PRINTER'S NO. 1813
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
1215
Session of
2020
INTRODUCED BY ARGALL AND J. WARD, JUNE 23, 2020
REFERRED TO BANKING AND INSURANCE, JUNE 23, 2020
AN ACT
Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
act relating to insurance; amending, revising, and
consolidating the law providing for the incorporation of
insurance companies, and the regulation, supervision, and
protection of home and foreign insurance companies, Lloyds
associations, reciprocal and inter-insurance exchanges, and
fire insurance rating bureaus, and the regulation and
supervision of insurance carried by such companies,
associations, and exchanges, including insurance carried by
the State Workmen's Insurance Fund; providing penalties; and
repealing existing laws," in health insurance coverage parity
and nondiscrimination, providing for nondiscrimination of
chiropractic services and imposing penalties.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of May 17, 1921 (P.L.682, No.284), known
as The Insurance Company Law of 1921, is amended by adding a
section to read:
Section 607-B. Chiropractic services.
(a) Prohibitions.--An insurer may not do any of the
following:
(1) Pay a chiropractor less for a service or procedure
identified under a particular physical medicine and
rehabilitation code, evaluation and management code or spinal
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manipulation code than the insurer pays other licensed
providers under the same or substantially similar code.
(2) Create a chiropractor-specific billing code.
(3) Place extra restrictions on managed care practices
for chiropractic benefits.
(4) Charge higher copayments and other out-of-pocket
expenses for chiropractic coverage than for similar care
provided by other licensed providers.
(5) Put stricter limitations on the number of visits or
days of coverage for chiropractic care.
(b) Construction of policies, plans and contracts.--
(1) Notwithstanding any other provision of law, when an
insurer provides payment for medical expense benefits or
procedures, the policy, plan or contract shall be construed
to include payment to a chiropractor who provides the medical
service benefits or procedures which are within the scope of
a chiropractic physician's license.
(2) A limitation or condition placed on payment to, or
upon services, diagnosis or treatment by a licensed physician
shall apply equally to all licensed physicians without unfair
discrimination to the usual and customary treatment
procedures of any class of physicians.
(c) Antidiscrimination.--An insurer shall conform to the
antidiscrimination provisions under section 2706 of the Federal
Patient Protection and Affordable Care Act (Public Law 111-148,
124 Stat. 119).
(d) Penalties.--An insurer that violates this section shall
be subject to review and appropriate penalties imposed by the
department, including possible nonrenewal of licenses as
provided in this act or other applicable law.
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Section 2. This act shall take effect in 60 days.
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