Section 764d.1 - Coverage for BRCA-related Genetic Counseling and Genetic Testing.(a) A health insurance policy offered, issued or renewed in this Commonwealth shall provide coverage for BRCA-related genetic counseling and genetic testing provided by an individual licensed, certified or otherwise regulated to provide genetic counseling and genetic testing under the laws of this Commonwealth. The minimum coverage required shall include all costs associated with genetic counseling and, if indicated after genetic counseling, a genetic laboratory test of the BRCA1 and BRCA2 genes for individuals assessed to be at an increased risk, based on a clinical risk assessment tool, of potentially harmful mutations in the BRCA1 or BRCA2 genes due to a personal or family history of breast or ovarian cancer.(b) As used in this section: "Genetic counseling" means the provision of services to individuals, couples, families and organizations by one or more appropriately trained individuals to address the physical and psychological issues associated with the occurrence or risk of occurrence of a genetic disorder, birth defect or genetically influenced condition or disease in an individual or a family.
"Health insurance policy" means an individual or group insurance policy, subscriber contract, certificate or plan issued by an insurer that provides medical or health care coverage, including emergency services. The term does not include any of the following:
(1) An accident only policy.(2) A credit only policy.(3) A long-term care or disability income policy.(4) A specified disease policy.(5) A Medicare supplement policy.(6) A fixed indemnity policy.(7) A hospital indemnity policy.(8) A dental only policy.(9) A vision only policy.(10) A worker's compensation policy.(11) An automobile medical payment policy.(12) A TRICARE policy, including a Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) supplement policy.(13) Any other similar policy providing for limited benefits."Insurer" means an entity licensed by the Insurance Department with accident and health authority to issue a health insurance policy that is offered or governed under any of the following:
(1) This act, including section 630 and Article XXIV.(2) The act of December 29, 1972 ( P.L. 1701, No.364), known as the "Health Maintenance Organization Act."(3) 40 Pa.C.S. Ch. 61 (Relating to hospital plan corporations) or 63 (Relating to professional health services plan corporations).Added by P.L. TBD 2023 No. 1, § 2, eff. 6/30/2023.