PRINTER'S NO. 1171
No. 1000 Session of 2007
INTRODUCED BY MANDERINO, KENNEY, ADOLPH, ARGALL, BARRAR, BELFANTI, BENNINGHOFF, BEYER, BIANCUCCI, BISHOP, BLACKWELL, BOYD, BUXTON, CALTAGIRONE, CAPPELLI, CARROLL, CASORIO, CIVERA, COHEN, COSTA, CREIGHTON, CURRY, DALLY, DeLUCA, DePASQUALE, DERMODY, DeWEESE, DiGIROLAMO, DONATUCCI, EACHUS, J. EVANS, FABRIZIO, FAIRCHILD, FRANKEL, FREEMAN, GEIST, GEORGE, GERGELY, GIBBONS, GINGRICH, GRELL, GRUCELA, HANNA, HARHART, HARKINS, HENNESSEY, HERSHEY, HESS, JAMES, JOSEPHS, KAUFFMAN, W. KELLER, KILLION, KING, KORTZ, KOTIK, KULA, LEACH, LEVDANSKY, MACKERETH, MAHONEY, MAJOR, MANN, MARKOSEK, McCALL, McGEEHAN, McILHATTAN, McILVAINE SMITH, MELIO, MENSCH, MOYER, MUNDY, MURT, MUSTIO, MYERS, NAILOR, NICKOL, D. O'BRIEN, M. O'BRIEN, OLIVER, O'NEILL, PALLONE, PARKER, PASHINSKI, PETRONE, PICKETT, PRESTON, QUIGLEY, RAMALEY, RAPP, RAYMOND, READSHAW, REED, REICHLEY, ROEBUCK, ROSS, RUBLEY, SAMUELSON, SANTONI, SCAVELLO, SHAPIRO, SHIMKUS, SIPTROTH, K. SMITH, M. SMITH, SOLOBAY, SONNEY, STEIL, STERN, R. STEVENSON, STURLA, SURRA, SWANGER, TANGRETTI, THOMAS, TRUE, VEREB, VULAKOVICH, WAGNER, WALKO, WANSACZ, WATSON, WILLIAMS, WOJNAROSKI, YOUNGBLOOD, YUDICHAK AND BENNINGTON, APRIL 3, 2007
REFERRED TO COMMITTEE ON INSURANCE, APRIL 3, 2007
AN ACT 1 Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An 2 act relating to insurance; amending, revising, and 3 consolidating the law providing for the incorporation of 4 insurance companies, and the regulation, supervision, and 5 protection of home and foreign insurance companies, Lloyds 6 associations, reciprocal and inter-insurance exchanges, and 7 fire insurance rating bureaus, and the regulation and 8 supervision of insurance carried by such companies, 9 associations, and exchanges, including insurance carried by 10 the State Workmen's Insurance Fund; providing penalties; and 11 repealing existing laws," providing, in quality health care 12 accountability and protection, for mental health services; 13 and further providing, in quality health care accountability 14 and protection, for procedures. 15 The General Assembly of the Commonwealth of Pennsylvania
1 hereby enacts as follows: 2 Section 1. The act of May 17, 1921 (P.L.682, No.284), known 3 as The Insurance Company Law of 1921, is amended by adding a 4 section to read: 5 Section 2116.1. Mental Health Services.--(a) If an enrollee 6 has obtained a referral or other authorization through 7 utilization review from a managed care plan or a licensed 8 insurer to receive outpatient mental health care services from a 9 health care provider or specialist, such referral or other 10 authorization shall constitute a standing referral for any 11 subsequent outpatient mental health care services provided by 12 any health care provider or specialist until the mental health 13 care service for which the referral or authorization was 14 approved has reached its conclusion. 15 Section 2. Section 2121(b) of the act, added June 17, 1998 16 (P.L.464, No.68), is amended to read: 17 Section 2121. Procedures.--* * * 18 (b) The department shall establish credentialing standards 19 for managed care plans. The department may adopt nationally 20 recognized accrediting standards to establish the credentialing 21 standards for managed care plans. With respect to outpatient 22 behavioral health services, the managed care plan or licensed 23 insurer shall inform credentialing applicants of a decision 24 within ninety (90) days after the complete application has been 25 submitted. 26 * * * 27 Section 3. This act shall take effect in 60 days. C12L40VDL/20070H1000B1171 - 2 -