Regular Session 2019-2020 House Bill 0924 P.N. 1803

PRIOR PRINTER'S NO. 1038

PRINTER'S NO. 1803

THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

No.

924

Session of

2019

INTRODUCED BY TOOHIL, ULLMAN, PETRARCA, PICKETT, KINSEY,

ISAACSON, MILLARD, DeLUCA, SAYLOR, SCHWEYER, HILL-EVANS,

WARREN, KAUFER, HEFFLEY, BROWN AND EVERETT, MARCH 20, 2019

AS REPORTED FROM COMMITTEE ON INSURANCE, HOUSE OF

REPRESENTATIVES, AS AMENDED, MAY 13, 2019

AN ACT

Providing for living donor protection; and imposing duties on

the Department of Health, the Department of Labor and

Industry and the Insurance Department.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1. Short title.

This act shall be known and may be cited as the Living Donor

Protection Act.

Section 2. Definitions.

The following words and phrases when used in this act shall

have the meanings given to them in this section unless the

context clearly indicates otherwise:

"Eligible employee." As defined in the FMLA.

"FMLA." Family and Medical Leave Act of 1993 (Public Law

103-3, 29 U.S.C. § 2601 et seq.).

"Insurance policy." A policy, subscriber contract,

certificate or plan which provides medical care, health care,

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life or accident insurance coverage and which is offered or

governed under any of the following:

(1) The act of May 17, 1921 (P.L.682, No.284), known as

The Insurance Company Law of 1921, including, but not limited

to, section 630 and Article XXIV of The Insurance Company Law

of 1921.

(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) COVERAGE AND WHICH IS OFFERED, ISSUED OR

RENEWED BY AN INSURER.

"Insurer." An entity licensed by the Insurance Department

with authority to issue insurance policies.

"INSURER." AS FOLLOWS:

(1) AN ENTITY LICENSED BY THE INSURANCE DEPARTMENT WITH

AUTHORITY TO ISSUE INSURANCE POLICIES OR GOVERNED UNDER ANY

OF THE FOLLOWING:

(I) THE ACT OF MAY 17, 1921 (P.L.682, NO.284), KNOWN

AS THE INSURANCE COMPANY LAW OF 1921, INCLUDING SECTION

630 AND ARTICLE XXIV OF THE INSURANCE COMPANY LAW OF

1921.

(II) THE ACT OF DECEMBER 29, 1972 (P.L.1701,

NO.364), KNOWN AS THE HEALTH MAINTENANCE ORGANIZATION

ACT.

(III) 40 PA.C.S. CH. 61 (RELATING TO HOSPITAL PLAN

CORPORATIONS) OR 63 (RELATING TO PROFESSIONAL HEALTH

SERVICES PLAN CORPORATIONS).

(2) THE TERM DOES NOT INCLUDE ACCIDENT ONLY, FIXED

INDEMNITY, HOSPITAL INDEMNITY, LIMITED BENEFIT, CREDIT,

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DENTAL, VISION, SPECIFIED DISEASE, MEDICARE SUPPLEMENT,

CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES

(CHAMPUS) SUPPLEMENT, LONG-TERM CARE OR DISABILITY INCOME,

WORKER'S COMPENSATION OR AUTOMOBILE MEDICAL PAYMENT

INSURANCE.

"Living donor." An individual who:

(1) has donated all or part of an organ or tissue; and

(2) is not deceased.

"Organ." As follows:

(1) A human kidney, liver, heart, lung, pancreas,

esophagus, stomach, small or large intestine or portion of

the gastrointestinal tract or another part of the human body

designated by the Department of Health by regulation.

(2) The term includes blood vessels recovered during the

recovery of an organ under paragraph (1) if the blood vessels

are intended for use in organ transplantation.

"Tissue." As follows:

(1) A portion of the human body other than an organ,

including, but not limited to, a human eye, skin, bone, bone

marrow, heart valve, spermatozoon, ova, artery, vein, tendon,

ligament, pituitary gland or fluid.

(2) The term does not include blood or a blood

derivative, unless the blood or blood derivative is donated

for the purpose of research or education.

