PRINTER'S NO. 3175
No. 2246 Session of 2005
INTRODUCED BY O'BRIEN, SCAVELLO, ARGALL, BAKER, BALDWIN, BEBKO-
JONES, BELARDI, BELFANTI, BLACKWELL, BOYD, BUNT, CALTAGIRONE,
CAPPELLI, CLYMER, CORRIGAN, CRAHALLA, CREIGHTON, DALLY,
DeWEESE, J. EVANS, FAIRCHILD, FLEAGLE, FLICK, GINGRICH,
GRELL, GRUCELA, HABAY, HARPER, HENNESSEY, HERMAN, HERSHEY,
HESS, M. KELLER, W. KELLER, KILLION, LaGROTTA, MAHER,
MARKOSEK, MARSICO, McGEEHAN, McILHATTAN, METCALFE, MICOZZIE,
MILLARD, MUSTIO, NAILOR, O'NEILL, PALLONE, PYLE, RAYMOND,
REICHLEY, ROSS, RUBLEY, SAINATO, SEMMEL, SHAPIRO, B. SMITH,
S. H. SMITH, SONNEY, T. STEVENSON, SURRA, J. TAYLOR, THOMAS,
TRUE, WALKO AND YUDICHAK, NOVEMBER 22, 2005
REFERRED TO COMMITTEE ON APPROPRIATIONS, NOVEMBER 22, 2005
AN ACT
1 Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
2 act to consolidate, editorially revise, and codify the public
3 welfare laws of the Commonwealth," further providing for
4 medical assistance benefit packages, coverages, copayments
5 and rates.
6 The General Assembly of the Commonwealth of Pennsylvania
7 hereby enacts as follows:
8 Section 1. Section 454 of the act of June 13, 1967 (P.L.31,
9 No.21), known as the Public Welfare Code, added July 7, 2005
10 (P.L.177, No.42), is amended to read:
11 Section 454. Medical Assistance Benefit Packages; Coverage,
12 Copayments[, Premiums] and Rates.--(a) Notwithstanding any
13 other provision of law to the contrary, the department shall
14 promulgate regulations as provided in subsection (b) to
15 establish provider payment rates[;] and the benefit packages and
1 any copayments for adults eligible for medical assistance under
2 Title XIX of the Social Security Act (49 Stat 620, 42 U.S.C. §
3 1396 et seq.) and adults eligible for medical assistance in
4 general assistance-related categories.[; and the premium
5 requirements for disabled children whose family income is above
6 two hundred percent of the Federal poverty income limit.] The
7 regulations shall authorize and describe the available benefit
8 packages and any copayments [and premiums.] The regulations
9 shall also specify the effective date for provider payment
10 rates.
11 (b) For purposes of implementing this section, and
12 notwithstanding any other provision of law, including section
13 814-A of this act, the secretary shall promulgate regulations
14 pursuant to section 204(1)(iv) of the act of July 31, 1968
15 (P.L.769, No.240), referred to as the Commonwealth Documents
16 Law, which shall, until December 31, 2005, be exempt from all of
17 the following acts:
18 (1) Section 205 of the Commonwealth Documents Law.
19 (2) Section 204(b) of the act of October 15, 1980 (P.L.950,
20 No.164), known as the "Commonwealth Attorneys Act."
21 (3) The act of June 25, 1982 (P.L.633, No.181), known as the
22 "Regulatory Review Act."
23 (c) The department is authorized to grant exceptions to any
24 limits specified in the benefit packages adopted under this
25 section or when any of the following circumstances applies:
26 (1) The department determines the recipient has a serious
27 chronic systemic illness or other serious health condition and
28 denial of the exception will jeopardize the life of or result in
29 the rapid, serious deterioration of the health of the recipient.
30 (2) The department determines that granting a specific
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1 exception to a limit is a cost-effective alternative for the
2 medical assistance program.
3 (3) The department determines that granting an exception to
4 a limit is necessary in order to comply with Federal law.
5 (d) As used in this section:
6 "Adult" means recipients twenty-one years of age or older,
7 except when in relation to copayments, for which the term means
8 recipients eighteen years of age or older.
9 "Benefit packages" means the list of items and services
10 covered by medical assistance, including any limitations on
11 covered items and services.
12 Section 2. This act shall take effect immediately.
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