HB 1519 — 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 mental illness coverage.

PRINTER'S NO.       1775

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                         HOUSE BILL
                         No. 1519
                                               Session of
                                                 2025

     INTRODUCED BY MALAGARI, PIELLI, KHAN, SANCHEZ, GIRAL, K.HARRIS,
        HILL-EVANS, SCHLOSSBERG, HOWARD, BOYD AND RIVERA,
        MAY 29, 2025

     REFERRED TO COMMITTEE ON INSURANCE, MAY 29, 2025


                                    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," in casualty insurance, further
12      providing for mental illness coverage.
13      The General Assembly of the Commonwealth of Pennsylvania
14   hereby enacts as follows:
15      Section 1.    Section 635.1(a) of the act of May 17, 1921
16   (P.L.682, No.284), known as The Insurance Company Law of 1921,
17   is amended and the section is amended by adding a subsection to
18   read:
19      Section 635.1.    Mental Illness Coverage.--(a)     As used in
20   this section:
21      (1)   "Serious mental illness" means [any of the following
22   mental illnesses as defined by the American Psychiatric
 1   Association in the most recent edition of the Diagnostic and
 2   Statistical Manual: schizophrenia, bipolar disorder, obsessive-
 3   compulsive disorder, major depressive disorder, panic disorder,
 4   anorexia nervosa, bulimia nervosa, schizoaffective disorder and
 5   delusional disorder.] a mental illness, disorder or condition
 6   included in the following classes of mental disorders designated
 7   in the American Psychiatric Association's Diagnostic and
 8   Statistical Manual of Mental Disorders, Fifth Edition, Text
 9   Revision, 2022 (DSM-5-TR):
10      (i)    Schizophrenia spectrum and other psychotic disorders.
11      (ii)    Bipolar and related disorders.
12      (iii)     Depressive disorders.
13      (iv)    Anxiety disorders.
14      (v)    Obsessive-compulsive and related disorders.
15      (vi)    Feeding and eating disorders.
16      [(2)    "Health insurance policy" means any group health,
17   sickness or accident policy or subscriber contract or
18   certificate issued by an entity subject to one (1) of the
19   following:
20      (i)    This act.
21      (ii)    The act of December 29, 1972 (P.L.1701, No.364), known
22   as the "Health Maintenance Organization Act."
23      (iii)     40 Pa.C.S. Ch. 61 (relating to hospital plan
24   corporations) or 63 (relating to professional health services
25   plan corporations).]
26      (3)    "Mental health medication" means a medication which is
27   approved by the United States Food and Drug Administration and
28   used for treatment of a serious mental illness.
29      (4)    "Health insurer" means as defined in section 2702.
30      (5)    "MA or CHIP managed care plan" means as defined in

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 1   section 2102.
 2      (6)   "Prior authorization" means as defined in section 2102.
 3      * * *
 4      (c.1)   A health insurer or MA or CHIP managed care plan may
 5   not, as a condition of coverage for a mental health medication,
 6   require prior authorization.
 7      * * *
 8      Section 2.    This act shall apply as follows:
 9            (1)   For a health insurance policy for which either rates
10      or forms are required to be filed with the Insurance
11      Department, the amendment of section 635.1 of the act shall
12      apply to a policy for which a form or rate is first filed on
13      or after the effective date of this paragraph.
14            (2)   For a health insurance policy for which neither
15      rates nor forms are required to be filed with the Insurance
16      Department, the amendment of section 635.1 of the act shall
17      apply to a policy issued or renewed on or after 180 days
18      after the effective date of this paragraph.
19      Section 3.    This act shall take effect in 60 days.




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