Bill > HB1445

This bill establishes new regulations for insurance coverage of health care services provided in school settings, aiming to ensure that students can access necessary health services without leaving their school. The legislation prohibits health insurance policies from excluding coverage for medically necessary health care services simply because they are provided in a school facility, whether by school employees, contractors, or authorized providers. The bill defines health care services to include mental health, behavioral health, and speech therapy, and specifies that insurers can only deny coverage under specific circumstances, such as when a service is not medically necessary or is provided outside the scope of a provider's practice. The bill also addresses coordination of benefits with individualized education programs, ensuring that school entities cannot shift costs to insurers for services they are legally required to provide. Additionally, the bill includes provisions for potential penalties against insurers who violate these regulations, with the Insurance Commissioner having the authority to impose fines, suspend licenses, or issue cease and desist orders. A companion section of the bill also updates telemedicine insurance coverage rules, clarifying that insurers cannot exclude services solely because they are delivered via telemedicine, while maintaining existing protections about school-mandated services.

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=1445