PRINTER'S NO. 2077
No. 1426 Session of 2008
INTRODUCED BY CORMAN, ARMSTRONG, GORDNER, EARLL, LOGAN, MADIGAN, O'PAKE, PIPPY, RAFFERTY, STACK AND TOMLINSON, MAY 22, 2008
REFERRED TO BANKING AND INSURANCE, MAY 22, 2008
AN ACT 1 Amending Title 40 (Insurance) of the Pennsylvania Consolidated 2 Statutes, further providing for the definitions of "health 3 service doctor" and "professional health services" and for 4 rights of health service doctors. 5 The General Assembly of the Commonwealth of Pennsylvania 6 hereby enacts as follows: 7 Section 1. The definitions of "health service doctor" and 8 "professional health services" in section 6302(a) of Title 40 of 9 the Pennsylvania Consolidated Statutes are amended to read: 10 § 6302. Definitions. 11 (a) General rule.--The following words and phrases when used 12 in this chapter shall have, unless the context clearly indicates 13 otherwise, the meanings given to them in this section: 14 * * * 15 "Health service doctor." [A doctor of dental surgery, doctor 16 of medicine, doctor of optometry, doctor of osteopathy, doctor 17 of podiatry, doctor of chiropractic, licensed physical 18 therapist, certified registered nurse anesthetist, certified 19 registered nurse practitioner, certified enterostomal therapy
1 nurse, certified community health nurse, certified psychiatric 2 mental health nurse, certified clinical nurse specialist, 3 licensed psychologist, licensed speech-language pathologist, 4 licensed audiologist or licensed teacher of persons who are 5 hearing impaired.] A health care professional duly licensed or 6 certified under a statute of this Commonwealth regulating a 7 particular branch of health care practice. 8 * * * 9 "Professional health services." [Dental services, medical 10 services, optometric services, osteopathic services, podiatry 11 services, chiropractic services, physical therapy services, 12 psychological services, speech-language pathology services, 13 audiology services, services of teachers of persons who are 14 hearing impaired, certified registered nurse services provided 15 by a certified registered nurse at any time except when the 16 certified registered nurse is acting as an employee of a health 17 care facility or of an anesthesiology group or any one or more 18 of them, provided any of the above-listed services are medically 19 necessary.] Professional services provided by a duly licensed 20 health service doctor, provided that such services are medically 21 necessary. 22 * * * 23 Section 2. Section 6324(a) of Title 40 is amended to read: 24 § 6324. Rights of health service doctors. 25 (a) Admission to plan.--Every health service doctor 26 practicing within the area covered by any professional health 27 service corporation shall have the right, on complying with such 28 regulations as the corporation may make with the approval of the 29 Department of Health, to register with such corporation for such 30 general or special professional health services as he may be 20080S1426B2077 - 2 -
1 licensed to practice, within that area, but the corporation may, 2 with the approval of the Department of Health, refuse to place 3 the name of any health service doctor on its register. Any 4 professional health service corporation may, with the approval 5 of the Department of Health, remove from its register the name 6 of any health service doctor after due notice and opportunity 7 for hearing for cause satisfactory to the corporation. Nothing 8 in this section shall be construed to limit the discretion of a 9 professional health service corporation to determine the classes 10 or kinds of services that will be covered under its contracts. 11 * * * 12 Section 3. This act shall take effect in 60 days. C28L40JS/20080S1426B2077 - 3 -