Pennsylvania HB 2427: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in quality health care accountability and protection, further providing for definitions and providing for utilization management for stage four, advanced metastatic cancer drugs; and making a repeal.

Bill Text

PRINTER'S NO. 3233
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 2427
Session of
2026
INTRODUCED BY WARREN, BENNINGHOFF, VENKAT, PICKETT, HILL-EVANS,
VITALI, SANCHEZ AND NEILSON, APRIL 20, 2026
REFERRED TO COMMITTEE ON INSURANCE, APRIL 21, 2026
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 quality health care
accountability and protection, further providing for
definitions and providing for utilization management for
stage four, advanced metastatic cancer drugs; and making a
repeal.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 2102 of the act of May 17, 1921 (P.L.682,
No.284), known as The Insurance Company Law of 1921, is amended
by adding a definition to read:
Section 2102. Definitions.--As used in this article, the
following words and phrases shall have the meanings given to
them in this section:
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"Stage four, advanced metastatic cancer." Cancer that has
spread from the primary or original site of the cancer to nearby
tissues, lymph nodes or other areas of the body.
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Section 2. The act is amended by adding a section to read:
Section 2157.1. Utilization management for stage four, advanced
metastatic cancer drugs.
An insurer or health insurance policy that, directly or
indirectly, covers the treatment of stage four, advanced
metastatic cancer may not require a covered person to first fail
to successfully respond to a different drug, or prove a history
of failure in use of a different drug, before providing coverage
for a covered drug to which both of the following apply:
(1) The drug is approved by the United States Food and
Drug Administration for this indication.
(2) The prescription of the drug is consistent with the
best clinical practices for the treatment of stage four,
advanced metastatic cancer or a severe adverse health
condition experienced as a result of stage four, advanced
metastatic cancer, and is supported by peer-reviewed medical
literature.
Section 3. Repeals are as follows:
(1) The General Assembly declares that the repeal under
paragraph (2) is necessary to effectuate the addition of
section 2157.1 of the act.
(2) The act of February 12, 2020 (P.L.11, No.6), known
as the Fair Access to Cancer Treatment Law, is repealed.
Section 4. The addition of section 2157.1 of the act is a
continuation of the act of February 12, 2020 (P.L.11, No.6),
known as the Fair Access to Cancer Treatment Law. The following
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shall apply:
(1) Except as otherwise provided in section 2157.1 of
the act, all activities initiated under the Fair Access to
Cancer Treatment Law shall continue and remain in full force
and effect and may be completed under section 2157.1 of the
act. Orders, regulations, rules and decisions which were made
under the Fair Access to Cancer Treatment Law, and which are
in effect on the effective date of this section, shall remain
in full force and effect until revoked, vacated or modified
under section 2157.1 of the act. Contracts, obligations and
collective bargaining agreements entered into under the Fair
Access to Cancer Treatment Law are not affected nor impaired
by the repeal of the Fair Access to Cancer Treatment Law.
(2) Any difference in language between section 2157.1 of
the act and the Fair Access to Cancer Treatment Law is
intended only to conform to the style of the Pennsylvania
Consolidated Statutes and is not intended to change or affect
the legislative intent, judicial construction or
administration and implementation of the Fair Access to
Cancer Treatment Law.
Section 5. This act shall take effect immediately.
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