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, providing for coverage for pelvic floor therapy.

PRINTER'S NO. 1393
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 1244
Session of
2025
INTRODUCED BY HANBIDGE, GIRAL, HILL-EVANS, WAXMAN, FREEMAN,
MADDEN, BURGOS, HOWARD, OTTEN, SANCHEZ, MAYES, CEPEDA-
FREYTIZ, D. WILLIAMS, KENYATTA, SHUSTERMAN, STEELE,
HOHENSTEIN AND GREEN, APRIL 17, 2025
REFERRED TO COMMITTEE ON INSURANCE, APRIL 17, 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, providing
for coverage for pelvic floor therapy.
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 635.11. Coverage for Pelvic Floor Therapy.--(a) A
government program offered or a health insurance policy issued
or renewed on or after the effective date of this subsection
shall provide coverage for the diagnosis and treatment of pelvic
floor dysfunction and linked or related conditions, including:
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(1) Pelvic floor therapy.
(2) Biofeedback.
(3) Trigger point therapy.
(4) Electrical stimulation.
(5) Postoperative care for prostatectomies.
(6) Postoperative care for hysterectomies.
(7) Postpartum pelvic floor assessments.
(b) Coverage under this section shall remain subject to an
insurer's or government program's medical necessity policies,
any copayment, coinsurance or deductible amounts stated in the
policy.
(c) As used in this section, the following words and phrases
shall have the meanings given to them in this subsection unless
the context clearly indicates otherwise:
"Government program" means any of the following:
(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 under Article
XXIII-A.
"Health insurance policy" means as follows:
(1) A policy, subscriber contract, certificate or plan
issued by an insurer that provides medical or health care
coverage.
(2) The term does not include accident only, fixed
indemnity, limited benefit, credit, dental, vision, specified
disease, Medicare supplement, Civilian Health and Medical
Program of the Uniformed Services supplement, long-term care or
disability income, workers' compensation or automobile medical
payment insurance.
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"Insurer" means an entity licensed by the Insurance
Department that offers, issues or renews an individual or group
health insurance policy that is offered or governed under any of
the following:
(1) This act, including section 630 and Article XXIV.
(2) The act of December 29, 1972 (P.L.1701, No.364), known
as the "Health Maintenance Organization Act."
(3) 40 Pa.C.S. Ch. 61 (relating to hospital plan
corporations) or 63 (relating to professional health services
plan corporations).
"Pelvic floor dysfunction" means the inability to control the
muscles of the pelvic floor.
"Pelvic floor therapy" means the treatment applied to pelvic
floor muscles to treat problems associated with the pelvic
floor, including incontinence, difficulty with urination or
bowel movements, constipation, chronic pelvic pain, painful
intercourse, diastasis recti, pelvic organ prolapse and linked
or related conditions.
Section 2. The addition of section 635.11 of the act shall
apply as follows:
(1) For health insurance policies for which either rates
or forms are required to be filed with the Federal Government
or the Insurance Department, this act shall apply to any
policy for which a form or rate is first filed on or after
the effective date of this paragraph.
(2) For health insurance policies for which neither
rates nor forms are required to be filed with the Federal
Government or the Insurance Department, this act shall apply
to any policy issued or renewed on or after 180 days after
the effective date of this paragraph.
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Section 3. This act shall take effect in 60 days.
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