HB 949 — 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
 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 speech therapy for stuttering.
13      The General Assembly of the Commonwealth of Pennsylvania
14   hereby enacts as follows:
15         Section 1.    Section 635.10 of the act of May 17, 1921
16   (P.L.682, No.284), known as The Insurance Company Law of 1921,
17   added October 16, 2024 (P.L.997, No.104), is amended to read:
18         Section 635.10.    Speech Therapy for Stuttering and Apraxia.--
19   (a)    A health insurance policy offered, issued or renewed in
20   this Commonwealth shall provide coverage for habilitative speech
21   therapy treatment and rehabilitative speech therapy treatment
22   for childhood stuttering and apraxia.
 1      (b)    The coverage required under this section shall be
 2   subject to the terms and conditions of a health insurance
 3   policy, including provisions relating to medical necessity,
 4   cost-sharing and utilization review.
 5      (c)    This section shall not be construed to require an
 6   insurer to cover school-based speech therapy for childhood
 7   stuttering based solely on inclusion of the therapy in an
 8   individualized education program.
 9      (d)    (1)   Except as provided in paragraph (2), the terms in
10   this section shall be given the same meaning as in section 2102
11   of this act.
12      (2)    As used in this section, the following words and phrases
13   shall have the meanings given to them in this paragraph unless
14   the context clearly indicates otherwise:
15      "Apraxia" means a neurological childhood speech sound
16   disorder in which the precision and consistency of movements
17   underlying speech are impaired in the absence of neuromuscular
18   deficits.
19      "Childhood stuttering" means a speech disorder characterized
20   by repetition of sounds, syllables or words, prolongation of
21   sounds and interruptions in speech developed between two and six
22   years of age.
23      "Cost-sharing" means:
24      (1)    The share of the health care costs covered by a health
25   insurance policy that an enrollee or covered person pays out of
26   pocket.
27      (2)    The term includes a deductible, coinsurance, copayment
28   or similar charge.
29      (3)    The term does not include a premium, a balance billed
30   amount from an out-of-network provider or the cost of a

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 1   noncovered service.
 2      "Habilitative speech therapy treatment" means speech therapy
 3   that helps an individual to keep, learn or improve skills and
 4   functioning for daily living.
 5      "Rehabilitative speech therapy treatment" means speech
 6   therapy that helps an individual restore or improve skills and
 7   functioning for daily living that have been lost or impaired.
 8      "Speech therapy" means the therapeutic care provided to an
 9   individual for treatment administered by a licensed speech-
10   language pathologist.
11      Section 2.   This act shall apply as follows:
12          (1)   For health insurance policies for which either rates
13      or forms are required to be filed with the Federal Government
14      or the Insurance Department, this act shall apply to any
15      policy for which a form or rate is first filed on or after
16      180 days after the effective date of this paragraph.
17          (2)   For health insurance policies for which neither
18      rates nor forms are required to be filed with the Federal
19      Government or the Insurance Department, this act shall apply
20      to any policy issued or renewed on or after 180 days after
21      the effective date of this paragraph.
22      Section 3.   This act shall take effect in 60 days.




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