Pennsylvania HB 1140: An Act providing for access to contraceptives; imposing duties on the Insurance Department and the Department of Human Services; providing for severability; and imposing penalties.

Bill Text

PRINTER'S NO. 1449
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 1140
Session of
2025
INTRODUCED BY KRUEGER, VENKAT, KINKEAD, WAXMAN, GIRAL, BOROWSKI,
HILL-EVANS, PROBST, MALAGARI, GUENST, SMITH-WADE-EL, RABB,
PIELLI, MADDEN, FIEDLER, CURRY, HOHENSTEIN, SANCHEZ, OTTEN,
BOYD, KENYATTA, D. WILLIAMS, O'MARA, RIVERA, DAVIDSON,
CERRATO, STEELE AND SCHLOSSBERG, APRIL 22, 2025
REFERRED TO COMMITTEE ON INSURANCE, APRIL 22, 2025
AN ACT
Providing for access to contraceptives; imposing duties on the
Insurance Department and the Department of Human Services;
providing for severability; and imposing penalties.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as the Contraceptive
Access for All Act.
Section 2. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Agreement with the Department of Human Services." An
agreement between an MA or CHIP managed care plan and the
Department of Human Services to manage the purchase and
provision of services.
"Cost sharing." As follows:
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(1) The share of the health care costs covered by an MA
or CHIP managed care plan or a health insurance policy that
an enrollee or covered person pays out of pocket.
(2) The term includes a deductible, coinsurance,
copayment or similar charge.
(3) The term does not include a premium, a balance
billed amount from an out-of-network provider or the cost of
a noncovered service.
"Covered person." A policyholder, subscriber, covered person
or other individual who is entitled to receive health care
services under a health insurance policy.
"Department." The Insurance Department of the Commonwealth.
"Enrollee." An individual who is entitled to receive health
care services under an agreement with the Department of Human
Services.
"FDA." The United States Food and Drug Administration.
"Health care provider." An individual who is authorized to
practice some component of the healing arts by a license,
permit, certificate or registration issued by a Commonwealth
licensing agency or board.
"Health insurance policy." As follows:
(1) A policy, subscriber contract, certificate or plan
issued by a health insurer that provides medical or health
care coverage.
(2) The term does not include any of the following:
(i) An accident only policy.
(ii) A credit only policy.
(iii) A long-term care policy.
(iv) A disability income policy.
(v) A specified disease policy.
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(vi) A Medicare supplement policy.
(vii) A fixed indemnity policy.
(viii) A dental only policy.
(ix) A vision only policy.
(x) A workers' compensation policy.
(xi) An automobile medical payment policy.
(xii) A policy under which benefits are provided by
the Federal Government to active or former military
personnel and their dependents.
(xiii) A hospital indemnity policy.
(xiv) Any other similar policy providing for limited
benefits.
"Health insurer." An entity licensed by the department that
offers, issues or renews an individual or group health insurance
policy that is offered or governed under any of the following:
(1) The act of May 17, 1921 (P.L.682, No.284), known as
The Insurance Company Law of 1921, including section 630 and
Article XXIV thereof.
(2) The act of December 29, 1972 (P.L.1701, No.364),
known as the Health Maintenance Organization Act.
(3) 40 Pa.C.S. Ch. 61 (relating to hospital plan
corporations) or 63 (relating to professional health services
plan corporations).
"Medical Assistance or CHIP managed care plan" or "MA or CHIP
managed care plan." A health care plan that uses a gatekeeper
to manage the utilization of health care services by medical
assistance or children's health insurance program enrollees and
integrates the financing and delivery of health care services.
"Out-of-network provider." A health care provider who does
not contract with an MA or CHIP managed care plan or a health
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insurer to provide health care services to an enrollee or
covered person.
"Prior authorization." As defined in section 2102 of The
Insurance Company Law of 1921.
"Step therapy." As defined in section 2102 of The Insurance
Company Law of 1921.
Section 3. Minimum coverage requirements.
(a) Mandatory coverage.--
(1) Except as provided in section 5 and subject to
subsection (e), an MA or CHIP managed care plan or health
insurance policy offered, issued or renewed in this
Commonwealth shall provide coverage for all of the following:
(i) Any of the following for which an enrollee or
covered person obtained a prescription:
(A) An FDA-approved contraceptive drug.
(B) An FDA-approved, cleared or granted
contraceptive device or other product.
(ii) All