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Bill > HB966
PA HB966
PA HB966In quality health care accountability and protection, further providing for departmental powers and duties and providing for additional penalties.
summary
Introduced
03/19/2025
03/19/2025
In Committee
03/19/2025
03/19/2025
Crossed Over
Passed
Dead
Introduced Session
2025-2026 Regular Session
Bill Summary
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, further providing for departmental powers and duties and providing for additional penalties.
AI Summary
This bill amends the Insurance Company Law of 1921 to enhance health insurance accountability and impose additional penalties on insurers. The bill requires the insurance department to post its annual report on its public website, detailing the implementation and enforcement of health insurance regulations. More significantly, the bill introduces a penalty system for insurers who have a high rate of overturned adverse benefit determinations. If more than 50% of an insurer's adverse benefit determinations are overturned through internal claim and appeal procedures or external review processes, the department will impose escalating financial penalties: $50,000 for the first overturned determination, $100,000 for the second, and $250,000 for the third and subsequent overturned determinations. These penalties are intended to be used for consumer protection activities and are in addition to any other existing penalties. The bill will take effect six months after its enactment, giving insurers time to adjust to the new requirements and potential financial consequences for repeated claim denials.
Committee Categories
Business and Industry
Sponsors (36)
Arvind Venkat (D)*,
Jessica Benham (D),
Lisa Borowski (D),
Tim Brennan (D),
Andre Carroll (D),
Missy Cerrato (D),
Joe Ciresi (D),
Dan Frankel (D),
Bob Freeman (D),
Paul Friel (D),
José Giral (D),
Nancy Guenst (D),
Jim Haddock (D),
Liz Hanbidge (D),
Pat Harkins (D),
Carol Hill-Evans (D),
Kristine Howard (D),
John Inglis (D),
Carol Kazeem (D),
Malcolm Kenyatta (D),
Tarik Khan (D),
Bridget Kosierowski (D),
Rick Krajewski (D),
Maureen Madden (D),
La'Tasha Mayes (D),
Jeanne McNeill (D),
Tom Mehaffie (R),
Chris Pielli (D),
Tarah Probst (D),
Chris Rabb (D),
Nikki Rivera (D),
Abigail Salisbury (D),
Ben Sanchez (D),
Gregory Scott (D),
Mandy Steele (D),
Joseph Webster (D),
Last Action
Referred to Insurance (on 03/19/2025)
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