HB 2041 — An Act amending the act of November 3, 2022 (P.L.2135, No.150), known as the Childhood Blood Lead Test Act, further providing for title of act, for legislative purpose, for definitions, for lead poisoning prevention, assessment and testing, for duties of department and for blood lead assessment and testing coverage.

PRINTER'S NO.   2611

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                         HOUSE BILL
                         No. 2041
                                               Session of
                                                 2025

     INTRODUCED BY LABS, GIRAL, RIVERA, WAXMAN, McNEILL, HOHENSTEIN,
        HANBIDGE, GILLEN, D. WILLIAMS, JAMES, CURRY, MADSEN,
        ARMANINI, PASHINSKI, POWELL, GUENST, BOROWSKI, PROKOPIAK,
        FIEDLER, NEILSON, SCOTT, DALEY, MARCELL, BRIGGS, CIRESI,
        SALISBURY, FRANKEL, KHAN, SMITH-WADE-EL AND GREEN,
        NOVEMBER 17, 2025

     REFERRED TO COMMITTEE ON CHILDREN AND YOUTH, NOVEMBER 17, 2025


                                    AN ACT
 1   Amending the act of November 3, 2022 (P.L.2135, No.150),
 2      entitled "An act providing for blood lead assessment and
 3      testing of certain children and pregnant women by health care
 4      providers; imposing duties on the Department of Health; and
 5      requiring certain health insurance policies to cover blood
 6      lead tests," further providing for title of act, for
 7      legislative purpose, for definitions, for lead poisoning
 8      prevention, assessment and testing, for duties of department
 9      and for blood lead assessment and testing coverage.
10      The General Assembly of the Commonwealth of Pennsylvania
11   hereby enacts as follows:
12      Section 1.    The title of the act of November 3, 2022
13   (P.L.2135, No.150), known as the Childhood Blood Lead Test Act,
14   is amended to read:
15                                  AN ACT
16   Providing for blood lead assessment and testing of certain
17      children and pregnant women by health care [providers]
18      practitioners; imposing duties on the Department of Health;
19      and requiring certain health insurance policies to cover
 1      blood lead tests.
 2      Section 2.     Section 3(3) of the act is amended to read:
 3   Section 3.   Legislative purpose.
 4      The purposes of this act are:
 5          * * *
 6          (3)     To [encourage] require the testing of all children
 7      in this Commonwealth by two years of age so that prompt
 8      diagnosis and treatment, as well as the prevention of harm,
 9      are possible.
10      Section 3.     Section 4 of the act is amended by adding
11   definitions to read:
12   Section 4.   Definitions.
13      The following words and phrases when used in this act shall
14   have the meanings given to them in this section unless the
15   context clearly indicates otherwise:
16      * * *
17      "Cost-sharing."     The share of health care costs covered by a
18   health insurance policy that an insured pays out of pocket. The
19   term includes deductibles, coinsurance, copayments and similar
20   charges. The term does not include premiums, balance-billed
21   amounts from an out-of-network health care provider or the cost
22   of noncovered services.
23      * * *
24      "Health care practitioner."      As defined in section 103 of the
25   act of July 19, 1979 (P.L.130, No.48), known as the Health Care
26   Facilities Act.
27      * * *
28      Section 4.     Sections 5 and 6(a) and (b)(2) of the act are
29   amended to read:
30   Section 5.   Lead poisoning prevention, assessment and testing

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 1                 requirements.
 2    [(a)    Lead testing for children.--
 3           (1)   The following apply:
 4                 (i)    A health care provider shall consider possible
 5           lead exposure in an individual patient by evaluating risk
 6           factors for lead exposure and perform blood lead testing
 7           in accordance with recommendations from the Centers for
 8           Disease Control and Prevention and the American Academy
 9           of Pediatrics by 24 months of age.
10                 (ii)    If a patient has never been tested in
11           accordance with recommendations from the Centers for
12           Disease Control and Prevention and the American Academy
13           of Pediatrics by 24 months of age, a health care provider
14           shall consider possible lead exposure and perform blood
15           lead testing in an individual patient between 24 months
16           and 72 months of age.
17                 (iii)    A health care provider shall make reasonable
18           efforts to ensure that a patient's parent or legal
19           guardian understands the risks and benefits of blood lead
20           testing prior to obtaining consent.
21           (2)   If a patient's parent or legal guardian consents to
22    blood lead testing for the patient under paragraph (1) and
23    the results of a capillary blood lead test indicate an
24    elevated blood lead level, the health care provider shall
25    perform a confirmatory blood lead test by venipuncture within
26    12 weeks of the first blood lead test after obtaining the
27    consent of the patient's parent or legal guardian.]
28    (a.1)    Lead testing requirements for children.--
29           (1)   A health care practitioner shall make reasonable
30    efforts to ensure that a patient under the health care

