PRINTER'S NO. 2126
No. 1661 Session of 2003
INTRODUCED BY FRANKEL, BEBKO-JONES, COY, CREIGHTON, CURRY,
DALEY, FABRIZIO, HARHAI, HENNESSEY, JOSEPHS, LaGROTTA,
LAUGHLIN, MANDERINO, MANN, McGEEHAN, MELIO, MUNDY, SCRIMENTI,
WALKO, WANSACZ, WASHINGTON, WATERS, YOUNGBLOOD AND COHEN,
JUNE 23, 2003
REFERRED TO COMMITTEE ON INSURANCE, JUNE 23, 2003
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," further providing for policy
12 provisions relating to health and accident insurance; and
13 requiring reimbursement for drug and alcohol testing at
14 trauma centers.
15 The General Assembly of the Commonwealth of Pennsylvania
16 hereby enacts as follows:
17 Section 1. Section 618(B)(11) of the act of May 17, 1921
18 (P.L.682, No.284), known as The Insurance Company Law of 1921,
19 added May 25, 1951 (P.L.417, No.99), is amended to read:
20 Section 618. Policy Provisions.--* * *
21 (B) Other Provisions. Except as provided in paragraph (C) of
22 this section, no such policy delivered or issued for delivery to
1 any person in this Commonwealth shall contain provisions
2 respecting the matters set forth below unless such provisions
3 are in the words in which the same appear in this section:
4 Provided, however, That the insurer may, at its option, use in
5 lieu of any such provision, a corresponding provision of
6 different wording approved by the commissioner, which is not
7 less favorable in any respect to the insured or the beneficiary.
8 Any such provision contained in the policy shall be preceded
9 individually by the appropriate caption appearing in this
10 subsection or, at the option of the insurer, by such appropriate
11 individual or group captions or subcaptions as the commissioner
12 may approve.
13 * * *
14 (11) A provision as follows:
15 Intoxicants and Narcotics: The insurer shall not be liable
16 for any loss sustained or contracted in consequence of the
17 insured's being intoxicated, or under the influence of any
18 narcotic unless administered on the advice of a physician. The
19 insurer shall not deny coverage for drug and alcohol testing of
20 patients admitted to trauma centers.
21 * * *
22 Section 2. The act is amended by adding a section to read:
23 Section 635.2. Reimbursement for Drug and Alcohol Testing at
24 Trauma Centers.--(a) Except to the extent already covered under
25 another policy, any individual or group health, sickness and
26 accident insurance policy, group health insurance
27 plans/policies, and all other forms of managed/capitated care
28 plans/policies or subscriber contract or certificate issued by
29 any entity subject to 40 Pa.C.S. Ch. 61 (relating to hospital
30 plan corporations) or 63 (relating to professional health
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1 services plan corporations) or the act of December 29, 1972
2 (P.L.1701, No.364), known as the "Health Maintenance
3 Organization Act," or this act providing hospital or
4 medical/surgical coverage shall provide coverage of drug and
5 alcohol testing of patients admitted to Level I and Level II
6 trauma centers accredited by the Pennsylvania Trauma Systems
7 Foundation under the act of July 3, 1985 (P.L.164, No.45), known
8 as the "Emergency Medical Services Act." The benefits specified
9 in this section may be provided through a combination of
10 policies, contracts, certificates or riders, including major
11 medical contracts.
12 (b) This section does not include the following policies:
13 accident only, fixed indemnity, limited benefit, credit, dental,
14 vision, specified disease, Medicare supplement, CHAMPUS
15 (Civilian Health and Medical Program for the Uniform Services)
16 supplement, long-term care, disability income, workers'
17 compensation or automobile medical payment.
18 Section 3. This act shall take effect in 60 days.
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