PRINTER'S NO. 745
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
673
Session of
2023
INTRODUCED BY BARTOLOTTA, KEARNEY, STREET, BREWSTER,
CAPPELLETTI, VOGEL, ARGALL, CULVER, PENNYCUICK AND J. WARD,
MAY 15, 2023
REFERRED TO BANKING AND INSURANCE, MAY 15, 2023
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 inpatient pasteurized donor human milk and
human milk-derived products.
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 633.1. Coverage for Inpatient Pasteurized Donor
Human Milk and Human Milk-derived Products.--(a) Every health
insurance policy that is delivered, issued, executed or renewed
in this Commonwealth on or after the effective date of this
section shall provide coverage for the use of pasteurized donor
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human milk and human milk-derived products in an inpatient
setting for an infant whose gestationally corrected age is under
twelve months, provided all of the following apply:
(1) A licensed health professional signs an order stating
that the milk and, if applicable, human milk-derived products,
are medically necessary due to any of the following:
(i) the infant has a birth weight less than one thousand
eight hundred grams or has an infant body weight below healthy
levels as determined by a licensed health professional;
(ii) the infant's gestational age at birth was thirty-four
weeks or less; or
(iii) the infant has a congenital or acquired condition that
the licensed health professional determines that the use of
pasteurized donor human milk or human milk-derived products is
medically necessary and will support the treatment and recovery
of the infant.
(2) The infant is medically or physically unable to receive
maternal breast milk or participate in breastfeeding, or the
infant's mother is medically or physically unable to produce
breast milk in sufficient quantities or of adequate caloric
density, despite lactation support.
(3) The pasteurized donor human milk or human milk-derived
product is obtained from a milk bank licensed in this
Commonwealth in accordance with the act of February 12, 2020
(P.L.13, No.7), known as the "Keystone Mother's Milk Bank Act."
(b) Reimbursement for pasteurized donor human milk and human
milk-derived products shall be separate from the hospital
payment for inpatient services.
(c) As used in this section, the following words and phrases
shall have the meanings given to them in this subsection unless
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the context clearly indicates otherwise:
"Health insurance policy" means:
(1) An individual or group health insurance policy, contract
or plan that provides medical or health care coverage by any
health care facility or licensed health care provider on an
expense-incurred service or prepaid basis and that is offered by
or is governed under any of the following:
(i) This act.
(ii) Subarticle (f) of Article IV of the act of June 13,
1967 (P.L.31, No.21), known as the "Human Services Code."
(iii) The act of December 29, 1972 (P.L.1701, No.364), known
as the "Health Maintenance Organization Act."
(iv) The act of May 18, 1976 (P.L.123, No.54), known as the
"Individual Accident and Sickness Insurance Minimum Standards
Act."
(v) A nonprofit corporation subject to 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:
(i) An accident only policy.
(ii) A credit only policy.
(iii) A long-term care or disability income policy.
(iv) A specified disease policy.
(v) A Medicare supplement policy.
(vi) A TRICARE policy, including a Civilian Health and
Medical Program of the Uniformed Services (CHAMPUS) supplement
policy.
(vii) A fixed indemnity policy.
(viii) A hospital indemnity policy.
(ix) A dental only policy.
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(x) A vision only policy.
(xi) A workers' compensation policy.
(xii) An automobile medical payment policy.
(xiii) A homeowners' insurance policy.
(xiv) A short-term limited duration policy.
(xv) Any other similar policy providing for limited
benefits.
"Licensed health professional" means a licensed physician,
licensed physician assistant or certified registered nurse
practitioner, including a clinical nurse specialist, certified
nurse-midwife or certified nurse practitioner.
Section 2. This act shall take effect in 60 days.
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