PRINTER'S NO. 444
No. 420 Session of 2005
INTRODUCED BY O'PAKE, KITCHEN, KASUNIC, LAVALLE, MUSTO, COSTA, RAFFERTY, RHOADES, LOGAN AND STACK, MARCH 21, 2005
REFERRED TO BANKING AND INSURANCE, MARCH 21, 2005
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 medical nutrition 12 therapy coverage requirements for health insurance policies. 13 The General Assembly of the Commonwealth of Pennsylvania 14 hereby enacts as follows: 15 Section 1. The act of May 17, 1921 (P.L.682, No.284), known 16 as The Insurance Company Law of 1921, is amended by adding a 17 section to read: 18 Section 635.2. Coverage for Medical Nutrition Therapy.--(a) 19 An individual or group health, sickness and accident insurance 20 policy, group health insurance plan or policy and any other form 21 of managed/capitated care plan or policy or subscriber contract 22 or certificate issued by any entity subject to 40 Pa.C.S. Ch. 61
1 (relating to hospital plan corporations) or 63 (relating to 2 professional health services plan corporations) or the act of 3 December 29, 1972 (P.L.1701, No.364), known as the "Health 4 Maintenance Organization Act" or Article XXIV of this act 5 providing hospital or medical/surgical coverage shall provide 6 coverage for medical nutrition therapy to aid in the treatment 7 of cardiovascular disease. The minimum coverage provided shall 8 include all costs associated with medical nutrition therapy for 9 the length of time that such therapy is determined necessary. 10 The benefits specified in this section may be provided through a 11 combination of policies, contracts, certificates or riders, 12 including major medical contracts. 13 (b) This section does not include the following policies: 14 accident only, fixed indemnity, limited benefit, credit, dental, 15 vision, specified disease, Medicare supplement, CHAMPUS 16 (Civilian Health and Medical Program for the Uniform Services) 17 supplement, long-term care, disability income, workers' 18 compensation or automobile medical payment. 19 (c) The coverage required under this section shall be 20 subject to the annual deductibles, copayments or coinsurance 21 requirements imposed by an entity subject to this section for 22 similar coverages under the same health insurance policy or 23 contract. 24 (d) As used in this section: 25 "Cardiovascular disease" means diseases of the heart and 26 blood vessels, including congestive heart failure, 27 arteriosclerosis, hyperlipidemia, hypertension and 28 hypercholesterolemia. 29 "Medical nutrition therapy" means the assessment of 30 nutritional status and the assignment of diet, counseling or 20050S0420B0444 - 2 -
1 specialized nutrition therapies to treat an illness or 2 condition, provided by a licensed dietitian/nutritionist. 3 Section 2. This act shall take effect in 60 days. B8L40JLW/20050S0420B0444 - 3 -