Pennsylvania HB 2673: An Act amending the act of March 10, 1949 (P.L.30, No.14), known as the Public School Code of 1949, in school health services, providing for portable airway clearance devices.

Bill Text

PRINTER'S NO. 3714
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 2673
Session of
2026
INTRODUCED BY VENKAT, KHAN, KOSIEROWSKI, WAXMAN, ABNEY,
MALAGARI, KINKEAD, RIVERA, BOROWSKI, STEELE, GUZMAN,
HOHENSTEIN, SANCHEZ, BOYD, D. WILLIAMS AND PASHINSKI,
JUNE 26, 2026
REFERRED TO COMMITTEE ON INSURANCE, JUNE 26, 2026
AN ACT
Amending Title 40 (Insurance) of the Pennsylvania Consolidated
Statutes, providing for preventive services coverage.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Title 40 of the Pennsylvania Consolidated
Statutes is amended by adding a chapter to read:
CHAPTER 52
PREVENTIVE SERVICES COVERAGE
Sec.
5201. Scope of chapter.
5202. Definitions.
5203. Preventive services coverage requirements.
5204. Additions and exceptions.
5205. Construction.
5206. Regulations.
5207. Enforcement.
§ 5201. Scope of chapter.
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This chapter relates to preventive services coverage.
§ 5202. Definitions.
The following words and phrases when used in this chapter
shall have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Advisory Committee on Immunization Practices." The Advisory
Committee on Immunization Practices of the Centers for Disease
Control and Prevention.
"Commissioner." The Insurance Commissioner of the
Commonwealth.
"Cost sharing." The share of health care costs covered by a
health insurance policy that an enrollee pays out of pocket. The
term includes deductibles, coinsurance, copayments and similar
charges. The term does not include a premium, a balance billed
amount from an out-of-network provider or the cost of a
noncovered service.
"Enrollee." As defined in section 9103 (relating to
definitions).
"Grandfathered health care plan." As defined in section
9103.
"Health care provider." A person who is licensed, certified
or otherwise regulated to provide health care services under the
laws of this Commonwealth.
"Health insurance policy." A policy, subscriber contract,
certificate or plan issued by an insurer that provides medical
or health care coverage. The term does not include any of the
following:
(1) An accident only policy.
(2) A credit only policy.
(3) A long-term care or disability income policy.
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(4) A specified disease policy.
(5) A Medicare supplement policy.
(6) A fixed indemnity policy.
(7) A dental only policy.
(8) A vision only policy.
(9) A workers' compensation policy.
(10) An automobile medical payment policy.
(11) A policy under which benefits are provided by the
Federal Government to active or former military personnel and
their dependents.
(12) A hospital indemnity policy.
(13) Any other similar policy providing for limited
benefits.
"Immunization." A vaccine or other immunizing agent. The
term includes vaccines or other immunizing agents required to be
covered by an individual health insurance policy approved to be
offered or issued in this Commonwealth on January 1, 2025.
"Insurer." As defined in section 9103.
"Out-of-network provider." A health care provider who does
not contract with an insurer to provide health care services to
an enrollee under a health insurance policy.
"Preventive service." A health care service that is on the
preventive services list.
"Preventive services list." A list of health care services
compiled by the department that includes health care services:
(1) Required to be covered by an individual health
insurance policy approved to be offered or issued in this
Commonwealth on January 1, 2025, as a preventive service in
accordance with 42 U.S.C. § 300gg-13 (relating to coverage of
preventive health services), other than any health care
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service exempted by the department under the modification
process under section 5204 (relating to additions and
exceptions).
(2) Added by the department under the modification
process under section 5204.
§ 5203. Preventive services coverage requirements.
An insurer offering, issuing or renewing a health insurance
policy shall provide coverage and may not impose any cost-
sharing requirements for services on the preventive services
list. This section shall not apply to a grandfathered health
care plan.
§ 5204. Additions and exceptions.
(a) Authority of department.--The department may, in
consultation with the Department of Health, add or except a
preventive service from the preventive services list if the
Department of Health makes a determination consistent with the
requirements of this section.
(b) Additions to preventive services list.--The department
may add a preventive service to the preventive services list and
establish the manner and frequency of the service's
administration based on a determination by the Department of
Health of at least one of the following:
(1) The service is the