An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, further providing for billing.

PRINTER'S NO. 95
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 117
Session of
2025
INTRODUCED BY CIRESI, SANCHEZ, BRENNAN, HILL-EVANS, GUENST,
HADDOCK AND KUZMA, JANUARY 14, 2025
REFERRED TO COMMITTEE ON INSURANCE, JANUARY 14, 2025
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, further
providing for billing.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 635.7 of the act of May 17, 1921
(P.L.682, No.284), known as The Insurance Company Law of 1921,
is amended by adding a subsection to read:
Section 635.7. Billing.--* * *
(b.1) An insurer that sends a reimbursement payment directly
by mail to a covered person for medically necessary emergency
medical services provided by a nonnetwork EMS agency shall
include a notice explaining the purpose of the payment. This
notice shall:
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(1) Clearly and conspicuously state the following:
(i) The services for which the payment is being made,
including the date of service and the name of the EMS agency
that provided emergency medical services.
(ii) The covered person is responsible for the bill for
emergency medical services provided by the EMS agency.
(iii) If the covered person has already paid the bill for
the emergency medical services provided by the EMS agency in
full, they can cash or deposit the reimbursement payment.
(iv) The covered person has the option to discuss or
negotiate the bill for emergency medical services with the EMS
agency prior to making or forwarding a payment. The covered
person will not pay the EMS agency less than the amount the
covered person received from the insurer for that service.
(v) Whether any payment, including the amount, has been made
by the insurer to the EMS agency related to this service.
(vi) Any copayment, coinsurance or deductible that is the
responsibility of the covered person under the covered person's
health insurance policy.
(2) Disclose the information required under paragraph (1) in
type of a size no less than that of the surrounding text and in
no less than a font size of ten points.
(3) Be printed on a separate page.
(4) Be printed on red colored paper.
(5) Include a heading, conspicuously placed at the top of
the notice, with the words "STOP" in at least twenty-four-point,
boldface type and "Read this notice before depositing payment"
in at least eighteen-point, boldface type.
* * *
Section 2. This act shall take effect in 120 days.
20250HB0117PN0095 - 2 -
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