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                                                      PRINTER'S NO. 1108

THE GENERAL ASSEMBLY OF PENNSYLVANIA


SENATE BILL

No. 919 Session of 2007


        INTRODUCED BY BOSCOLA, GORDNER AND FONTANA, JUNE 7, 2007

        REFERRED TO BANKING AND INSURANCE, JUNE 7, 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 nondiscrimination
    12     against providers in service area of health insurers and
    13     managed care plans.

    14     The General Assembly of the Commonwealth of Pennsylvania
    15  hereby enacts as follows:
    16     Section 1.  The act of May 17, 1921 (P.L.682, No.284), known
    17  as The Insurance Company Law of 1921, is amended by adding a
    18  section to read:
    19     Section 2172.  Nondiscrimination against Health Care
    20  Providers in Service Area.--(a)  No insurer may discriminate
    21  against a health care provider that is located within the
    22  service area set forth in the insurer's health insurance policy
    23  and agrees to meet the terms and conditions of participation in

     1  the plan, including, but not limited to, any credentialing
     2  standards, established by the insurer, Medicaid program and
     3  Medicaid partnerships.
     4     (b)  (1)  The term "health insurance policy" when used in
     5  this section means any individual or group health insurance
     6  policy, subscriber contract, certificate or plan which provides
     7  medical or health care coverage by any health care facility or
     8  licensed health care provider which is offered by or is governed
     9  under this act or any of the following:
    10     (i)  Subarticle (f) of Article IV of the act of June 13, 1967
    11  (P.L.31, No.21), known as the "Public Welfare Code."
    12     (ii)  The act of December 29, 1972 (P.L.1701, No.364), known
    13  as the "Health Maintenance Organization Act."
    14     (iii)  The act of May 18, 1976 (P.L.123, No.54), known as the
    15  "Individual Accident and Sickness Insurance Minimum Standards
    16  Act."
    17     (iv)  A nonprofit corporation subject to 40 Pa.C.S. Chs. 61
    18  (relating to hospital plan corporations) and 63 (relating to
    19  professional health services plan corporations).
    20     (2)  The term "insurer" when used in this section means any
    21  entity that issues an individual or group health insurance
    22  policy, contract or plan described under clause (1) of this
    23  subsection.
    24     Section 2.  This act shall take effect in 60 days.




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