Pennsylvania SB 622: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, further providing for billing.

Bill Text

PRINTER'S NO. 633
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No. 622
Session of
2025
INTRODUCED BY MUTH, BROOKS, TARTAGLIONE, PENNYCUICK, FONTANA,
COMITTA, LAUGHLIN, SANTARSIERO, KANE, KEARNEY, CAPPELLETTI,
COSTA, HUTCHINSON, L. WILLIAMS, SCHWANK, FLYNN AND MILLER,
APRIL 11, 2025
REFERRED TO BANKING AND INSURANCE, APRIL 11, 2025
AN ACT
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 casualty insurance, further
providing for billing.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 635.7(b), (d), (e) and (h) of the act of
May 17, 1921 (P.L.682, No.284), known as The Insurance Company
Law of 1921, are amended to read:
Section 635.7. Billing.--* * *
[(b) An insurer must reimburse a nonnetwork EMS agency under
the following:
(1) The EMS agency has submitted a completed standardized
form to the department requesting nonnetwork direct
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reimbursement from an insurer an EMS agency has identified. The
form must be submitted to the department annually by October 15.
The form shall declare the EMS agency's intention to receive
direct payment from an insurer identified on the form for the
next calendar year. The department shall develop a standardized
form, using an EMS agency's assigned license number, to be used
by an EMS agency that meets the conditions established under
this section. The department shall develop and maintain a
publicly accessible electronic registry that indicates which EMS
agency has requested nonnetwork direct reimbursement from an
insurer identified on the form.
(2) An EMS agency has provided notification to the insurer
upon submitting a claim for reimbursement that the EMS agency is
registered with the department to receive direct reimbursement
as provided for under this section.]
* * *
[(d) Where an insurer has reimbursed a nonnetwork EMS agency
at the same rate it has established for a network EMS agency,
the EMS agency may not bill the insured directly or indirectly
or otherwise attempt to collect from the insured for the service
provided, except for a billing to recover a copayment,
coinsurance or deductible as specified in the health insurance
policy.
(e) An EMS agency that submits a form under this section may
solicit donations or memberships or conduct fundraising, except
that an EMS agency may not promise, suggest or infer to donors
that a donation will result in the donor not being billed
directly for any payment as provided under this section.
Notwithstanding this paragraph, an EMS agency may bill in
accordance with subsection (d). A violation of this section
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shall be considered a violation of the act of December 17, 1968
(P.L.1224, No.387), known as the "Unfair Trade Practices and
Consumer Protection Law."]
* * *
(h) The following words and phrases when used in this
section shall have the meanings given to them in this subsection
unless the context clearly indicates otherwise:
["Department." Department of Health of the Commonwealth.]
"EMS agency." As defined in 35 Pa.C.S. § 8103 (relating to
definitions).
"Emergency medical services." As defined in 35 Pa.C.S. §
8103 (relating to definitions).
"Insurer." As follows:
(1) An entity that is responsible for providing or paying
for all or part of the cost of emergency medical services
covered by an insurance policy, contract or plan. The term
includes an entity subject to:
(i) section 630, Article XXIV or any other provision of this
act;
(ii) the act of December 29, 1972 (P.L.1701, No.364), known
as the Health Maintenance Organization Act; or
(iii) 40 Pa.C.S. Ch. 61 (relating to hospital plan
corporations) or 63 (relating to professional health services
plan corporations).
(2) The term does not include an entity that is responsible
for providing or paying under an insurance policy, contract or
plan which meets any of the following:
(i) Is a homeowner's insurance policy.
(ii) Provides any of the following types of insurance:
(A) Accident only.
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(B) Fixed indemnity.
(C) Limited benefit.
(D) Credit.
(E) Dental.
(F) Vision.
(G) Specified disease.
(H) Medicare supplement.
(I) Civilian Health and Medical Program of the Uniformed
Services (CHAMPUS) supplement.
(J) Long-term care