PRINTER'S NO. 1457
No. 1177 Session of 2007
INTRODUCED BY FABRIZIO, SEIP, SURRA, BELFANTI, BIANCUCCI,
BRENNAN, BUXTON, CURRY, DALEY, FRANKEL, GEORGE, GERGELY,
GRUCELA, HARKINS, JOSEPHS, KIRKLAND, KOTIK, LEACH, MARKOSEK,
McGEEHAN, McILHATTAN, MUNDY, MYERS, PETRONE, RAYMOND,
READSHAW, REICHLEY, SANTONI, SCAVELLO, SIPTROTH, SOLOBAY,
STURLA, TANGRETTI, WOJNAROSKI, YOUNGBLOOD, MURT, KING,
BENNINGTON, GIBBONS AND PALLONE, MAY 1, 2007
REFERRED TO COMMITTEE ON INSURANCE, MAY 1, 2007
AN ACT
1 Requiring health insurance policies issued by insurance
2 companies to reimburse for mental health services provided by
3 licensed clinical social workers.
4 The General Assembly of the Commonwealth of Pennsylvania
5 hereby enacts as follows:
6 Section 1. Short title.
7 This act shall be known and may be cited as the Mental Health
8 Services Reimbursement Act.
9 Section 2. Definitions.
10 The following words and phrases when used in this act shall
11 have the meanings given to them in this section unless the
12 context clearly indicates otherwise:
13 "Health insurance policy." Any individual or group health
14 insurance policy, subscriber contract, certificate or plan which
15 provides medical or health care coverage which is offered by or
16 is governed under any of the following:
1 (1) Any stock insurance company incorporated for the
2 purposes set forth in section 202(c) of the act of May 17,
3 1921 (P.L.682, No.284), known as The Insurance Company Law of
4 1921.
5 (2) Any mutual insurance company incorporated for any of
6 the purposes set forth in section 202(d) of The Insurance
7 Company Law of 1921.
8 (3) Any professional health services plan corporation as
9 defined in 40 Pa.C.S. Ch. 63 (relating to professional health
10 services plan corporations).
11 (4) Any fraternal benefit society as defined in 40
12 Pa.C.S. Ch. 63.
13 (5) Any health maintenance organization as defined in
14 the act of December 29, 1972 (P.L.1701, No.364), known as the
15 Health Maintenance Organization Act.
16 (6) Any person who sells or issues contracts or
17 certificates of insurance which meet the requirements of this
18 act.
19 (7) Any hospital plan corporation as defined in 40
20 Pa.C.S. Ch. 61 (relating to hospital plan corporations).
21 "Licensed clinical social worker." A provider with a
22 master's or doctoral degree in social work who assesses,
23 intervenes and treats individuals, families and groups with
24 biopsychosocial problems or disorders and who holds a current
25 advanced standing clinical license under the act of July 9, 1987
26 (P.L.220, No.39), known as the Social Workers, Marriage and
27 Family Therapists and Professional Counselors Act.
28 Section 3. Reimbursement for services provided by licensed
29 clinical social workers.
30 (a) Reimbursement.--Whenever a health insurance policy
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1 provides reimbursement for any mental health service which is
2 within those areas of practice for which a licensed clinical
3 social worker is licensed to provide, the insured or any other
4 person covered by the policy shall be entitled to reimbursement
5 for such service duly provided.
6 (b) Licensed clinical social worker rights.--Whenever such
7 service is performed by a licensed clinical social worker and
8 reimbursed by a professional health services plan corporation,
9 the licensed clinical social worker shall be granted such rights
10 of participation, plan admission and registration as may be
11 granted by the professional health services plan corporation
12 under 40 Pa.C.S. Ch. 63 (relating to professional health
13 services plan corporations).
14 Section 4. Rules and regulations.
15 The Insurance Commissioner may promulgate such rules and
16 regulations as are deemed necessary for the effective
17 implementation and operation of this act.
18 Section 5. Effective date.
19 This act shall take effect in 60 days.
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