Bill > SB959

This bill amends the Insurance Company Law of 1921 to update provisions related to health insurance claim forms, primarily focusing on creating a uniform claim form for insurers and healthcare providers. The bill replaces references to the "Department of Public Welfare" with "Department of Human Services" and establishes guidelines for developing a standardized health insurance claim form. Key provisions include requiring the department to consult with insurers and healthcare providers to develop a uniform claim form, potentially using existing forms like UB-82/HCFA-1450 and HCFA-1500, and allowing insurers to request additional information on the form with departmental approval. The bill also introduces new requirements for dental claim forms, specifically mandating that insurers make direct payments to dental service providers if specifically authorized by the insured. Additionally, the Legislative Budget and Finance Committee is tasked with conducting a comprehensive study examining the costs, benefits, and impacts of direct reimbursement to non-participating providers, including potential effects on network participation. The study results could trigger a public notification process if a significant decrease in dental network participation is discovered. The bill will take effect 60 days after its passage, aiming to streamline and standardize health insurance claim processes across Pennsylvania.

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https://www.legis.state.pa.us/cfdocs/billinfo/bill_history.cfm?syear=2025&sind=0&body=S&type=B&bn=959