PRINTER'S NO. 185
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. L8L40JLW/20010S0177B0185 - 2 -