Pennsylvania House Bill 839 doubles health insurance continuity of care transitional period to 120 days

Original title: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in quality health care accountability and protection, further providing for continuity of care.

Last action · March 10, 2025: Referred to INSURANCE, March 10, 2025Sponsors: Joe Webster and 8 others

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What This Bill Would Do

Pennsylvania House Bill 839 extends the transitional period for patients to continue seeing a doctor after a health plan network change or new enrollment from 60 to 120 days. The measure applies to commercial health insurance policies as well as Medicaid (MA) and Children's Health Insurance Program (CHIP) managed care plans. It also protects patients from surprise balance billing by nonparticipating providers during the transitional period beyond standard cost-sharing rates.

Why it matters

Patients undergoing ongoing medical treatments or enrolling in new health plans gain an additional two months of coverage continuity with out-of-network providers, while nonparticipating doctors are barred from balance billing patients beyond standard in-network cost-sharing amounts.

Who It Would Affect

Groups the bill's text would affect if enacted, as described in the record. Being affected is not a position for or against it.

Directly affected

Covered persons and enrollees

Enrollees gain a longer transitional period of up to 120 days to continue treatment with out-of-network or terminating providers and receive protection from direct balance billing.

Directly affected

Insurers and MA or CHIP managed care plans

Insurers and managed care plans must cover transitional care for up to 120 days, provide network status change notices to enrollees, and reimburse providers under applicable participating terms.

Directly affected

Participating and nonparticipating health care providers

Providers participate in transitional care consultations and are restricted from balance billing patients beyond standard cost-sharing when reimbursed at established rates.

Key Facts

You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.

Frequently Asked Questions

How long can I continue seeing my doctor if my health plan drops them from its network?

You may continue your ongoing course of treatment with that health care provider for a transitional period of up to 120 days from the date you were notified of the termination, expiration, or nonrenewal.

What happens if I am pregnant when my doctor leaves the health plan network?

If you are in your second or third trimester of pregnancy at the time of the termination notice, the transitional period extends through postpartum care related to the delivery.

Can an out-of-network doctor bill me for the full cost of care during the transitional period?

No, if the insurer reimburses the nonparticipating provider at the established in-network rate, the provider cannot bill you directly except for standard cost-sharing rates specified in your plan.

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Where This Stands

Currently in committee. The next step in the legislative lifecycle is Floor Vote.

Procedural history

1 action

Mar 10, 2025HouseCommittee
Referred to INSURANCE, March 10, 2025

Version history

Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.

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