SB 622 — 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 billing.

PRINTER'S NO.   633

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                        SENATE BILL
                        No. 622
                                               Session of
                                                 2025

     INTRODUCED BY MUTH, BROOKS, TARTAGLIONE, PENNYCUICK, FONTANA,
        COMITTA, LAUGHLIN, SANTARSIERO, KANE, KEARNEY, CAPPELLETTI,
        COSTA, HUTCHINSON, L. WILLIAMS, SCHWANK, FLYNN AND MILLER,
        APRIL 11, 2025

     REFERRED TO BANKING AND INSURANCE, APRIL 11, 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 billing.
13      The General Assembly of the Commonwealth of Pennsylvania
14   hereby enacts as follows:
15      Section 1.    Section 635.7(b), (d), (e) and (h) of the act of
16   May 17, 1921 (P.L.682, No.284), known as The Insurance Company
17   Law of 1921, are amended to read:
18      Section 635.7.    Billing.--* * *
19      [(b)   An insurer must reimburse a nonnetwork EMS agency under
20   the following:
21      (1)    The EMS agency has submitted a completed standardized
22   form to the department requesting nonnetwork direct
 1   reimbursement from an insurer an EMS agency has identified. The
 2   form must be submitted to the department annually by October 15.
 3   The form shall declare the EMS agency's intention to receive
 4   direct payment from an insurer identified on the form for the
 5   next calendar year. The department shall develop a standardized
 6   form, using an EMS agency's assigned license number, to be used
 7   by an EMS agency that meets the conditions established under
 8   this section. The department shall develop and maintain a
 9   publicly accessible electronic registry that indicates which EMS
10   agency has requested nonnetwork direct reimbursement from an
11   insurer identified on the form.
12      (2)    An EMS agency has provided notification to the insurer
13   upon submitting a claim for reimbursement that the EMS agency is
14   registered with the department to receive direct reimbursement
15   as provided for under this section.]
16      * * *
17      [(d)    Where an insurer has reimbursed a nonnetwork EMS agency
18   at the same rate it has established for a network EMS agency,
19   the EMS agency may not bill the insured directly or indirectly
20   or otherwise attempt to collect from the insured for the service
21   provided, except for a billing to recover a copayment,
22   coinsurance or deductible as specified in the health insurance
23   policy.
24      (e)    An EMS agency that submits a form under this section may
25   solicit donations or memberships or conduct fundraising, except
26   that an EMS agency may not promise, suggest or infer to donors
27   that a donation will result in the donor not being billed
28   directly for any payment as provided under this section.
29   Notwithstanding this paragraph, an EMS agency may bill in
30   accordance with subsection (d). A violation of this section

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 1   shall be considered a violation of the act of December 17, 1968
 2   (P.L.1224, No.387), known as the "Unfair Trade Practices and
 3   Consumer Protection Law."]
 4      * * *
 5      (h)    The following words and phrases when used in this
 6   section shall have the meanings given to them in this subsection
 7   unless the context clearly indicates otherwise:
 8      ["Department."     Department of Health of the Commonwealth.]
 9      "EMS agency."    As defined in 35 Pa.C.S. § 8103 (relating to
10   definitions).
11      "Emergency medical services."        As defined in 35 Pa.C.S. §
12   8103 (relating to definitions).
13      "Insurer."    As follows:
14      (1)    An entity that is responsible for providing or paying
15   for all or part of the cost of emergency medical services
16   covered by an insurance policy, contract or plan. The term
17   includes an entity subject to:
18      (i)    section 630, Article XXIV or any other provision of this
19   act;
20      (ii)    the act of December 29, 1972 (P.L.1701, No.364), known
21   as the Health Maintenance Organization Act; or
22      (iii)    40 Pa.C.S. Ch. 61 (relating to hospital plan
23   corporations) or 63 (relating to professional health services
24   plan corporations).
25      (2)    The term does not include an entity that is responsible
26   for providing or paying under an insurance policy, contract or
27   plan which meets any of the following:
28      (i)    Is a homeowner's insurance policy.
29      (ii)    Provides any of the following types of insurance:
30      (A)    Accident only.

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 1      (B)   Fixed indemnity.
 2      (C)   Limited benefit.
 3      (D)   Credit.
 4      (E)   Dental.
 5      (F)   Vision.
 6      (G)   Specified disease.
 7      (H)   Medicare supplement.
 8      (I)   Civilian Health and Medical Program of the Uniformed
 9   Services (CHAMPUS) supplement.
10      (J)   Long-term care.
11      (K)   Disability income.
12      (L)   Workers' compensation.
13      (M)   Automobile medical payment insurance.
14      Section 2.   This act shall take effect in 60 days.




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