SB 1342 — 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.     1737

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                        SENATE BILL
                        No. 1342
                                               Session of
                                                 2026

     INTRODUCED BY ROBINSON, J. WARD, MASTRIANO, PENNYCUICK,
        BARTOLOTTA, PISCIOTTANO, COLLETT, LANGERHOLC, SCHWANK,
        L. WILLIAMS, FLYNN AND KIM, MAY 21, 2026

     REFERRED TO BANKING AND INSURANCE, MAY 21, 2026


                                    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 (g) of the act of
16   May 17, 1921 (P.L.682, No.284), known as The Insurance Company
17   Law of 1921, are amended and the section is amended by adding
18   subsections to read:
19      Section 635.7.    Billing.--* * *
20      [(b)   An insurer must reimburse a nonnetwork EMS agency under
21   the following:
22      (1)    The EMS agency has submitted a completed standardized
 1   form to the department requesting nonnetwork direct
 2   reimbursement from an insurer an EMS agency has identified. The
 3   form must be submitted to the department annually by October 15.
 4   The form shall declare the EMS agency's intention to receive
 5   direct payment from an insurer identified on the form for the
 6   next calendar year. The department shall develop a standardized
 7   form, using an EMS agency's assigned license number, to be used
 8   by an EMS agency that meets the conditions established under
 9   this section. The department shall develop and maintain a
10   publicly accessible electronic registry that indicates which EMS
11   agency has requested nonnetwork direct reimbursement from an
12   insurer identified on the form.
13      (2)   An EMS agency has provided notification to the insurer
14   upon submitting a claim for reimbursement that the EMS agency is
15   registered with the department to receive direct reimbursement
16   as provided for under this section.]
17      (b.1)   An EMS agency may seek reimbursement and shall accept
18   payment from an insurer for services that have been provided to
19   a covered person for dispatched 911 emergency medical services.
20      (b.2)   Upon receiving a bill for dispatched 911 emergency
21   medical services, an insurer shall directly reimburse a
22   designated EMS agency within forty-five days at three hundred
23   fifty percent of the current published rate for ambulance
24   services as established by the Centers for Medicare and Medicaid
25   Services under 42 U.S.C. Ch. 7 Subch. XVIII (relating to health
26   insurance for aged and disabled) for the same service provided
27   in the same geographic area and according to:
28      (1)   The allowable amount afforded under this section only
29   applies to dispatched 911 emergency medical services and does
30   not apply to any other covered service provided by a

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 1   participating network provider under a health insurance policy.
 2      (2)     Payment made by the insurer in compliance with this
 3   section shall be considered payment in full for the service
 4   provided, except for any copayment, coinsurance, deductible or
 5   other cost-sharing amounts required to be paid by the covered
 6   person.
 7      (3)     An EMS agency may not bill the covered person directly
 8   or indirectly or otherwise attempt to collect from a covered
 9   person, except to recover a cost-sharing amount.
10      (4)     An insurer may not require an EMS agency to contract
11   with the insurer to receive reimbursement under this section.
12      * * *
13      [(d)     Where an insurer has reimbursed a nonnetwork EMS agency
14   at the same rate it has established for a network EMS agency,
15   the EMS agency may not bill the insured directly or indirectly
16   or otherwise attempt to collect from the insured for the service
17   provided, except for a billing to recover a copayment,
18   coinsurance or deductible as specified in the health insurance
19   policy.]
20      (e)     An EMS agency [that submits a form under this section]
21   may solicit donations or memberships or conduct fundraising,
22   except that an EMS agency may not promise, suggest or infer to
23   donors that a donation will result in the donor not being billed
24   directly for any payment as provided under this section.
25   Notwithstanding this paragraph, an EMS agency may bill in
26   accordance with subsection [(d)] (b.2)(3). A violation of this
27   section shall be considered a violation of the act of December
28   17, 1968 (P.L.1224, No.387), known as the "Unfair Trade
29   Practices and Consumer Protection Law."
30      * * *

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1      [(g)    This section shall apply only to an EMS agency that is
2   a nonnetwork provider and provides emergency medical services,
3   unless preempted by Federal law.]
4      * * *
5      Section 2.   This act shall take effect in 60 days.




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