HB 1244 — 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, providing for coverage for pelvic floor therapy.

PRINTER'S NO.   1393

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                         HOUSE BILL
                         No. 1244
                                               Session of
                                                 2025

     INTRODUCED BY HANBIDGE, GIRAL, HILL-EVANS, WAXMAN, FREEMAN,
        MADDEN, BURGOS, HOWARD, OTTEN, SANCHEZ, MAYES, CEPEDA-
        FREYTIZ, D. WILLIAMS, KENYATTA, SHUSTERMAN, STEELE,
        HOHENSTEIN AND GREEN, APRIL 17, 2025

     REFERRED TO COMMITTEE ON INSURANCE, APRIL 17, 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, providing
12      for coverage for pelvic floor therapy.
13      The General Assembly of the Commonwealth of Pennsylvania
14   hereby enacts as follows:
15      Section 1.    The act of May 17, 1921 (P.L.682, No.284), known
16   as The Insurance Company Law of 1921, is amended by adding a
17   section to read:
18      Section 635.11.    Coverage for Pelvic Floor Therapy.--(a)   A
19   government program offered or a health insurance policy issued
20   or renewed on or after the effective date of this subsection
21   shall provide coverage for the diagnosis and treatment of pelvic
22   floor dysfunction and linked or related conditions, including:
 1      (1)     Pelvic floor therapy.
 2      (2)     Biofeedback.
 3      (3)     Trigger point therapy.
 4      (4)     Electrical stimulation.
 5      (5)     Postoperative care for prostatectomies.
 6      (6)     Postoperative care for hysterectomies.
 7      (7)     Postpartum pelvic floor assessments.
 8      (b)     Coverage under this section shall remain subject to an
 9   insurer's or government program's medical necessity policies,
10   any copayment, coinsurance or deductible amounts stated in the
11   policy.
12      (c)     As used in this section, the following words and phrases
13   shall have the meanings given to them in this subsection unless
14   the context clearly indicates otherwise:
15      "Government program" means any of the following:
16      (1)     The Commonwealth's medical assistance program
17   established under the act of June 13, 1967 (P.L.31, No.21),
18   known as the "Human Services Code."
19      (2)     The children's health insurance program under Article
20   XXIII-A.
21      "Health insurance policy" means as follows:
22      (1)     A policy, subscriber contract, certificate or plan
23   issued by an insurer that provides medical or health care
24   coverage.
25      (2)     The term does not include accident only, fixed
26   indemnity, limited benefit, credit, dental, vision, specified
27   disease, Medicare supplement, Civilian Health and Medical
28   Program of the Uniformed Services supplement, long-term care or
29   disability income, workers' compensation or automobile medical
30   payment insurance.

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 1      "Insurer" means an entity licensed by the Insurance
 2   Department that offers, issues or renews an individual or group
 3   health insurance policy that is offered or governed under any of
 4   the following:
 5      (1)   This act, including section 630 and Article XXIV.
 6      (2)   The act of December 29, 1972 (P.L.1701, No.364), known
 7   as the "Health Maintenance Organization Act."
 8      (3)   40 Pa.C.S. Ch. 61 (relating to hospital plan
 9   corporations) or 63 (relating to professional health services
10   plan corporations).
11      "Pelvic floor dysfunction" means the inability to control the
12   muscles of the pelvic floor.
13      "Pelvic floor therapy" means the treatment applied to pelvic
14   floor muscles to treat problems associated with the pelvic
15   floor, including incontinence, difficulty with urination or
16   bowel movements, constipation, chronic pelvic pain, painful
17   intercourse, diastasis recti, pelvic organ prolapse and linked
18   or related conditions.
19      Section 2.    The addition of section 635.11 of the act shall
20   apply as follows:
21            (1)   For health insurance policies for which either rates
22      or forms are required to be filed with the Federal Government
23      or the Insurance Department, this act shall apply to any
24      policy for which a form or rate is first filed on or after
25      the effective date of this paragraph.
26            (2)   For health insurance policies for which neither
27      rates nor forms are required to be filed with the Federal
28      Government or the Insurance Department, this act shall apply
29      to any policy issued or renewed on or after 180 days after
30      the effective date of this paragraph.

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1     Section 3.    This act shall take effect in 60 days.




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