HB 2773 — An Act amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, prohibiting unilateral changes to contracts between insurers and health care providers.

Summary

Prohibiting Unilateral Changes to Contracts Between Health Insurers and Healthcare Providers

Bill Text

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This bill prohibits insurers from unilaterally changing contract terms with health care providers.

• Title 40 of the Pennsylvania Consolidated Statutes

  CHAPTER 31 PROHIBITING UNILATERAL CHANGES TO CONTRACTS BETWEEN INSURERS AND HEALTH CARE PROVIDERS

  This adds a new chapter to define and regulate unilateral changes in contracts between insurers and health care providers.

• § 3102

  An insurer or administrator acting on behalf of an insurer that offers, issues or renews a health insurance policy in this Commonwealth may not unilaterally modify, amend or reinterpret any material term or condition of a contract with a health care provider during the term of the contract.

  This introduces a prohibition against unilateral contract modifications by insurers during the contract term.

• § 3102(b)

  An insurer or administrator acting on behalf of an insurer may implement changes to a contract with a health care provider: after the mutual written agreement of the insurer or administrator and the health care provider; or if the change is expressly required by Federal or State law.

  This specifies the circumstances under which contract changes can legally occur.

• § 3102(c)

  A change not required by law may not take effect until the renewal of the contract term and then only if the insurer or administrator has provided written notice of the proposed change at least 90 days before the renewal of the contract.

  This establishes a notice requirement before non-legally mandated changes to contracts take effect.

• § 3102(d)

  A violation of this chapter shall be deemed a violation of the act of December 17, 1968 (P.L.1224, No.387), known as the Unfair Trade Practices and Consumer Protection Law, and the act of July 22, 1974 (P.L.589, No.205), known as the Unfair Insurance Practices Act. The department shall have the authority to impose a civil penalty of up to $1,000 on an insurer or administrator that violates this chapter and to impose any other penalties authorized by law.

  This states that violations of the new rules will result in penalties under existing consumer protection laws.

• § 3102(e)

  Nothing in this section shall be construed to: Prohibit an insurer or administrator and a health care provider from mutually agreeing to modify, amend or reinterpret a material term or condition of a contract during the term of the contract; Prohibit a health insurer from adding coverage for a health care service during the term of a health insurance policy; Apply to any of the following: A self-funded employer-sponsored health benefit plan governed by 29 U.S.C. Ch. 18 (relating to Employee Retirement Income Security Program); An employer acting in its capacity as a plan sponsor; A health benefit arrangement not subject to regulation by the department.

  This clarifies the limitations of the new chapter to ensure mutual agreement can still occur and identifies plans not governed by these provisions.

• § 3103

  The department may promulgate regulations as necessary and appropriate to carry out the provisions of this chapter.

  This allows the regulatory department to create necessary rules to enforce the new chapter.

Action History

1. September 15, 2026

   Referred to INSURANCE, Sept. 15, 2026

Sponsors

• Tim Brennan · Cosponsor
• Eddie Day Pashinski · Cosponsor
• Dan K. Williams · Cosponsor
• Benjamin V. Sanchez · Cosponsor
• Patrick J. Harkins · Cosponsor
• John C. Inglis III · Cosponsor
• Lisa A. Borowski · Cosponsor
• Jim Haddock · Cosponsor
• Carol Hill-Evans · Cosponsor
• Manuel Guzman · Cosponsor
• Arvind Venkat · Primary

Subjects