Bill > SB318

This bill mandates that health insurance policies in Pennsylvania provide comprehensive coverage for postacute neurorehabilitation services for individuals with acquired brain injuries. The legislation requires insurers to cover a wide range of medically necessary treatments, including cognitive communication therapy, cognitive rehabilitation therapy, neurobehavioral therapy, neurophysiological and neuropsychological testing, functional rehabilitation therapy, community reintegration services, and day and transitional rehabilitation treatments in both facility and home-based settings. The bill specifies that insurers must verify that neurorehabilitation practitioners are accredited and qualified, and prohibits limitations on the number of covered treatment days if deemed medically necessary by the patient's treating physician. The coverage must not impose greater out-of-pocket costs than other benefits, and the Insurance Department is tasked with creating rules for personnel training and preauthorization processes. The bill defines various types of therapies and treatments related to brain injury rehabilitation and explicitly excludes certain types of insurance policies from these requirements, such as accident-only, dental, vision, and workers' compensation policies. The new regulations will apply to health insurance policies either upon initial form filing or within 180 days of the act's effective date, which is 60 days after passage.

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https://www.legis.state.pa.us/cfdocs/billinfo/bill_history.cfm?syear=2025&sind=0&body=S&type=B&bn=318