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 1      practitioner's care receives at least one blood lead test by
 2      12 months of age and a second blood lead test by 24 months of
 3      age.
 4             (2)   If a patient has never been tested by 24 months of
 5      age, a health care practitioner shall ensure that the patient
 6      receives at least one blood lead test between 24 months and
 7      72 months of age.
 8             (3)   If a capillary blood lead test indicates an elevated
 9      blood lead level, a health care practitioner shall perform a
10      confirmatory blood lead test by venipuncture in accordance
11      with recommendations from the Centers for Disease Control and
12      Prevention.
13      (b)    Lead exposure risk assessment and testing requirements
14   for pregnant women.--A health care [provider] practitioner shall
15   consider possible lead exposure in individual pregnant women by
16   evaluating risk factors for lead exposure and perform blood lead
17   testing if a single risk factor is identified in accordance with
18   recommendations from the Centers for Disease Control and
19   Prevention and the American College of Obstetricians and
20   Gynecologists.
21      (c)    Reporting.--Health care [providers] practitioners and
22   laboratories shall comply with reporting regulations as
23   specified in 28 Pa. Code § 27.34 (relating to reporting cases of
24   lead poisoning).
25      (d)    Communication of risks and benefits.--Notwithstanding
26   subsection (e), a health care practitioner shall make reasonable
27   efforts to ensure that a child's parent or legal guardian, or a
28   woman under prenatal care, understands the benefits and risks of
29   a blood lead test.
30      (e)    Nonapplicability.--The requirements under this section

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 1   shall not apply if a child's parent or legal guardian, or a
 2   woman under prenatal care, objects to the blood lead test for
 3   any reason. A health care practitioner shall document the
 4   objection in writing and include the objection in the patient's
 5   medical record. Before performing a blood lead test under this
 6   section, the health care practitioner shall notify the child's
 7   parent or legal guardian, or the woman under prenatal care, of
 8   the option to object to a blood lead test.
 9   Section 6.     Duties of department.
10      (a)   Comprehensive educational program.--The department shall
11   conduct a public information campaign to inform parents of young
12   children, physicians, nurses and other health care [providers]
13   practitioners of the lead assessment and testing requirements of
14   this act.
15      (b)   Distribution of literature about childhood lead
16   poisoning.--
17            * * *
18            (2)     Educational materials shall be available at no cost
19      and shall be developed for specific audiences, including
20      health care [providers] practitioners, homeowners, landlords
21      and parents or caregivers.
22      Section 5.      Section 7(a) and (b) of the act are amended and
23   the section is amended by adding a subsection to read:
24   Section 7.     Blood lead assessment and testing coverage.
25      (a)   General rule.--A health insurance policy or government
26   program covered under this section shall provide to covered
27   individuals or recipients blood lead tests as follows:
28            (1)   In the case of individuals or recipients who are
29      pregnant, one blood lead test per pregnancy [if a single risk
30      factor is identified in accordance with recommendations from

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 1      the Centers for Disease Control and Prevention and the
 2      American College of Obstetricians and Gynecologists].
 3             (2)   In the case of individuals or recipients who are:
 4                   (i)    under two years of age, at least [one blood lead
 5             test] two blood lead tests by 24 months of age in
 6             accordance with recommendations from the Centers for
 7             Disease Control and Prevention and the American Academy
 8             of Pediatrics [and, if]; and
 9                   (ii)    between 24 months of age and 72 months of age,
10             at least one blood lead test by 72 months of age if the
11             individual or recipient has never been tested by 24
12             months of age.
13             (3)   If the result of the blood [level] lead test covered
14      under paragraph (1) or (2) indicates an elevated blood lead
15      level, another blood lead test by venipuncture [within 12
16      weeks of the blood level test in which the elevated blood
17      lead level was indicated.] in accordance with recommendations
18      from the Centers for Disease Control and Prevention.
19      [(b)    Copayments, deductibles and coinsurance.--Coverage
20   under this section shall be subject to copayment, deductible and
21   coinsurance provisions and any other general exclusions or
22   limitations of a health insurance policy or government program
23   to the same extent as other medical services covered by the
24   policy or program are subject to these provisions.]
25      (b.1)    Cost-sharing.--A blood lead test covered under
26   subsection (a) shall not be subject to cost-sharing.
27      * * *
28      Section 6.         The amendment of section 7 of the act shall apply
29   as follows:
30             (1)   For health insurance policies for which either rates

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 1    or forms are required to be filed with the Insurance
 2    Department or the Federal Government, the amendment of
 3    section 7 of the act shall apply to any policy for which a
 4    form or rate is first filed on or after the effective date of
 5    this section.
 6        (2)    For health insurance policies for which neither
 7    rates nor forms are required to be filed with the Insurance
 8    Department or the Federal Government, the amendment of
 9    section 7 of the act shall apply to any policy issued or
10    renewed on or after 180 days after the effective date of this
11    section.
12    Section 7.    This act shall take effect in 60 days.




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