HB 1439 — An Act amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, in regulation of insurers and related persons generally, providing for mental health parity and access to addiction treatment.

PRIOR PRINTER'S NO.

1777 PRINTER'STHE NO.GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL Session of No.

36291439 THE2019 GENERALINTRODUCED ASSEMBLYBY OFKAUFER, PENNSYLVANIAMILLARD, HOUSEDiGIROLAMO, BILLSCHLOSSBERG, SessionDeLUCA, MURT, MOUL AND OTTEN, MAY 8, 2019 REFERRED TO COMMITTEE ON INSURANCE, MAY 8, 2019 AN ACT Amending Title 40 (Insurance) of No.the Pennsylvania Consolidated Statutes, in regulation of insurers and related persons generally, providing for mental health parity and access to addiction treatment.

1439 2019 INTRODUCED BY KAUFER, MILLARD, DiGIROLAMO, SCHLOSSBERG, DeLUCA, MURT, MOUL, OTTEN, WEBSTER AND DAVIDSON, MAY 8, 2019 AS REPORTED FROM COMMITTEE ON INSURANCE, HOUSE OF REPRESENTATIVES, AS AMENDED, APRIL 27, 2020 AN ACT Amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, in regulation of insurers and related persons generally, providing for mental health parity and access to addiction treatment.

CertificationCertification. ANNUAL ATTESTATION.

<-- 4304.

This chapter relates to a certification AN ATTESTATION of <-- compliance with Federal and State insurance laws regarding mental health and substance use disorder benefits.

<-- (1) An entity that issues or administers health insurance policies or health plans and is subject to the jurisdiction of the department.

"HEALTH INSURANCE POLICY." AS FOLLOWS:

<-- (1) AN INSURANCE POLICY, SUBSCRIBER CONTRACT, CERTIFICATE OR PLAN THAT PROVIDES MEDICAL OR HEALTH CARE COVERAGE, INCLUDING EMERGENCY SERVICES.

(2) THE TERM DOES NOT INCLUDE ANY OF THE FOLLOWING TYPES OF POLICIES:

(I) ACCIDENT ONLY.

20190HB1439PN3629 - 2 - (II) FIXED INDEMNITY.

(III) CREDIT.

(IV) DENTAL ONLY.

(V) VISION ONLY.

(VI) SPECIFIED DISEASE.

(VII) MEDICARE SUPPLEMENT.

(VIII) CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS) SUPPLEMENT.

(IX) LONG-TERM CARE.

(X) DISABILITY INCOME.

(XI) WORKERS' COMPENSATION.

(XII) AUTOMOBILE MEDICAL PAYMENT INSURANCE.

"INSURER." AN ENTITY LICENSED BY THE DEPARTMENT WITH ACCIDENT AND HEALTH AUTHORITY TO ISSUE A 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 OF THAT ACT.

(2) THE ACT OF DECEMBER 29, 1972 (P.L.1701, NO.364), KNOWN AS THE HEALTH MAINTENANCE ORGANIZATION ACT.

(3) CHAPTER 61 (RELATING TO HOSPITAL PLAN CORPORATIONS) OR 63 (RELATING TO PROFESSIONAL HEALTH SERVICES PLAN CORPORATIONS).

<-- No later than January 1 of each year, an insurer that issues or administers a health insurance policy or health plan in this Commonwealth, including a policy or plan in which mental health 20190HB1439PN3629 - 3 - or substance use disorder benefits are managed by an entity 20190HB1439PN1777 - 2 - other than the insurer, shall file with the department a written certification signed by an officer of the insurer under oath attesting that:

§ 4303.

ANNUAL ATTESTATION.

<-- (A) STATEMENT REGARDING MHPAEA COMPLIANCE.--FOR THE FORM FOR EACH HEALTH INSURANCE POLICY OFFERED, ISSUED OR RENEWED BY AN INSURER, THE INSURER SHALL ANNUALLY FILE WITH THE DEPARTMENT A STATEMENT ATTESTING TO THE INSURER'S DOCUMENTED ANALYSES OF EFFORTS TO COMPLY WITH MHPAEA AND THE FEDERAL REGULATIONS RELATING TO MENTAL HEALTH AND SUBSTANCE USE DISORDER PARITY AS OF THE DATE OF THE ATTESTATION.

(B) STATEMENT REGARDING MHPAEA NONAPPLICABILITY.--FOR THE FORM FOR EACH INSURANCE POLICY OFFERED, ISSUED OR RENEWED BY AN INSURER IN THIS COMMONWEALTH THAT IS REQUIRED TO BE FILED BUT TO WHICH MHPAEA DOES NOT APPLY, THE INSURER SHALL ANNUALLY FILE WITH THE DEPARTMENT A STATEMENT ATTESTING TO THE NONAPPLICABILITY OF MHPAEA TO THE POLICY FORM.

(C) FILING.--EACH ATTESTATION REQUIRED UNDER THIS SECTION 20190HB1439PN3629 - 4 - MUST BE FILED BY APRIL 30 OF EACH YEAR OR WITH THE FORM FILING, WHICHEVER IS EARLIER.

The department shall MAY promulgate regulations necessary to <-- implement this chapter.

All acts and parts of acts are repealed insofar <-- as they are inconsistent with 40 Pa.C.S.

SECTION 2.

THIS ACT SHALL APPLY TO THE FORMS FOR EACH <-- INSURANCE POLICY TO BE OFFERED, ISSUED OR RENEWED BY AN INSURER IN THIS COMMONWEALTH AFTER DECEMBER 31, 2021.

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