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                                                       PRINTER'S NO. 185

THE GENERAL ASSEMBLY OF PENNSYLVANIA


SENATE BILL

No. 177 Session of 2001


        INTRODUCED BY EARLL, JUBELIRER, KUKOVICH, M. WHITE, COSTA,
           HELFRICK, RHOADES, WAGNER, WAUGH, STOUT, MELLOW, BODACK,
           BOSCOLA AND SCHWARTZ, JANUARY 30, 2001

        REFERRED TO PUBLIC HEALTH AND WELFARE, JANUARY 30, 2001

                                     AN ACT

     1  Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
     2     act relating to insurance; amending, revising, and
     3     consolidating the law providing for the incorporation of
     4     insurance companies, and the regulation, supervision, and
     5     protection of home and foreign insurance companies, Lloyds
     6     associations, reciprocal and inter-insurance exchanges, and
     7     fire insurance rating bureaus, and the regulation and
     8     supervision of insurance carried by such companies,
     9     associations, and exchanges, including insurance carried by
    10     the State Workmen's Insurance Fund; providing penalties; and
    11     repealing existing laws," providing for presumptive
    12     eligibility for free or subsidized health care insurance for
    13     children.

    14     The General Assembly of the Commonwealth of Pennsylvania
    15  hereby enacts as follows:
    16     Section 1.  The act of May 17, 1921 (P.L.682, No.284), known
    17  as The Insurance Company Law of 1921, is amended by adding a
    18  section to read:
    19     Section 2314.  Presumptive Eligibility.--(a)  Notwithstanding
    20  any inconsistent provision of law to the contrary and subject to
    21  the availability of Federal financial participation under Title
    22  XIX of the Social Security Act (49 Stat. 620, 42 U.S.C. § 301 et
    23  seq.), a child shall be presumed eligible for payments under

     1  this article, once during a twelve (12) month period when a
     2  qualified entity determines, on the basis of preliminary
     3  information, that a child is eligible for free or subsidized
     4  health care insurance under section 2311. The presumptive
     5  eligibility period shall continue until the earlier date an
     6  eligibility determination is made pursuant to this article, the
     7  child is found eligible for medical assistance, or sixty (60)
     8  days after the date of presumptive eligibility begins. However,
     9  a presumptive eligibility period may be extended in the event a
    10  determination of eligibility for benefits under this article or
    11  for medical assistance is not made within the sixty (60) day
    12  period through no fault of the applicant.
    13     (b)  The Insurance Department shall assure that children who
    14  are enrolled under this section receive appropriate follow-up
    15  for a determination of eligibility for benefits under this
    16  article or for medical assistance prior to the termination of
    17  the presumptive eligibility period. The Insurance Department
    18  shall assure that outreach activities under section 2312 include
    19  information related to presumptive eligibility under this
    20  section.
    21     Section 2.  This act shall take effect in 60 days.






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