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SB 1316

An Act amending the act of June 13, 1967 (P.L.31, No.21), known as the Human Services Code, in public assistance, providing for pending medical assistance applications.

2025-2026 Regular Session Introduced by Lisa Baker and 8 co-sponsors

The bill aims to streamline and protect access for pending medical assistance applications by clarifying timelines, procedures, and rights during pendency.

Referred to Health & Human Services
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Bill Summary · SB 1316

Summary: SB 1316 (Session 2025-2026) – Pennsylvania Human Services Code (Public Assistance) Pending Medical Assistance Applications

Overview

SB 1316 proposes amending the act of June 13, 1967 (P.L. 31, No. 21), known as the Human Services Code, to address the handling of pending medical assistance (MA) applications. The bill aims to modify procedures related to applications for medical assistance to improve administration, timing, and access to coverage for applicants.

  • Session: 2025-2026
  • Jurisdiction: Pennsylvania
  • Current Status: Referred to Health & Human Services (as of 2026-05-01)
  • Co-sponsors: Lynda Culver; Pat Stefano; Dan Laughlin; Scott Hutchinson; Camera Bartolotta; Elder Vogel; Lisa Baker; Judy Ward; Lisa Boscola

Purpose and Intent

The proposed amendments seek to clarify and streamline the process surrounding medical assistance applications that are in a pending status. The intent appears to be:
- Ensuring timely determination of MA eligibility.
- Providing explicit processes or protections for individuals with pending MA applications.
- Potentially reducing gaps in coverage and administrative delays for applicants seeking MA benefits.

Key Provisions (Proposed Changes)

While the exact statutory language is not provided here, the bill’s focus is on:
1. Pending MA Applications: Revisions to how pending MA applications are handled within the public assistance framework.
2. Eligibility Determination Timeline: Possible implementation or adjustment of timelines by which determinations must be made.
3. Rights and Protections for Applicants: Provisions that may safeguard applicants’ access to services or continuation of coverage during the pendency of their MA application.
4. Administrative Procedures: Changes to administrative rules, notices, or appeal processes related to pending MA applications to improve efficiency and clarity.

Who Would Be Affected

  • Applicants for Medical Assistance: Individuals applying for MA who have pending determinations.
  • Public Assistance Agencies/Departments: State and county human services agencies responsible for processing MA applications and managing eligibility determinations.
  • Health Care Providers and Vendors: Entities that rely on MA coverage for patient services and reimbursement timing may experience changes in processing.

Potential Impacts and Considerations

  • Access to Coverage: By addressing pending applications more efficiently, applicants may experience fewer delays in receiving MA benefits.
  • Administrative Efficiency: Clearer procedures could reduce backlogs and improve processing times within human services agencies.
  • Appeals and Due Process: If the bill strengthens protections during pendency, it could affect how applicants request reconsideration or appeals.
  • Budget and Funding Implications: Changes in processing timelines or coverage continuity could influence state funding allocations or Administrative costs.

Procedural and Timeline Aspects

  • Introduced/Referral: The bill has been referred to the Health & Human Services committee, indicating initial consideration and potential revisions.
  • Next Steps: Committee evaluation, potential amendments, and subsequent votes in the legislative process. If advanced, it would proceed through chamber readings, potential Senate approval, and eventual reconciliation with any House version before becoming law.

If you’d like, I can add more detail once the bill’s full text or fiscal notes become available, including exact statutory language, specific timelines (e.g., days to make determinations, continuation of benefits rules during pendency), and any fiscal impact estimates.

Compiled from official sources — confirm details with the bill’s official record.

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