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PRIOR PRINTER'S NO. 1607
PRINTER'S NO. 1769
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
1201
Session of
2022
INTRODUCED BY PITTMAN, KANE, LAUGHLIN, SANTARSIERO, SCAVELLO,
COSTA, J. WARD, ROBINSON, MARTIN, MASTRIANO, ARGALL,
PHILLIPS-HILL, L. WILLIAMS AND STEFANO, APRIL 21, 2022
SENATOR DiSANTO, BANKING AND INSURANCE, AS AMENDED,
JUNE 15, 2022
AN ACT
Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
act relating to insurance; amending, revising, and
consolidating the law providing for the incorporation of
insurance companies, and the regulation, supervision, and
protection of home and foreign insurance companies, Lloyds
associations, reciprocal and inter-insurance exchanges, and
fire insurance rating bureaus, and the regulation and
supervision of insurance carried by such companies,
associations, and exchanges, including insurance carried by
the State Workmen's Insurance Fund; providing penalties; and
repealing existing laws," in casualty insurance, providing
for coverage for refill of prescription eye drops.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of May 17, 1921 (P.L.682, No.284), known
as The Insurance Company Law of 1921, is amended by adding a
section to read:
Section 635.8. Coverage for Refill of Prescription Eye
Drops.--(a) A health insurance policy offered, issued or
renewed in this Commonwealth shall provide coverage for a
prescription eye drops refill if the refill:
(1) Complies with one of the following IS REQUESTED :
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(i) For a thirty-day supply, between twenty-one and thirty
days of the later of:
(A) t he original date the prescription was distributed to
the insured; or
(B) the date the most recent refill was distributed to the
insured.
(ii) For a sixty-day supply, between forty-two and sixty
days from the later of:
(A) the original date the prescription was distributed to
the insured; or
(B) the date the most recent refill was distributed to the
insured.
(iii) For a ninety-day supply, between sixty-three and
ninety days from the later of:
(A) the original date the prescription was distributed to
the insured; or
(B) the date the most recent refill was distributed to the
insured.
(2) Is prescribed by a HEALTH CARE practitioner and is a
covered benefit under the health insurance policy of the
insured.
(3) Regardless of timing, does DOES not exceed the total
number of refills indicated on the original prescription.
(b) As used in this section, the term "health insurance
policy" AS USED IN THIS SECTION:
"HEALTH INSURANCE POLICY" means an individual or group
insurance policy, subscriber contract, certificate or plan
issued by a health AN insurer that provides medical or health
care coverage, including emergency services. The term does not
include:
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(1) An accident only policy.
(2) A credit only policy.
(3) A long-term care or disability income policy.
(4) A specified disease policy.
(5) A medicare supplement policy.
(6) A TRICARE policy, including a Civilian Health and
Medical Program of the Uniformed Services (CHAMPUS) supplement
policy.
(7) A fixed indemnity policy.
(8) A HOSPITAL INDEMNITY POLICY.
(8) (9) A dental only policy.
(9) (10) A vision only policy.
(10) (11) A workers' compensation policy.
(11) (12) An automobile medical payment policy.
(12) (13) A homeowners' insurance policy.
(13) (14) A short-term limited duration policy.
(14) (15) Any other similar policy providing for limited
benefits.
Section 2. The addition of section 635.8 of the act shall
apply to a health insurance policy offered, issued or renewed on
or after the effective date of this section.
"INSURER" MEANS AN ENTITY LICENSED BY THE DEPARTMENT WITH
ACCIDENT AND HEALTH AUTHORITY TO ISSUE A HEALTH INSURANCE POLICY
THAT IS OFFERED OR GOVERNED UNDER ANY OF THE FOLLOWING:
(1) THIS ACT, INCLUDING SECTION 630 AND ARTICLE XXIV.
(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).
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SECTION 2. THE ADDITION OF SECTION 635.8 OF THE ACT SHALL
APPLY TO THE FOLLOWING:
(1) FOR A HEALTH INSURANCE POLICY FOR WHICH EITHER RATES
OR FORMS ARE REQUIRED TO BE FILED WITH THE INSURANCE
DEPARTMENT OR THE FEDERAL GOVERNMENT, A POLICY FOR WHICH A
FORM OR RATE IS FIRST FILED ON OR AFTER THE EFFECTIVE DATE OF
THIS SECTION.
(2) FOR A HEALTH INSURANCE POLICY FOR WHICH RATES OR
FORMS ARE NOT REQUIRED TO BE FILED WITH THE INSURANCE
DEPARTMENT OR THE FEDERAL GOVERNMENT, A POLICY ISSUED OR
RENEWED ON OR AFTER 180 DAYS FROM THE EFFECTIVE DATE OF THIS
SECTION.
(3) A CONTRACT BETWEEN A HEALTH CARE PRACTITIONER AND AN
INSURER THAT IS EXECUTED OR RENEWED ON OR AFTER 180 DAYS FROM
THE EFFECTIVE DATE OF THIS SECTION.
Section 3. This act shall take effect in 160 60 days.
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