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PRINTER'S NO. 644
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
596
Session of
2021
INTRODUCED BY ARGALL, J. WARD, SCAVELLO, PITTMAN, VOGEL,
SCHWANK, YUDICHAK AND HUTCHINSON, APRIL 21, 2021
REFERRED TO BANKING AND INSURANCE, APRIL 21, 2021
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 quality health care
accountability and protection, providing for chiropractors.
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 2167. Chiropractors.--(a) A health carrier may not
pay a chiropractor less for a service or procedure identified
under a particular physical medicine and rehabilitation code,
evaluation and management code or spinal manipulation code than
it pays any other licensed provider under the same or
substantially similar code. A carrier may not circumvent this
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requirement by creating a chiropractic-specific-code.
(b) Health insurance plans may not do any of the following:
(1) Have more restrictive managed care practices for
chiropractic benefits for other health care services.
(2) Charge higher co-payments and other out-of-pocket
expenses for chiropractic coverage than for similar care
provided by other licensed providers.
(3) Put higher limitations on the number of visits or days
of coverage for chiropractor care than they do for other health
care providers.
(c) Notwithstanding any other provision of law, when any
health insurance policy, health care services plan or other
contract provides for the 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. Any limitation or condition
placed upon payment to, or upon services, diagnosis or treatment
by, any licensed physician shall apply equally to all licensed
physicians without unfair discrimination to the usual and
customary treatment procedures of any class of physicians.
(d) Health carriers shall conform to the anti-discrimination
language contained in section 2706 of The Patient Protection and
Affordable Care Act (Public Law 111-148, 124 Stat. 119).
(e) The office of the Commissioner of the Insurance
Department may adopt rules necessary to implement this section.
(f) Health carriers or health care plans found in violation
of this section shall be subject to review and appropriate
penalties imposed by the Pennsylvania Insurance Department
including possible non-renewal of licenses.
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Section 2. This act shall take effect in 90 days.
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