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A01409
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
924
Session of
2019
INTRODUCED BY TOOHIL, ULLMAN, PETRARCA, PICKETT, KINSEY,
ISAACSON, MILLARD, DeLUCA, SAYLOR, SCHWEYER, HILL-EVANS,
WARREN, KAUFER, HEFFLEY, BROWN AND EVERETT, MARCH 20, 2019
AS REPORTED FROM COMMITTEE ON INSURANCE, HOUSE OF
REPRESENTATIVES, AS AMENDED, MAY 13, 2019
AN ACT
Providing for living donor protection; and imposing duties on
the Department of Health, the Department of Labor and
Industry and the Insurance Department.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as the Living Donor
Protection Act.
Section 2. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Eligible employee." As defined in the FMLA.
"FMLA." Family and Medical Leave Act of 1993 (Public Law
103-3, 29 U.S.C. ยง 2601 et seq.).
"Insurance policy." A policy, subscriber contract,
certificate or plan which provides medical care, health care,
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life or accident insurance coverage and which 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, but not limited
to, section 630 and Article XXIV of The Insurance Company Law
of 1921.
(2) The act of December 29, 1972 (P.L.1701, No.364),
known as the Health Maintenance Organization Act.
(3) 40 Pa.C.S. Ch. 61 (relating to hospital plan
corporations) or 63 (relating to professional health services
plan corporations) COVERAGE AND WHICH IS OFFERED, ISSUED OR
RENEWED BY AN INSURER.
"Insurer." An entity licensed by the Insurance Department
with authority to issue insurance policies.
"INSURER." AS FOLLOWS:
(1) AN ENTITY LICENSED BY THE INSURANCE DEPARTMENT WITH
AUTHORITY TO ISSUE INSURANCE POLICIES OR GOVERNED UNDER ANY
OF THE FOLLOWING:
(I) 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 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) 40 PA.C.S. CH. 61 (RELATING TO HOSPITAL PLAN
CORPORATIONS) OR 63 (RELATING TO PROFESSIONAL HEALTH
SERVICES PLAN CORPORATIONS).
(2) THE TERM DOES NOT INCLUDE ACCIDENT ONLY, FIXED
INDEMNITY, HOSPITAL INDEMNITY, LIMITED BENEFIT, CREDIT,
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DENTAL, VISION, SPECIFIED DISEASE, MEDICARE SUPPLEMENT,
CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES
(CHAMPUS) SUPPLEMENT, LONG-TERM CARE OR DISABILITY INCOME,
WORKER'S COMPENSATION OR AUTOMOBILE MEDICAL PAYMENT
INSURANCE.
"Living donor." An individual who:
(1) has donated all or part of an organ or tissue; and
(2) is not deceased.
"Organ." As follows:
(1) A human kidney, liver, heart, lung, pancreas,
esophagus, stomach, small or large intestine or portion of
the gastrointestinal tract or another part of the human body
designated by the Department of Health by regulation.
(2) The term includes blood vessels recovered during the
recovery of an organ under paragraph (1) if the blood vessels
are intended for use in organ transplantation.
"Tissue." As follows:
(1) A portion of the human body other than an organ,
including, but not limited to, a human eye, skin, bone, bone
marrow, heart valve, spermatozoon, ova, artery, vein, tendon,
ligament, pituitary gland or fluid.
(2) The term does not include blood or a blood
derivative, unless the blood or blood derivative is donated
for the purpose of research or education.
Section 3. Informational materials.
(a) Authorization.--The Department of Health shall develop
informational materials relating to living donors and the live
donation of organs and tissue.
(b) Contents.--The informational materials shall include,
but not be limited to, the following:
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(1) The benefits of live organ and tissue donation.
(2) The impact of the donation of organs or tissue on a
living donor's access to insurance and assistance.
(3) The reduction in Federal adjusted gross income, for
State personal income tax purposes, granted to a living
donor.
(4) The protections granted to a living donor under this
act., INCLUDING A LIVING DONOR'S RIGHTS UNDER THE FMLA AND
INFORMATION ON FILING A COMPLAINT WITH THE UNITED STATES
DEPARTMENT OF LABOR'S WAGE AND HOUR DIVISION IF THE LIVING
DONOR BELIEVES THAT THE LIVING DONOR'S EMPLOYER IS NOT IN
COMPLIANCE WITH THE FMLA.
(c) Distribution.--The informational materials shall be:
(1) distributed in printed form, upon request; and
(2) posted on the publicly accessible Internet website
of the Department of Health.
(d) Update.--The Department of Health shall periodically
update the informational materials.
Section 4. Prohibited practices.
An (A) PROHIBITIONS.--SUBJECT TO SUBSECTION (B), AN insurer
may not:
(1) Engage in any of the following actions against an
individual based solely upon the individual's status as a
living donor without additional actuarial risks RISK BASED ON
SOUND ACTUARIAL PRINCIPLES REASONABLY RELATED TO ACTUAL OR
ANTICIPATED LOSS EXPERIENCE:
(i) Decline to provide an insurance policy to the
individual.
(ii) Limit coverage under an insurance policy of the
individual.
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(iii) Otherwise discriminate against the individual
regarding the premium rating, offering, issuance,
cancellation, amount of coverage or any other condition
of an insurance policy.
(2) Preclude an insured from donating all or part of an
organ or tissue as a condition for receiving or continuing to
receive coverage under an insurance policy., EXCEPT THAT AN
INSURER MAY DECLINE TO ISSUE AN INSURANCE POLICY TO AN
APPLICANT WITH A SCHEDULED DONATION UNTIL THE APPLICANT IS
RELEASED WITHOUT COMPLICATION BY THE SURGEON TO THE CARE OF
THE APPLICANT'S PRIMARY CARE PHYSICIAN.
(B) CONSTRUCTION.--SUBSECTION (A)(2) SHALL NOT BE
CONSTRUED TO REQUIRE AN INSURANCE POLICY FORM TO INCLUDE
COVERAGE OF ORGAN DONATION.
Section 5. Family and medical leave.
(a) Entitlement.--An employer subject to the FMLA shall
provide the same leave to which an eligible employee is entitled
under the FMLA, when the eligible employee is unable to work
because of a serious health condition or when the eligible
employee must care for the eligible employee's spouse, child or
parent with a serious medical condition, for the preparation and
recovery necessary for surgery related to organ or tissue
donation by or for the eligible employee or the eligible
employee's spouse, child or parent.
(b) Documentation.--An employer may require an eligible
employee to submit written documentation regarding the
preparation and recovery necessary for surgery described under
subsection (a).
Section 6. Enforcement.
(a) Insurance Department.--The Insurance Department shall
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ensure compliance with section 4 of this act.
(b) Department of Labor and Industry.--The Department of
Labor and Industry shall ensure compliance with section 5 of
this act.
A VIOLATION OF SECTION 4 IS AN UNFAIR OR DECEPTIVE ACT OR
PRACTICE UNDER THE ACT OF JULY 22, 1974 (P.L.589, NO.205), KNOWN
AS THE UNFAIR INSURANCE PRACTICES ACT.
Section 7. Rules and regulations.
The Department of Health, the Department of Labor and
Industry and the Insurance Department may EACH promulgate rules
and OR regulations as may be necessary to carry out the
provisions of this act.
Section 8. Effect of act.
Unless specifically provided otherwise under this act,
nothing in this act shall be construed to interfere with other
State law regarding organ or tissue donation.
Section 9. Effective date.
This act shall take effect in 60 days.
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