PRINTER'S NO.  2462

  

THE GENERAL ASSEMBLY OF PENNSYLVANIA

  

HOUSE BILL

 

No.

1888

Session of

2011

  

  

INTRODUCED BY DeLUCA, MATZIE, BISHOP, CALTAGIRONE, KOTIK, DONATUCCI, V. BROWN, GEIST, FABRIZIO, KULA, READSHAW, M. O'BRIEN, JOSEPHS, HARKINS, D. COSTA, MURT, YOUNGBLOOD AND TOOHIL, OCTOBER 3, 2011

  

  

REFERRED TO COMMITTEE ON INSURANCE, OCTOBER 3, 2011  

  

  

  

AN ACT

  

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Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An

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act relating to insurance; amending, revising, and

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consolidating the law providing for the incorporation of

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insurance companies, and the regulation, supervision, and

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protection of home and foreign insurance companies, Lloyds

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associations, reciprocal and inter-insurance exchanges, and

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fire insurance rating bureaus, and the regulation and

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supervision of insurance carried by such companies,

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associations, and exchanges, including insurance carried by

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the State Workmen's Insurance Fund; providing penalties; and

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repealing existing laws," providing for cranial hair vacuum

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prosthesis coverage standards for health insurance policies.

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The General Assembly of the Commonwealth of Pennsylvania

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hereby enacts as follows:

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Section 1.  The act of May 17, 1921 (P.L.682, No.284), known

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as The Insurance Company Law of 1921, is amended by adding a

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section to read:

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Section 635.6.  Cranial Hair Vacuum Prosthesis Insurance

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Coverage.--(a)  A health insurance policy shall provide that the

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health insurance benefits applicable under the policy include

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coverage for the cost of a medically necessary cranial hair

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vacuum prosthesis when prescribed by a physician for a person

 


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who sustains hair loss as a result of alopecia totalis or

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alopecia universalis.

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(b)  If a health insurance policy provides coverage or

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benefits to a resident of this Commonwealth, it shall be deemed

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to be delivered in this Commonwealth within the meaning of this

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section, regardless of whether the insurer issuing or delivering

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the policy is located within or outside this Commonwealth.

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(c)  Benefits for a cranial hair vacuum prosthesis shall be

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subject to any annual deductible, copayment and coinsurance

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provisions of a health insurance policy to the extent that other

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medical services covered by the policy are subject to those

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provisions. A benefit limit of one thousand five hundred dollars

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once every three years shall apply to cranial hair vacuum

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prostheses covered under this section.

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(d)  This section shall apply to any health insurance policy

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offered, issued or renewed on or after the effective date of

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this section in this Commonwealth: Provided, That this section

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shall not include the following policies: accident only, fixed

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indemnity, limited benefit, credit, dental, vision, specified

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disease, Medicare supplement, CHAMPUS (Civilian Health and

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Medical Program of the Uniformed Services) supplement, long-term

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care, disability income, workers' compensation or automobile

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medical payment.

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(e)  As used in this section:

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(1)  "Alopecia totalis" means an autoimmune disease resulting

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in complete scalp hair loss.

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(2)  "Alopecia universalis" means an autoimmune disease

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resulting in complete body hair loss.

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(3)  "Cranial hair vacuum prosthesis" means a custom designed

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system utilizing specialized materials to replace hair loss due

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to alopecia totalis or alopecia universalis.

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(4)  "Health insurance policy" means any group health,

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sickness or accident policy or subscriber contract or

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certificate issued by an entity subject to one of the following:

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(i)  This act.

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(ii)  The act of December 29, 1972 (P.L.1701, No.364), known

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as the "Health Maintenance Organization Act."

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(iii)  40 Pa.C.S. Ch. 61 (relating to hospital plan

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corporations) or 63 (relating to professional health services

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plan corporations).

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(5)  "Insurer" means an entity that issues a health insurance

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policy.

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Section 2.  This act shall take effect in 60 days.

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