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 certified EMT firefighter billing.

PRINTER'S NO. 362
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 397
Session of
2025
INTRODUCED BY GROVE, HAMM, GREINER, KUTZ, STAATS AND GILLEN,
JANUARY 28, 2025
REFERRED TO COMMITTEE ON INSURANCE, JANUARY 28, 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 certified EMT firefighter billing.
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. Certified EMT Firefighter Billing.--(a)
When a fire company is dispatched by a public safety answering
point as defined in 35 Pa.C.S. § 5302 (relating to definitions)
for an emergency, and a certified EMT firefighter within the
fire company provides medically necessary emergency medical
services at the emergency scene, the fire company may file a
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claim with an insurer for a payment to be made by an insurer, in
accordance with a health insurance policy for emergency medical
service performed by a certified EMT firefighter and the payment
shall be paid directly to the fire company.
(b) If more than one certified EMT firefighter from more
than one fire company provides necessary emergency medical
services in response to an emergency, separate bills may be
submitted by the fire companies.
(c) An insurer may not require a fire company to contract
with the insurer to receive payment under this section.
(d) A fire company that files a false claim under this
section commits a summary offense and, upon conviction, shall be
sentenced to pay a fine of not more than one hundred dollars
($100). A fire company shall pay a fine of one thousand dollars
($1,000) for each subsequent offense.
(e) 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:
"Certified EMT firefighter." A volunteer firefighter who is
a member of a fire company and possesses a current and valid
certification to administer emergency medical services.
"Emergency medical services." The term shall mean the same
as defined under 35 Pa.C.S. § 8103 (relating to definitions).
"Fire company." A volunteer fire company located in this
Commonwealth.
"Insurer." As follows:
(1) An entity that is responsible for providing or paying
for all or part of the cost of emergency medical services
covered by an insurance policy, contract or plan. The term
includes an entity subject to:
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(i) section 630, Article XXIV or any other provision of this
act;
(ii) the act of December 29, 1972 (P.L.1701, No.364), known
as the "Health Maintenance Organization Act"; or
(iii) 40 Pa.C.S. Ch. 61 (relating to hospital plan
corporations) or 63 (relating to professional health services
plan corporations).
(2) The term does not include an entity that is responsible
for providing or paying under an insurance policy, contract or
plan which meets any of the following:
(i) Is a homeowner's insurance policy.
(ii) Provides any of the following types of insurance:
(A) Accident only.
(B) Fixed indemnity.
(C) Limited benefit.
(D) Credit.
(E) Dental.
(F) Vision.
(G) Specified disease.
(H) Medicare supplement.
(I) Civilian Health and Medical Program of the Uniformed
Services (CHAMPUS) supplement.
(J) Long-term care.
(K) Disability income.
(L) Workers' compensation.
(M) Automobile medical payment insurance.
Section 2. This act shall take effect in 60 days.
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