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                                                       PRINTER'S NO. 602

THE GENERAL ASSEMBLY OF PENNSYLVANIA


HOUSE BILL

No. 531 Session of 2007


        INTRODUCED BY DALLY, BASTIAN, BEYER, BISHOP, CALTAGIRONE,
           CREIGHTON, CURRY, FREEMAN, GEIST, HORNAMAN, JAMES, REICHLEY,
           SIPTROTH, WALKO, WANSACZ AND YOUNGBLOOD, MARCH 6, 2007

        REFERRED TO COMMITTEE ON INSURANCE, MARCH 6, 2007

                                     AN ACT

     1  Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
     2     act relating to insurance; amending, revising, and
     3     consolidating the law providing for the incorporation of
     4     insurance companies, and the regulation, supervision, and
     5     protection of home and foreign insurance companies, Lloyds
     6     associations, reciprocal and inter-insurance exchanges, and
     7     fire insurance rating bureaus, and the regulation and
     8     supervision of insurance carried by such companies,
     9     associations, and exchanges, including insurance carried by
    10     the State Workmen's Insurance Fund; providing penalties; and
    11     repealing existing laws," providing for medical nutrition
    12     therapy coverage requirements for health insurance policies.

    13     The General Assembly of the Commonwealth of Pennsylvania
    14  hereby enacts as follows:
    15     Section 1.  The act of May 17, 1921 (P.L.682, No.284), known
    16  as The Insurance Company Law of 1921, is amended by adding a
    17  section to read:
    18     Section 635.2.  Coverage for Medical Nutrition Therapy.--(a)
    19  An individual or group health, sickness and accident insurance
    20  policy, group health insurance plan or policy and any other form
    21  of managed/capitated care plan or policy or subscriber contract
    22  or certificate issued by any entity subject to 40 Pa.C.S. Ch. 61


     1  (relating to hospital plan corporations) or 63 (relating to
     2  professional health services plan corporations) or the act of
     3  December 29, 1972 (P.L.1701, No.364), known as the "Health
     4  Maintenance Organization Act," or this act providing hospital or
     5  medical/surgical coverage shall provide coverage for medical
     6  nutrition therapy to aid in the treatment of cardiovascular
     7  disease. The minimum coverage provided shall include all costs
     8  associated with medical nutrition therapy for the length of time
     9  that such therapy is determined necessary. The benefits
    10  specified in this section may be provided through a combination
    11  of policies, contracts, certificates or riders, including major
    12  medical contracts.
    13     (b)  This section does not include the following policies:
    14  accident only, fixed indemnity, limited benefit, credit, dental,
    15  vision, specified disease, Medicare supplement, CHAMPUS
    16  (Civilian Health and Medical Program for the Uniform Services)
    17  supplement, long-term care, disability income, workers'
    18  compensation or automobile medical payment.
    19     (c)  The coverage required under this section shall be
    20  subject to the annual deductibles, copayments or coinsurance
    21  requirements imposed by an entity subject to this section for
    22  similar coverages under the same health insurance policy or
    23  contract.
    24     (d)  As used in this section:
    25     "Cardiovascular disease" means diseases of the heart and
    26  blood vessels, including congestive heart failure,
    27  arteriosclerosis, hyperlipidemia, hypertension and
    28  hypercholesterolemia.
    29     "Medical nutrition therapy" means the assessment of
    30  nutritional status and the assignment of diet, counseling or
    20070H0531B0602                  - 2 -     

     1  specialized nutrition therapies to treat an illness or
     2  condition, provided by a licensed dietitian/nutritionist.
     3     Section 2.  This act shall take effect in 60 days.


















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