.L.1701, NO.364), KNOWN
AS THE "HEALTH MAINTENANCE ORGANIZATION ACT."
(3) 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 apply as follows:
(1) For health insurance policies for which either rates
or forms are required to be filed with the Federal Government
or the Insurance Department, this act shall apply to any
policy for which a form or rate is first filed on or after
the effective date of this section.
(2) For health insurance policies for which neither
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rates nor forms are required to be filed with the Federal
Government or the Insurance Department, this act shall apply
to any policy issued or renewed on or after 180 days after
the effective date of this section.
Section 3. This act shall take effect in 60 days.
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