PENNSYLVANIA, June 29 - PRIOR PRINTER'S NOS. 453, 948, 1809

PRINTER'S NO. 1837

THE GENERAL ASSEMBLY OF PENNSYLVANIA

SENATE BILL

No.

225

Session of

2021

INTRODUCED BY PHILLIPS-HILL, MARTIN, J. WARD, MENSCH, COLLETT,

MUTH, KANE, STEFANO, AUMENT, CAPPELLETTI, BAKER, BROOKS,

BOSCOLA, HUTCHINSON, SABATINA, TOMLINSON, LAUGHLIN,

MASTRIANO, SANTARSIERO, KEARNEY, SCHWANK, DUSH, COMITTA,

FLYNN, L. WILLIAMS AND DILLON, MARCH 18, 2021

AS AMENDED ON THIRD CONSIDERATION, JUNE 29, 2022

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, for responsibilities of managed care plans, for

financial incentives prohibition, for medical gag clause

prohibition, for emergency services, for continuity of care,

providing for medication assisted treatment, further

providing for procedures, for confidentiality, for required

disclosure, providing for medical policy and clinical review

criteria adopted by insurer, MCO or contractor, further

providing for internal complaint process, for appeal of

complaint, for complaint resolution, for certification, for

operational standards, providing for step therapy

considerations, for prior authorization review and for

provider portal, further providing for internal grievances

process, for records, for external grievance process, for

prompt payment of claims, for health care provider and

managed care plan, for departmental powers and duties, for

penalties and sanctions, for compliance with National

Accrediting Standards; and making editorial changes.

The General Assembly of the Commonwealth of Pennsylvania

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