Pennsylvania HB 392: 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. 357
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 392
Session of
2025
INTRODUCED BY GROVE, STENDER, KUTZ, STAATS AND GILLEN,
JANUARY 28, 2025
REFERRED TO COMMITTEE ON INSURANCE, JANUARY 28, 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 of the act of May 17, 1921
(P.L.682, No.284), known as The Insurance Company Law of 1921,
is amended by adding subsections to read:
Section 635.7. Billing.--* * *
(b.1) When an insurer reimburses for a nonnetwork EMS agency
emergency medical service and the reimbursement payment is paid
directly to an insurance policyholder, the payment shall be
accompanied with a notification in writing that includes the
following information:
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(1) the date the emergency medical service was performed;
(2) the name of the EMS agency that performed the emergency
medical service;
(3) an itemized explanation of the claim amount and
reimbursement amount issued by the insurer;
(4) the EMS agency billing address that filed the claim for
the emergency medical service performed; and
(5) a disclosure that states:
This reimbursement payment is issued to the policyholder
(insert NAME), for a claim filed for nonnetwork emergency
medical services on (insert DATE of emergency service). The
reimbursement funds enclosed are to be used for the sole purpose
of payment of a liability for emergency medical services
outlined in this notification. The use of these funds for any
other purpose other than to satisfy the emergency medical
services liability may result in an insurance fraud claim
against the policyholder or individual that received the
emergency medical service on (insert DATE).
(b.2) An insurer that reimburses for a nonnetwork EMS agency
emergency medical service shall notify the EMS agency monthly
that a claim payment has been issued by the insurer to the
policyholder for the billing of a medically necessary emergency
medical service.
* * *
Section 2. This act shall take effect in 60 days.
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