Unconsolidated Pennsylvania Statutes

INSURANCE (TITLE 40)

HOSPITAL AND MEDICAL SERVICE PLANS

OPTOMETRIC SERVICES, REIMBURSEMENT

§ 1501. Definitions.
§ 1502. Reimbursement.
§ 1503. Repeals.

NONDISCRIMINATORY REIMBURSEMENT

§ 1511. Treatment performed by licensed person, reimbursement of policy claims.

HEALTH MAINTENANCE ORGANIZATIONS

§ 1551. Short title.
§ 1552. Purpose.
§ 1553. Definitions.
§ 1554. Services which shall be provided.
§ 1555. [Repealed.]
§ 1555.1. Certificate of authority.
§ 1556. [Repealed.]
§ 1556.1. Foreign health maintenance organizations.
§ 1557. Board of directors.
§ 1558. Contracts with practitioners, hospitals, insurance companies, etc.
§ 1559. Right to service or benefits when outside the state.
§ 1560. Supervision.
§ 1561. Reports and examinations.
§ 1562. Contracts to provide medical care.
§ 1563. Exemption from taxation.
§ 1564. Rules and regulations.
§ 1565. Penalty.
§ 1566. Exclusions.
§ 1567. Effect of act on other plans.
§ 1568. [Repealed.]

WOMEN'S PREVENTATIVE HEALTH SERVICES ACT

§ 1571. Short title.
§ 1572. Declaration of policy.
§ 1573. Definitions.
§ 1574. Mandated coverage.
§ 1575. Delivery of policy.
§ 1576. Repeals.
§ 1577. Applicability.

HEALTH SECURITY ACT

§ 1581. Short title.
§ 1582. Definitions.
§ 1583. Post partum coverage standards.
§ 1584. Refusal to contract or compensate.

OPTOMETRIC SERVICES, REIMBURSEMENT

§ 1501. Definitions.

[to be inserted.]

§ 1502. Reimbursement.

[to be inserted.]

§ 1503. Repeals.

[to be inserted.]

NONDISCRIMINATORY REIMBURSEMENT

§ 1511. Treatment performed by licensed person, reimbursement of policy claims.

[to be inserted.]

HEALTH MAINTENANCE ORGANIZATIONS

§ 1551. Short title.

This act shall be known and may be cited as the "Health Maintenance Organization Act."

[Note: There is no private cause of action under this statute. See, Britamco Underwriters, Inc. v. C.J.H., Inc., 845 F. Supp. 1090 (E.D.Pa.: 1994), aff'd. 37 F. 3d 1485.

§ 1552. Declaration of purpose.

[to be inserted.]

§ 1553. Definitions.

[to be inserted.]

§ 1554. Services which shall be provided.

[to be inserted.]

§ 1555.1. Certificate of authority.

[to be inserted.]

§ 1556.1. Foreign health maintenance organizations.

[to be inserted.]

§ 1557. Board of directors.

[to be inserted.]

§ 1558. Contracts with practitioners, hospitals, insurance companies, etc.

[to be inserted.]

§ 1559. Right to service or benefits when outside the state.

[to be inserted.]

§ 1560. Supervision.

[to be inserted.]

§ 1561. Reports and examinations.

[to be inserted.]

§ 1562. Contracts to provide medical care.

[to be inserted.]

§ 1563. Exemption from taxation.

[to be inserted.]

§ 1564. Rules and regulations.

[to be inserted.]

§ 1565. Penalty.

[to be inserted.]

§ 1566. Exclusions.

[to be inserted.]

§ 1567. Effect of act on other plans.

[to be inserted.]

WOMEN'S PREVENTATIVE HEALTH SERVICES ACT

§ 1571. Short title.

This act shall be known and may be cited as the Women's Preventative Health Services Act.

§ 1572. Declaration of policy.

[to be inserted.]

§ 1573. Definitions.

[to be inserted.]

§ 1574. Mandated coverage.

A health insurance policy which is delivered, issued for delivery, renewed, extended or modified in this Commonwealth by a health care insurer shall provide that the health insurance benefits applicable under the policy include coverage for periodic health maintenance to include:

1. Annual gynecological examination, including a pelvic examination and clinical breast examination.
2. Routine pap smears in accordance with the recommendations of the American College of Obstetricians and Gynecologists.

§ 1575. Delivery of policy.

If a health insurance policy provides coverage or benefits to a resident of this Commonwealth, it shall be deemed to be delivered in this Commonwealth within the meaning of this act, regardless of whether the health care insurer issuing or delivering the policy is located within or outside of this Commonwealth.

§ 1576. Repeals.

All acts and parts of acts are repealed insofar as they are inconsistent with this act.

§ 1577. Applicability.

This act shall apply to all insurance policies, subscriber contracts and group insurance certificates issued under any group master policy delivered or issued for delivery on or after the effective date of this act. This act shall also apply to all renewals of contracts on any renewal date which is on or after the effective date of this act.

HEALTH SECURITY ACT

§ 1581. Short title.

[to be inserted.]

§ 1582. Definitions.

[to be inserted.]

§ 1583. Post partum coverage standards.

[to be inserted.]

§ 1584. Refusal to contract or compensate.

[to be inserted.]

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