Pennsylvania HB 1519: 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 mental illness coverage.

Bill Text

PRINTER'S NO. 1775
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 1519
Session of
2025
INTRODUCED BY MALAGARI, PIELLI, KHAN, SANCHEZ, GIRAL, K.HARRIS,
HILL-EVANS, SCHLOSSBERG, HOWARD, BOYD AND RIVERA,
MAY 29, 2025
REFERRED TO COMMITTEE ON INSURANCE, MAY 29, 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 mental illness coverage.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 635.1(a) of the act of May 17, 1921
(P.L.682, No.284), known as The Insurance Company Law of 1921,
is amended and the section is amended by adding a subsection to
read:
Section 635.1. Mental Illness Coverage.--(a) As used in
this section:
(1) "Serious mental illness" means [any of the following
mental illnesses as defined by the American Psychiatric
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Association in the most recent edition of the Diagnostic and
Statistical Manual: schizophrenia, bipolar disorder, obsessive-
compulsive disorder, major depressive disorder, panic disorder,
anorexia nervosa, bulimia nervosa, schizoaffective disorder and
delusional disorder.] a mental illness, disorder or condition
included in the following classes of mental disorders designated
in the American Psychiatric Association's Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition, Text
Revision, 2022 (DSM-5-TR):
(i) Schizophrenia spectrum and other psychotic disorders.
(ii) Bipolar and related disorders.
(iii) Depressive disorders.
(iv) Anxiety disorders.
(v) Obsessive-compulsive and related disorders.
(vi) Feeding and eating disorders.
[(2) "Health insurance policy" means any group health,
sickness or accident policy or subscriber contract or
certificate issued by an entity subject to one (1) of the
following:
(i) This act.
(ii) The act of December 29, 1972 (P.L.1701, No.364), known
as the "Health Maintenance Organization Act."
(iii) 40 Pa.C.S. Ch. 61 (relating to hospital plan
corporations) or 63 (relating to professional health services
plan corporations).]
(3) "Mental health medication" means a medication which is
approved by the United States Food and Drug Administration and
used for treatment of a serious mental illness.
(4) "Health insurer" means as defined in section 2702.
(5) "MA or CHIP managed care plan" means as defined in
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section 2102.
(6) "Prior authorization" means as defined in section 2102.
* * *
(c.1) A health insurer or MA or CHIP managed care plan may
not, as a condition of coverage for a mental health medication,
require prior authorization.
* * *
Section 2. This act shall apply as follows:
(1) For a health insurance policy for which either rates
or forms are required to be filed with the Insurance
Department, the amendment of section 635.1 of the act shall
apply to a policy for which a form or rate is first filed on
or after the effective date of this paragraph.
(2) For a health insurance policy for which neither
rates nor forms are required to be filed with the Insurance
Department, the amendment of section 635.1 of the act shall
apply to a policy issued or renewed on or after 180 days
after the effective date of this paragraph.
Section 3. This act shall take effect in 60 days.
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