PRIOR PRINTER'S NO. 1777
PRINTER'S NO. 3629
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1439
Session of
2019
INTRODUCED BY KAUFER, MILLARD, DiGIROLAMO, SCHLOSSBERG, DeLUCA,
MURT, MOUL, OTTEN, WEBSTER AND DAVIDSON, MAY 8, 2019
AS REPORTED FROM COMMITTEE ON INSURANCE, HOUSE OF
REPRESENTATIVES, AS AMENDED, APRIL 27, 2020
AN ACT
Amending Title 40 (Insurance) of the Pennsylvania Consolidated
Statutes, in regulation of insurers and related persons
generally, providing for mental health parity and access to
addiction treatment.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Title 40 of the Pennsylvania Consolidated
Statutes is amended by adding a chapter to read:
CHAPTER 43
MENTAL HEALTH PARITY AND
ACCESS TO ADDICTION TREATMENT
Sec.
4301. Scope of chapter.
4302. Definitions.
4303. Certification ANNUAL ATTESTATION .
4304. Regulations.
§ 4301. Scope of chapter.
This chapter relates to a certification AN ATTESTATION of
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compliance with Federal and State insurance laws regarding
mental health and substance use disorder benefits.
§ 4302. Definitions.
The following words and phrases when used in this chapter
shall have the meanings given to them in this section unless the
context clearly indicates otherwise:
" Insurer. " As follows:
(1) An entity that issues or administers health
insurance policies or health plans and is subject to the
jurisdiction of the department.
(2) The term includes an entity organized or existing
under, or subject to, any of the following:
(i) The act of May 17, 1921 (P.L.682, No.284), known
as The Insurance Company Law of 1921.
(ii) The act of December 29, 1972 (P.L.1701,
No.364), known as the Health Maintenance Organization
Act.
(iii) The act of May 18, 1976 (P.L.123, No.54),
known as the Individual Accident and Sickness Insurance
Minimum Standards Act.
(iv) Chapter 61 (relating to hospital plan
corporations) or 63 (relating to professional health
services plan corporations).
"HEALTH INSURANCE POLICY." AS FOLLOWS:
(1) A N INSURANCE POLICY, SUBSCRIBER CONTRACT,
CERTIFICATE OR PLAN THAT PROVIDES MEDICAL OR HEALTH CARE
COVERAGE, INCLUDING EMERGENCY SERVICES.
(2) THE TERM DOES NOT INCLUDE ANY OF THE FOLLOWING TYPES
OF POLICIES:
(I) ACCIDENT ONLY.
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(II) FIXED INDEMNITY.
(III) CREDIT.
(IV) DENTAL ONLY.
(V) VISION ONLY.
(VI) SPECIFIED DISEASE.
(VII) MEDICARE SUPPLEMENT.
(VIII) CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE
UNIFORMED SERVICES (CHAMPUS) SUPPLEMENT.
(IX) LONG-TERM CARE.
(X) DISABILITY INCOME.
(XI) WORKERS' COMPENSATION.
(XII) AUTOMOBILE MEDICAL PAYMENT INSURANCE.
"INSURER." AN ENTITY LICENSED BY THE DEPARTMENT WITH
ACCIDENT AND HEALTH AUTHORITY TO ISSUE A HEALTH INSURANCE POLICY
THAT IS OFFERED OR GOVERNED UNDER ANY OF THE FOLLOWING:
(1) THE ACT OF MAY 17, 1921 (P.L.682, NO.284), KNOWN AS
THE INSURANCE COMPANY LAW OF 1921, INCLUDING SECTION 630 AND
ARTICLE XXIV OF THAT ACT.
(2) THE ACT OF DECEMBER 29, 1972 (P.L.1701, NO.364),
KNOWN AS THE HEALTH MAINTENANCE ORGANIZATION ACT.
(3) CHAPTER 61 (RELATING TO HOSPITAL PLAN CORPORATIONS)
OR 63 (RELATING TO PROFESSIONAL HEALTH SERVICES PLAN
CORPORATIONS).
"MHPAEA." The Paul Wellstone and Pete Domenici Mental Health
Parity and Addiction Equity Act of 2008 (Public Law 110-343, 122
Stat. 3765).
§ 4303. Certification.
No later than January 1 of each year, an insurer that issues
or administers a health insurance policy or health plan in this
Commonwealth, including a policy or plan in which mental health
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or substance use disorder benefits are managed by an entity
other than the insurer, shall file with the department a written
certification signed by an officer of the insurer under oath
attesting that:
(1) The insurer has completed a comprehensive review of
all health insurance policies and health plans issued or
administered by the insurer, including policies and plans in
which mental health or substance use disorder benefits are
managed by an entity other than the insurer, for compliance
with the requirements of MHPAEA and its implementing
regulations and compliance with section 604-B of the act of
May 17, 1921 (P.L.682, No.284), known as The Insurance
Company Law of 1921, and its implementing regulations.
(2) All policies and plans under paragraph (1) comply
with the laws and regulations referred to in paragraph (1).
§ 4303. ANNUAL ATTESTATION.
(A) STATEMENT REGARDING MHPAEA COMPLIANCE.--FOR THE FORM FOR
EACH HEALTH INSURANCE POLICY OFFERED, ISSUED OR RENEWED BY AN
INSURER, THE INSURER SHALL ANNUALLY FILE WITH THE DEPARTMENT A
STATEMENT ATTESTING TO THE INSURER'S DOCUMENTED ANALYSES OF
EFFORTS TO COMPLY WITH MHPAEA AND THE FEDERAL REGULATIONS
RELATING TO MENTAL HEALTH AND SUBSTANCE USE DISORDER PARITY AS
OF THE DATE OF THE ATTESTATION.
(B) STATEMENT REGARDING MHPAEA NONAPPLICABILITY.--F OR THE
FORM FOR EACH INSURANCE POLICY OFFERED, ISSUED OR RENEWED BY AN
INSURER IN THIS COMMONWEALTH THAT IS REQUIRED TO BE FILED BUT TO
WHICH MHPAEA DOES NOT APPLY, THE INSURER SHALL ANNUALLY FILE
WITH THE DEPARTMENT A STATEMENT ATTESTING TO THE
NONAPPLICABILITY OF MHPAEA TO THE POLICY FORM.
(C) FILING.--EACH ATTESTATION REQUIRED UNDER THIS SECTION
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MUST BE FILED BY APRIL 30 OF EACH YEAR OR WITH THE FORM FILING,
WHICHEVER IS EARLIER.
§ 4304. Regulations.
The department shall MAY promulgate regulations necessary to
implement this chapter.
Section 2. All acts and parts of acts are repealed insofar
as they are inconsistent with 40 Pa.C.S. Ch. 43.
SECTION 2. THIS ACT SHALL APPLY TO THE FORMS FOR EACH
INSURANCE POLICY TO BE OFFERED, ISSUED OR RENEWED BY AN INSURER
IN THIS COMMONWEALTH AFTER DECEMBER 31, 2021.
Section 3. This act shall take effect immediately.
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