An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in quality health care accountability and protection, further providing for definitions and for step therapy considerations.
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed House
- To Governor
- Became Law
Overview
This bill amends Pennsylvania’s Insurance Company Law of 1921 to improve quality in healthcare and address mental health care access. It introduces definitions for ‘behavioral health crisis’ and ‘serious mental illness.’ Specifically, it modifies step therapy requirements, allowing for an exemption when a prescription drug is prescribed in response to a behavioral health crisis or for a serious mental illness, provided it meets certain evidence-based criteria.
Key provisions
- Defines ‘behavioral health crisis’ and ‘serious mental illness.’
- Modifies step therapy requirements for prescription drugs prescribed for serious mental illness.
- Allows an exemption to step therapy when a drug is prescribed in response to a behavioral health crisis.
- Specifies criteria for the exemption, including FDA approval, use in response to a crisis, and adherence to evidence-based standards.
- Establishes a review process for step therapy exceptions consistent with existing regulations.
Who is affected
- Individuals with mental illness
- Health insurers
- Managed care organizations (MA and CHIP)
- Healthcare providers
- Patients
Notable changes
- Introduces specific definitions related to mental health crises and illnesses.
- Creates an exception to step therapy requirements for medications used to treat serious mental illnesses during a behavioral health crisis.
Bill text
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Document of record
- Version
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Sponsors
Official sponsors from legislative records.
9 on record
Primary sponsor
Cosponsors
David Argall
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