Bill > HB755

This bill establishes the Health Insurance Preventive Services Coverage Act, which requires health insurers in Pennsylvania to provide coverage for certain preventive services without cost-sharing for enrollees. The bill defines key terms like "preventive service" and creates a process for the Insurance Department to maintain a list of covered preventive services, which initially includes services recommended by the U.S. Preventive Services Task Force, the CDC's Advisory Committee on Immunization Practices, and the U.S. Health Resources and Services Administration. Insurers must cover these services for all non-grandfathered health insurance policies, though they retain some flexibility, such as using medical management techniques to determine service frequency and delivery. The bill also establishes an administrative process for adding or removing services from the preventive services list, which involves public notice and comment periods. Enforcement mechanisms include potential penalties for insurers who violate the act, such as fines up to $5,000 per violation, license suspension, or revocation. The bill includes a contingency provision that allows for adaptation if federal preventive services coverage requirements are repealed, invalidated, or not enforced, ensuring continued protection of preventive health services for Pennsylvania residents.

Budget and Finance, Business and Industry

https://www.legis.state.pa.us/cfdocs/billinfo/bill_history.cfm?syear=2025&sind=0&body=H&type=B&bn=755