Section 3. Informational materials.

(a) Authorization.--The Department of Health shall develop

informational materials relating to living donors and the live

donation of organs and tissue.

(b) Contents.--The informational materials shall include,

but not be limited to, the following:

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(1) The benefits of live organ and tissue donation.

(2) The impact of the donation of organs or tissue on a

living donor's access to insurance and assistance.

(3) The reduction in Federal adjusted gross income, for

State personal income tax purposes, granted to a living

donor.

(4) The protections granted to a living donor under this

act., INCLUDING A LIVING DONOR'S RIGHTS UNDER THE FMLA AND

INFORMATION ON FILING A COMPLAINT WITH THE UNITED STATES

DEPARTMENT OF LABOR'S WAGE AND HOUR DIVISION IF THE LIVING

DONOR BELIEVES THAT THE LIVING DONOR'S EMPLOYER IS NOT IN

COMPLIANCE WITH THE FMLA.

(1) distributed in printed form, upon request; and

(2) posted on the publicly accessible Internet website

of the Department of Health.

(d) Update.--The Department of Health shall periodically

update the informational materials.

Section 4. Prohibited practices.

An (A) PROHIBITIONS.--SUBJECT TO SUBSECTION (B), AN insurer

may not:

(1) Engage in any of the following actions against an

individual based solely upon the individual's status as a

living donor without additional actuarial risks RISK BASED ON

SOUND ACTUARIAL PRINCIPLES REASONABLY RELATED TO ACTUAL OR

ANTICIPATED LOSS EXPERIENCE:

(i) Decline to provide an insurance policy to the

individual.

(ii) Limit coverage under an insurance policy of the

individual.

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(iii) Otherwise discriminate against the individual

regarding the premium rating, offering, issuance,

cancellation, amount of coverage or any other condition

of an insurance policy.

(2) Preclude an insured from donating all or part of an

organ or tissue as a condition for receiving or continuing to

receive coverage under an insurance policy., EXCEPT THAT AN

INSURER MAY DECLINE TO ISSUE AN INSURANCE POLICY TO AN

APPLICANT WITH A SCHEDULED DONATION UNTIL THE APPLICANT IS

RELEASED WITHOUT COMPLICATION BY THE SURGEON TO THE CARE OF

THE APPLICANT'S PRIMARY CARE PHYSICIAN.

(B) CONSTRUCTION.--SUBSECTION (A)(2) SHALL NOT BE

CONSTRUED TO REQUIRE AN INSURANCE POLICY FORM TO INCLUDE

COVERAGE OF ORGAN DONATION.

Section 5. Family and medical leave.

(a) Entitlement.--An employer subject to the FMLA shall

provide the same leave to which an eligible employee is entitled

under the FMLA, when the eligible employee is unable to work

because of a serious health condition or when the eligible

employee must care for the eligible employee's spouse, child or

parent with a serious medical condition, for the preparation and

recovery necessary for surgery related to organ or tissue

donation by or for the eligible employee or the eligible

employee's spouse, child or parent.

(b) Documentation.--An employer may require an eligible

employee to submit written documentation regarding the

preparation and recovery necessary for surgery described under

subsection (a).

Section 6. Enforcement.

(a) Insurance Department.--The Insurance Department shall

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ensure compliance with section 4 of this act.

(b) Department of Labor and Industry.--The Department of

Labor and Industry shall ensure compliance with section 5 of

this act.

A VIOLATION OF SECTION 4 IS AN UNFAIR OR DECEPTIVE ACT OR

PRACTICE UNDER THE ACT OF JULY 22, 1974 (P.L.589, NO.205), KNOWN

AS THE UNFAIR INSURANCE PRACTICES ACT.

Section 7. Rules and regulations.

The Department of Health, the Department of Labor and

Industry and the Insurance Department may EACH promulgate rules

and OR regulations as may be necessary to carry out the

provisions of this act.

Section 8. Effect of act.

Unless specifically provided otherwise under this act,

nothing in this act shall be construed to interfere with other

State law regarding organ or tissue donation.

Section 9. Effective date.

This act shall take effect in 60 days.

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