PRINTER'S NO. 1532
No. 1151 Session of 2007
INTRODUCED BY PUNT, MUSTO, EARLL, O'PAKE, ERICKSON, RAFFERTY,
BOSCOLA, FONTANA, GREENLEAF, C. WILLIAMS, DINNIMAN, WAUGH,
KITCHEN, COSTA, ROBBINS, WASHINGTON, LAVALLE, RHOADES AND
HUGHES, NOVEMBER 5, 2007
REFERRED TO BANKING AND INSURANCE, NOVEMBER 5, 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," further providing for coverage for
12 mammographic examinations.
13 The General Assembly of the Commonwealth of Pennsylvania
14 hereby enacts as follows:
15 Section 1. Section 632 of the act of May 17, 1921 (P.L.682,
16 No.284), known as The Insurance Company Law of 1921, amended
17 December 15, 1992 (P.L.1129, No.148), is amended to read:
18 Section 632. Coverage for Mammographic Examinations.--All
19 group or individual health or sickness or accident insurance
20 policies providing hospital or medical/surgical coverage and all
21 group or individual subscriber contracts or certificates issued
22 by any entity subject to 40 Pa.C.S. Ch. 61 (relating to hospital
1 plan corporations) or 63 (relating to professional health
2 services plan corporations), this act, the act of December 29,
3 1972 (P.L.1701, No.364), known as the "Health Maintenance
4 Organization Act," [the act of July 29, 1977 (P.L.105, No.38),
5 known as the "Fraternal Benefit Society Code,"] or an employe
6 welfare benefit plan as defined in section 3 of the Employee
7 Retirement Income Security Act of 1974 (Public Law 93-406, 29
8 U.S.C. § 1001 et seq.) providing hospital or medical/surgical
9 coverage shall also provide coverage for mammographic
10 examinations. The minimum coverage required shall include all
11 costs associated with [a] any mammogram [every year for women 40
12 years of age or older and with any mammogram based on a
13 physician's recommendation for women under 40 years of age]
14 prescribed by a woman's treating physician. Prior to payment for
15 a screening mammogram, insurers shall verify that the screening
16 mammography service provider is properly licensed by the
17 department in accordance with the act of July 9, 1992 (P.L.449,
18 No.93), known as the "Mammography Quality Assurance Act."
19 Nothing in this section shall be construed to require an insurer
20 to cover the surgical procedure known as mastectomy or to
21 prevent application of deductible or copayment provisions
22 contained in the policy or plan.
23 Section 2. This act shall take effect in 60 days.
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