Mandated Benefits Review - Senate Bill 39 - Review Process

The Pennsylvania Health Care Cost Containment Council's enabling legislation, Act 89 of 1986 (as re-authorized by Act 34 of 1993), provides that the Council review existing or proposed mandated health benefits when requested by the executive and legislative branches of government.

On February 10, 1998, Senator F. Joseph Loeper, Chairman of the Senate Committee on Rules and Executive Nominations, requested that the Council review the provisions of Senate Bill 39 (PN 33, Senator Hole), which would mandate insurance coverage for cancer screening and early detection. A copy of the bill is attached.

Notification was published in the Pennsylvania Bulletin on March 14, 1998, requesting that interested parties submit documentation and information pertaining to the bill to the Council by May 29, 1998. Letters were also sent to 27 potentially interested individuals and organizations informing them of the pending review and inviting them to submit documentation pursuant to the notice. Following the initial comment period, an opportunity was provided for interested individuals and organizations to examine the responses received. The Pennsylvania Department of Health and the Insurance Department were notified of the review and received a copy of the submissions. As provided under the Act, respondents were also given an opportunity to submit a second round of documentation after examining the responses received. A list of documentation submitted to the Council is attached.

Act 34 also provides for a preliminary Council staff review of submitted materials to determine if documentation submitted is sufficient to proceed with the formal Mandated Benefits Review process outlines in the Act. This report presents the results of the Council's preliminary staff review and the conclusions of the Council regarding whether the material is sufficient to proceed with the formal review process.