PRIOR PRINTER'S NO. 1929 PRINTER'S NO. 3151
No. 1554 Session of 2005
INTRODUCED BY PISTELLA, DeWEESE, BEBKO-JONES, BELFANTI,
CALTAGIRONE, FABRIZIO, FREEMAN, GEORGE, JAMES, JOSEPHS,
KOTIK, ROBERTS, SHANER, SOLOBAY, STABACK, TIGUE, WALKO AND
YOUNGBLOOD, MAY 10, 2005
AS RE-REPORTED FROM COMMITTEE ON APPROPRIATIONS, HOUSE OF
REPRESENTATIVES, AS AMENDED, NOVEMBER 21, 2005
AN ACT
1 Amending the act of July 19, 1979 (P.L.130, No.48), entitled "An
2 act relating to health care; prescribing the powers and
3 duties of the Department of Health; establishing and
4 providing the powers and duties of the State Health
5 Coordinating Council, health systems agencies and Health Care
6 Policy Board in the Department of Health, and State Health
7 Facility Hearing Board in the Department of Justice;
8 providing for certification of need of health care providers
9 and prescribing penalties," prohibiting third-party
10 guarantees of payment for admission; imposing powers and
11 duties upon the Department of Health; AND imposing penalties <--
12 for violation; and making an appropriation. <--
13 The General Assembly of the Commonwealth of Pennsylvania
14 hereby enacts as follows:
15 Section 1. The act of July 19, 1979 (P.L.130, No.48), known
16 as the Health Care Facilities Act, is amended by adding a
17 chapter to read:
18 CHAPTER 8-A
19 THIRD-PARTY SIGNERS TO NURSING HOME ADMISSIONS CONTRACTS
20 Section 801-A. Legislative policy.
21 The General Assembly finds and declares as follows:
1 (1) A nursing home may not require a third party to
2 guarantee payment for residents or prospective residents.
3 (2) It is desirable to provide protection for third
4 parties, with respect to admissions policies, beyond that
5 afforded by section 1819(c)(5)(A)(ii) of the Social Security
6 Act (49 Stat. 620, 42 U.S.C. § 1395i-3(c)(5)(A)(ii)).
7 Consistent with this intent, the use of the term "responsible
8 party" in admissions agreements is overbroad and should not
9 be construed as a guarantee of payment by the third party.
10 Section 802-A. Definitions.
11 The following words and phrases when used in this chapter
12 shall have the meanings given to them in this section unless the
13 context clearly indicates otherwise:
14 "Agent." A person that assists the resident during admission
15 or residency at a long-term care nursing facility.
16 "Department." The Department of Health of the Commonwealth.
17 "Facility." A facility licensed under Article X of the act
18 of June 13, 1967 (P.L.31, No.21), known as the Public Welfare
19 Code.
20 "Resident." An individual who resides at a facility.
21 Section 803-A. Liability.
22 (a) Construction.--This chapter shall not be construed to
23 impose liability on a third-party signer who signed prior to the
24 effective date of this chapter.
25 (b) Agents.--
26 (1) Except as set forth in paragraph (2), an agent shall
27 not incur personal liability to a facility for costs
28 associated with residence at a facility.
29 (2) Paragraph (1) does not apply if the agent does any
30 of the following:
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1 (i) Breaches a duty to provide payment from the
2 resident's income or resources.
3 (ii) Misuses the resident's income or resources.
4 (3) A person that signs an agreement with a facility as
5 a "responsible party" is presumed to be signing as an agent.
6 Section 804-A. Third-party signature on admissions contract.
7 (a) Prohibition.--A facility may not require a third-party
8 guarantee of payment to the facility as a condition of
9 admission, expedited admission or continued stay in the
10 facility.
11 (b) Requirement to pay.--.
12 (1) Persons who may be required to act as primary payers
13 for the resident's care and be held personally liable for
14 payments include the following:
15 (i) The resident, individually or through power of
16 attorney. This paragraph includes public assistance
17 provided to the resident.
18 (ii) An insurer.
19 (iii) A voluntary third-party payer, other than one
20 signing as "agent" or "responsible party."
21 (2) A third-party is presumed to be signing in the
22 capacity of an agent unless signing as "guarantor" or
23 "voluntary third-party payer."
24 (c) Effect.--A contract in violation of this section is
25 void.
26 Section 805-A. Administration.
27 The department shall promulgate regulations to ensure that
28 third parties are not required to guarantee payment and that
29 only those individuals listed in section 804-A(b)(1) (relating
30 to third-party signature on admissions contract) are required to
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1 pay for the resident's care.
2 Section 806-A. Remedies.
3 (a) Penalties.--The department may recover a civil penalty
4 of up to $1,000 against a facility that violates any provision
5 of this chapter. A penalty shall be levied for each violation,
6 with the maximum civil penalty of $10,000 for repeat violations
7 within any calendar year.
8 (b) Equity.--The department may seek an injunction to
9 prevent a facility from violating this chapter.
10 Section 2. The sum of $ , or as much thereof as may be <--
11 necessary, is hereby appropriated to the Department of Health to
12 carry out the provisions of Chapter 8-A of the act.
13 Section 3 2. This act shall take effect as follows: <--
14 (1) The following provisions shall take effect
15 immediately:
16 (i) Section 803-A of the act.
17 (ii) Section 805-A of the act.
18 (iii) Section 2 of this act. <--
19 (iv) (III) This section. <--
20 (2) The remainder of this act shall take effect on the
21 effective date of the regulations promulgated under section
22 805-A of the act.
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