PRINTER'S NO. 362 THE GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL No.397 Session of 2025 INTRODUCED BY GROVE, HAMM, GREINER, KUTZ, STAATS AND GILLEN, JANUARY 28, 2025 REFERRED TO COMMITTEE ON INSURANCE, JANUARY 28, 2025 AN ACT Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An act relating to insurance; amending, revising, and consolidating the law providing for the incorporation of insurance companies, and the regulation, supervision, and protection of home and foreign insurance companies, Lloyds associations, reciprocal and inter-insurance exchanges, and fire insurance rating bureaus, and the regulation and supervision of insurance carried by such companies, associations, and exchanges, including insurance carried by the State Workmen's Insurance Fund; providing penalties; and repealing existing laws," in casualty insurance, providing for certified EMT firefighter billing. The General Assembly of the Commonwealth of Pennsylvania hereby enacts as follows: Section 1. The act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, is amended by adding a section to read: Section 635.11. Certified EMT Firefighter Billing.--(a) When a fire company is dispatched by a public safety answering point as defined in 35 Pa.C.S. § 5302 (relating to definitions) for an emergency, and a certified EMT firefighter within the fire company provides medically necessary emergency medical services at the emergency scene, the fire company may file a 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 claim with an insurer for a payment to be made by an insurer, in accordance with a health insurance policy for emergency medical service performed by a certified EMT firefighter and the payment shall be paid directly to the fire company. (b) If more than one certified EMT firefighter from more than one fire company provides necessary emergency medical services in response to an emergency, separate bills may be submitted by the fire companies. (c) An insurer may not require a fire company to contract with the insurer to receive payment under this section. (d) A fire company that files a false claim under this section commits a summary offense and, upon conviction, shall be sentenced to pay a fine of not more than one hundred dollars ($100). A fire company shall pay a fine of one thousand dollars ($1,000) for each subsequent offense. (e) As used in this section, the following words and phrases shall have the meanings given to them in this subsection unless the context clearly indicates otherwise: "Certified EMT firefighter." A volunteer firefighter who is a member of a fire company and possesses a current and valid certification to administer emergency medical services. "Emergency medical services." The term shall mean the same as defined under 35 Pa.C.S. § 8103 (relating to definitions). "Fire company." A volunteer fire company located in this Commonwealth. "Insurer." As follows: (1) An entity that is responsible for providing or paying for all or part of the cost of emergency medical services covered by an insurance policy, contract or plan. The term includes an entity subject to: 20250HB0397PN0362 - 2 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 (i) section 630, Article XXIV or any other provision of this act; (ii) the act of December 29, 1972 (P.L.1701, No.364), known as the "Health Maintenance Organization Act"; or (iii) 40 Pa.C.S. Ch. 61 (relating to hospital plan corporations) or 63 (relating to professional health services plan corporations). (2) The term does not include an entity that is responsible for providing or paying under an insurance policy, contract or plan which meets any of the following: (i) Is a homeowner's insurance policy. (ii) Provides any of the following types of insurance: (A) Accident only. (B) Fixed indemnity. (C) Limited benefit. (D) Credit. (E) Dental. (F) Vision. (G) Specified disease. (H) Medicare supplement. (I) Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) supplement. (J) Long-term care. (K) Disability income. (L) Workers' compensation. (M) Automobile medical payment insurance. Section 2. This act shall take effect in 60 days. 20250HB0397PN0362 - 3 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27