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 speech therapy for stuttering.

PRINTER'S NO. 1017
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 949
Session of
2025
INTRODUCED BY MARKOSEK, HOHENSTEIN, HILL-EVANS, GIRAL, McNEILL,
MADDEN, SAMUELSON, FREEMAN, GUENST, INGLIS, SCHLOSSBERG,
D. MILLER, BOROWSKI, CERRATO, KULIK, NEILSON, DONAHUE,
SANCHEZ AND MALAGARI, MARCH 18, 2025
REFERRED TO COMMITTEE ON INSURANCE, MARCH 18, 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 speech therapy for stuttering.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 635.10 of the act of May 17, 1921
(P.L.682, No.284), known as The Insurance Company Law of 1921,
added October 16, 2024 (P.L.997, No.104), is amended to read:
Section 635.10. Speech Therapy for Stuttering and Apraxia.--
(a) A health insurance policy offered, issued or renewed in
this Commonwealth shall provide coverage for habilitative speech
therapy treatment and rehabilitative speech therapy treatment
for childhood stuttering and apraxia.
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(b) The coverage required under this section shall be
subject to the terms and conditions of a health insurance
policy, including provisions relating to medical necessity,
cost-sharing and utilization review.
(c) This section shall not be construed to require an
insurer to cover school-based speech therapy for childhood
stuttering based solely on inclusion of the therapy in an
individualized education program.
(d) (1) Except as provided in paragraph (2), the terms in
this section shall be given the same meaning as in section 2102
of this act.
(2) As used in this section, the following words and phrases
shall have the meanings given to them in this paragraph unless
the context clearly indicates otherwise:
"Apraxia" means a neurological childhood speech sound
disorder in which the precision and consistency of movements
underlying speech are impaired in the absence of neuromuscular
deficits.
"Childhood stuttering" means a speech disorder characterized
by repetition of sounds, syllables or words, prolongation of
sounds and interruptions in speech developed between two and six
years of age.
"Cost-sharing" means:
(1) The share of the health care costs covered by a health
insurance policy that an enrollee or covered person pays out of
pocket.
(2) The term includes a deductible, coinsurance, copayment
or similar charge.
(3) The term does not include a premium, a balance billed
amount from an out-of-network provider or the cost of a
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noncovered service.
"Habilitative speech therapy treatment" means speech therapy
that helps an individual to keep, learn or improve skills and
functioning for daily living.
"Rehabilitative speech therapy treatment" means speech
therapy that helps an individual restore or improve skills and
functioning for daily living that have been lost or impaired.
"Speech therapy" means the therapeutic care provided to an
individual for treatment administered by a licensed speech-
language pathologist.
Section 2. This 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
180 days 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.
Section 3. This act shall take effect in 60 days.
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