PRINTER'S NO. 2667
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
2087
Session of
2024
INTRODUCED BY T. DAVIS, JOZWIAK, MUNROE, KHAN, SANCHEZ, McNEILL,
KINSEY, MADDEN, BOROWSKI, ZIMMERMAN, GILLEN, DONAHUE, DALEY,
WARREN, COOPER, D. MILLER, CEPEDA-FREYTIZ, GAYDOS, CERRATO
AND D. WILLIAMS, MARCH 6, 2024
REFERRED TO COMMITTEE ON INSURANCE, MARCH 6, 2024
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 casualty insurance, providing
for coverage for treatment of pediatric autoimmune
neuropsychiatric disorders associated with streptococcal
infections and pediatric acute onset neuropsychiatric
syndrome.
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 635.9. Coverage for Treatment of Pediatric
Autoimmune Neuropsychiatric Disorders Associated with
Streptococcal Infections and Pediatric Acute Onset
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Neuropsychiatric Syndrome.--(a) A health insurance policy that
is offered after the effective date of this section shall
provide coverage for treatment of pediatric autoimmune
neuropsychiatric disorders associated with streptococcal
infection and pediatric acute onset neuropsychiatric syndrome,
including the use of intravenous immunoglobulin therapy.
(b) As used in this section:
(1) "Health insurance policy" means a policy, subscriber
contract, certificate or plan issued by a health insurer that
provides medical or health care coverage. The term does not
include:
(i) An accident only policy.
(ii) A dental only policy.
(iii) A vision only policy.
(iv) A credit only policy.
(v) A long-term care policy.
(vi) A disability income policy.
(vii) A specified disease policy.
(viii) A Medicare supplement policy.
(ix) A fixed indemnity policy.
(x) A workers' compensation policy.
(xi) An automobile medical payment policy.
(xii) A policy under which benefits are provided by the
Federal government to active or former military personnel and
their dependents.
(xiii) A homeowner's insurance policy.
(xiv) Any other policy providing for limited benefits.
(2) "Health insurer" means an entity that offers, issues or
renews an individual or group health insurance policy that is
offered or governed under any of the following:
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(i) This act, including section 630 and Article XXIV.
(ii) The act of December 29, 1972 (P.L.1701, No.364), known
as the "Health Maintenance Organization Act."
(iii) 40 Pa.C.S. Chs. 61 (relating to hospital plan
corporations) and 63 (relating to professional health services
plan corporations).
(3) "Pediatric acute onset neuropsychiatric syndrome" means
a clinical diagnosis given to children who have a sudden onset
of neuropsychiatric symptoms, including obsessive-compulsive
disorder and restricted food intake.
(4) "Pediatric autoimmune neuropsychiatric disorders
associated with streptococcal infections" means a clinical
diagnosis given to children who develop a sudden onset of
obsessive-compulsive disorder or involuntary purposeless
movements as a result of a streptococcal infection.
Section 2. This section shall apply as follows:
(1) For a health insurance policy for which either rates
or forms are required to be filed with the Federal Government
or the Insurance Department, this act shall apply to any
policy for which a form or rate is first permitted to be used
180 days after the effective date of this paragraph.
(2) For a health insurance policy for which neither
rates nor forms are required to be filed with the Federal
Government or the Insurance Department, this act shall apply
to any policy issued or renewed on or after 180 days after
the effective date of this paragraph.
Section 3. This act shall take effect in 60 days.
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