PRINTER'S NO. 845
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
869
Session of
2023
INTRODUCED BY D. WILLIAMS, BRENNAN, GUENST, HANBIDGE, HILL-
EVANS, HOWARD, KHAN, KINSEY, KRAJEWSKI, MADDEN, OTTEN, RABB
AND SANCHEZ, APRIL 10, 2023
REFERRED TO COMMITTEE ON INSURANCE, APRIL 10, 2023
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 casualty insurance, providing
for coverage of medication assisted treatment.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of May 17, 1921 (P.L.682, No.284), known
as The Insurance Company Law of 1921, is amended by adding a
section to read:
Section 635.9. Coverage of Medication Assisted Treatment.--
(a) A health insurance policy or government program that is
offered, issued or renewed in this Commonwealth shall provide
coverage for MAT, including coverage for counseling and
behavioral therapies and any fees related to the provision of
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
MAT.
(b) The use of prior authorization for the approval of MAT
is prohibited, including prior authorization used for approval
of MAT in a health insurance policy or government program that
is issued or renewed in this Commonwealth.
(c) The following words and phrases when used in this
section shall have the meanings given to them in this subsection
unless the context clearly indicates otherwise:
"Controlled substance." As defined in section 2 of the act
of April 14, 1972 (P.L.233, No.64), known as "The Controlled
Substance, Drug, Device and Cosmetic Act."
"Drug." As defined in section 2 of "The Controlled
Substance, Drug, Device and Cosmetic Act."
"Government program." The term includes:
(1) The Commonwealth's medical assistance program
established under the act of June 13, 1967 (P.L.31, No.21),
known as the "Human Services Code."
(2) The Children's Health Insurance Program.
"Health insurance policy." As defined in 40 Pa.C.S. ยง 9103
(relating to definitions).
"Medication assisted treatment" or "MAT." The use of
medication, approved by the United States Food and Drug
Administration, in combination with counseling and behavioral
therapies to treat a substance use disorder.
"Substance use disorder." A chronic, relapsing medical
illness characterized by:
(1) recurrent use of a drug or controlled substance despite
harmful consequences;
(2) long-lasting changes in brain chemistry;
(3) clinically significant impairment, including physical or
20230HB0869PN0845 - 2 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
mental health problems or disability; or
(4) the inability or failure to meet the demands of and
responsibilities at work, school or home.
Section 2. This act shall take effect in 60 days.
20230HB0869PN0845 - 3 -
1
2
3
4