Pennsylvania House Bill HB1391

Pennsylvania 2025-2026 Regular Session

• Introduced: 5/5/25
• Refer: 5/5/25

Caption

In casualty insurance, providing for reimbursement for custom-fabricated devices, custom-fitted devices, orthosis, orthotics, over-the-counter prostheses, orthoses and pedorthic devices, prefabricated orthoses, prostheses, prosthetics and components of such devices.

Impact

The bill significantly alters the existing insurance framework by requiring insurers to provide coverage specifically for a range of devices that have previously faced obstacles in reimbursement claims. This change is anticipated to affect a variety of health policies issued within the Commonwealth, compelling insurers to comply with these new provisions and enhancing access to necessary medical equipment for patients across different demographics. Over time, it aims to improve health outcomes by ensuring individuals can obtain the support they need without prohibitive costs.

Summary

House Bill 1391 aims to amend the Insurance Company Law of 1921 by expanding coverage on custom-fabricated and custom-fitted devices, such as prostheses and orthoses, under health insurance policies in Pennsylvania. This legislation mandates that individual and group health plans must reimburse prescribed devices when deemed medically necessary by authorized medical professionals. By doing so, the bill seeks to ensure that patients have better access to essential medical devices that enhance their quality of life, particularly for those with musculoskeletal impairments.

Sentiment

The general sentiment surrounding HB 1391 is positive among healthcare advocates who see the legislation as a crucial step towards making necessary medical devices more accessible to patients in need. Supporters argue that the bill addresses significant gaps in health insurance coverage that have historically left many individuals without adequate support for rehabilitation or daily living. However, some insurance providers express concerns about the potential increase in healthcare costs and the implications for policy reform that may arise as a result.

Contention

While the bill is designed to expand healthcare access, points of contention arise predominantly from discussions about insurance reimbursement levels and the potential financial burden on insurers. Opponents worry that mandating coverage could lead to increased premiums across the board, and some healthcare providers call for balanced approaches that prevent overburdening the healthcare system while still ensuring that patients receive the support they require. The balance between adequate coverage and sustainable insurance practices remains a focal point of the discussion.