1Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
2act relating to insurance; amending, revising, and
3consolidating the law providing for the incorporation of
4insurance companies, and the regulation, supervision, and
5protection of home and foreign insurance companies, Lloyds
6associations, reciprocal and inter-insurance exchanges, and
7fire insurance rating bureaus, and the regulation and
8supervision of insurance carried by such companies,
9associations, and exchanges, including insurance carried by
10the State Workmen's Insurance Fund; providing penalties; and
11repealing existing laws," in children's health care, further
12providing for legislative findings and intent, for
13definitions and for children's health care eligibility and 
14renewal processes.

15The General Assembly of the Commonwealth of Pennsylvania
16hereby enacts as follows:

17Section 1. Section 2302 of the act of May 17, 1921 (P.L.682,
18No.284), known as The Insurance Company Law of 1921, is amended
19by adding a paragraph to read:

20Section 2302. Legislative Findings and Intent.--The General
21Assembly finds and declares as follows:

22* * *

23(4.1) All reasonable measures should be taken to insure

1eligible children and to keep them insured. Strategies should be
2considered to maximize opportunities for coverage and to
3simplify and streamline eligibility and renewal processes for
4families.

5* * *

6Section 2. Section 2303 of the act is amended by adding
7definitions to read:

8Section 2303. Definitions.--As used in this article, the
9following words and phrases shall have the meanings given to
10them in this section:

11"Administrative renewals."  A process by which the Insurance
12Department provides a preprinted form, populated with
13eligibility information available to the Commonwealth, to the
14child's parent or representative, along with a notice that
15eligibility will be renewed or continued based upon such
16information, unless the Commonwealth is provided additional
17information which affects eligibility. The child's parent or
18representative must confirm the accuracy of the information and
19the desire to continue eligibility by signing a copy of the form
20in a format acceptable to the department.

21* * *

22"Continuous eligibility."  A process which assures coverage
23for a child for twelve (12) continuous months, regardless of a
24change in circumstances other than the following:

25(1)  The child no longer resides in this Commonwealth.

26(2)  The death of the child.

27(3)  The child reaches nineteen (19) years of age.

28(4)  The child's parent or representative requests
29disenrollment.

30(5)  A child who is enrolled under this article files an

1application for or is determined eligible for Medicaid and is
2enrolled in Medicaid without a coverage gap.

3(6) Any other change in circumstances as determined by the
4Insurance Department and adopted in a statement of policy.

5* * *

6"Express lane eligibility." A process which permits the use
7of findings for eligibility factors, including, but not limited
8to, income and household size from an express lane partner
9administering a government program.

10"Express lane partner."  An agency determining eligibility
11for assistance for any of the following programs:

12(1)  Temporary Assistance for Needy Families (TANF).

13(2)  Child support enforcement.

14(3)  Medicaid.

15(4)  Supplemental Nutrition Assistance Program (SNAP).

16(5)  The National School Lunch Program.

17(6)  WIC.

18(7)  The United States Housing Act of 1937 (50 Stat. 888, 42
19U.S.C. § 1437 et seq.).

20(8)  Head Start.

21(9)  Child care provided under the Child Care and Development
22Block Grant Act of 1990 (Public Law 101-508, 42 U.S.C. § 9858 et
23seq.).

24* * *

25Section 3. Section 2311(b)(2) and (g) of the act, amended
26November 2, 2006 (P.L.1314, No.136), are amended and subsection
27(i) is amended by adding a paragraph to read:

28Section 2311. Children's Health Care.--* * *

29(b) * * *

30(2) The fund, along with Federal, State and other money

1available for the program, shall be used for health care
2coverage for children as specified in this section. The
3department shall assure that the program is implemented
4Statewide. All contracts awarded under this section shall be
5awarded through a competitive procurement process. The
6department and the Department of Public Welfare shall use their
7best efforts to ensure that eligible children across this
8Commonwealth have access to health care services to be provided
9under this article and that strategies are used to simplify and 
10streamline the eligibility and renewal processes for families.

11* * *

12(g) The department shall:

13(1) Administer the children's health care program pursuant
14to this article.

15(2) Review all bids and approve and execute all contracts
16for the purpose of expanding access to health care services for
17eligible children as provided for in this subdivision.

18(3) Conduct monitoring and oversight of contracts entered
19into.

20(3.1) Implement an administrative renewal process and
21continuous eligibility process for children receiving health
22care pursuant to this article. Nothing in this article shall
23preclude the department from performing audits of initial
24applications and renewal applications to ensure the financial
25accuracy and continued eligibility based on the submitted
26information.

27(3.2)  In consultation with appropriate Commonwealth
28agencies, develop interoperability standards for data sharing
29across agencies from any express lane partner program in the
30determination of a child's eligibility for health care pursuant

1to this article and implement express lane eligibility as
2appropriate.

3(4) Issue an annual report to the Governor, the General
4Assembly and the public for each calendar year no later than
5March 1 outlining primary health services funded for the year,
6detailing the outreach and enrollment efforts and reporting by
7number of children by county and by per centum of the Federal
8poverty level, the number of children receiving health care
9services; by county and by per centum of the Federal poverty
10level, the projected number of eligible children; and the number
11of eligible children on waiting lists for enrollment in the
12health insurance program established under this act by county
13and by per centum of the Federal poverty level[.]; and detailing 
14the efforts on the implementation of strategies to streamline 
15and simplify the eligibility and renewal processes, including 
16administrative renewal, continuous eligibility and express lane 
17eligibility.

18(5) In consultation with appropriate Commonwealth agencies,
19coordinate the development and supervision of the outreach plan
20required under section 2312.

21(6) In consultation with appropriate Commonwealth agencies,
22monitor, review and evaluate the adequacy, accessibility and
23availability of services delivered to children who are enrolled
24in the health insurance program established under this
25subdivision.

26* * *

27(i) The Children's Health Advisory Council is established
28within the department as an advisory council. The following
29shall apply:

30* * *

1(10) The council shall review and evaluate the
2implementation of strategies to streamline and simplify
3eligibility and renewal processes, including administrative
4renewal, continuous eligibility and express lane eligibility.

5* * *

6Section 4. This act shall take effect in 180 days.