Pennsylvania Act 1994-150 — DOMESTIC RELATIONS CODE (23 PA.C.S.) - AMEND

Act text

DOMESTIC RELATIONS CODE (23 PA.C.S.) - AMEND
                 Act of Dec. 16, 1994, P.L. 1286, No. 150             Cl. 23
                             Session of 1994
                               No. 1994-150

     SB 710

                                  AN ACT

     Amending Title 23 (Domestic Relations) of the Pennsylvania
        Consolidated Statutes, implementing the provisions of the
        Omnibus Budget Reconciliation Act of 1993 relating to
        required State laws for medical child support; and further
        providing for improvements in child support enforcement and
        for acknowledgment and claim of paternity.

        The General Assembly of the Commonwealth of Pennsylvania
     hereby enacts as follows:

        Section 1.  Sections 4326(g), (h), (i), (j), (k) and (l) and
     4342(a) of Title 23 of the Pennsylvania Consolidated Statutes
     are amended and the sections are amended by adding subsections
     to read:
      § 4326.  Mandatory inclusion of child medical support.
        * * *
        (g)  Obligations of insurance companies.--Every insurer doing
     business within this Commonwealth shall be obligated as follows:
            (1)  [to receive, process and pay claims to a custodial
        parent who has complied with subsection (i) in the same
        manner that the insurer is responsible to receive, process
        and pay claims to other insureds under the policy;] to permit
        the custodial parent or the provider, with the custodial
        parent's approval, to submit claims for covered services
        without the approval of the noncustodial parent and to make
        payment on such claims directly to such custodial parent, the
        provider or, in the case of Medical Assistance patients, to
        the Department of Public Welfare;
            (2)  to provide such information to the custodial parent
        as may be necessary to obtain benefits, including copies of
        benefit booklets, insurance contracts and claims information
        [to custodial parents];
            (3)  if coverage is made available for dependents of the
        insured, to make such coverage available to the insured's
        children without regard to enrollment season restrictions,
        whether the child was born out of wedlock, whether the child
        is claimed as a dependent on the parent's Federal income tax
        return, whether the child resides in the insurer's service
        area, the amount of support contributed by a parent, the
        amount of time the child spends in the home or the custodial
        arrangements for the child;
            (4)  to permit the enrollment of children under court
        order [within 60 days of the issuance] upon application of
        the custodial parent, domestic relations section or the
        Department of Public Welfare within 30 days of receipt by the
        insurer of the order; [and]
            (4.1)  not to disenroll or eliminate coverage of any
        child unless the insurer is provided satisfactory written
        evidence that a court order requiring coverage is no longer
        in effect or that the child is or will be enrolled in
        comparable health coverage through another insurer which will
        take effect no later than the effective date of such
        disenrollment;
            (4.2)  to receive, process and pay claims (whether or not
        on behalf of a child), including electronically submitted
        claims, submitted by the Department of Public Welfare within
        the time permitted by law without imposing any patient
        signature requirement or other requirement different from
        those imposed upon providers, agents or assignees of any
        insured individual;
            (5)  to provide the custodial parent who has complied
        with subsection [(i)] (j) with the same notification of
        termination or modification of any health care coverage due
        to nonpayment of premiums or other reason as is provided to
        other insureds under the policy[.]; and
            (6)  except as provided in paragraph (4.2), to not take
        into account the fact that any individual, whether or not a
        child, is eligible for or is being provided medical
        assistance when enrolling that individual or when making any
        payments for benefits to the individual or on the
        individual's behalf.
        (h)  Obligations of noninsurers.--To the maximum extent
     permitted by Federal law, the obligations of subsection (g)
     shall apply to noninsurers providing health care coverage within
     this Commonwealth, including health maintenance organizations,
     self-insured employee health benefit plans[, and to insurers
     providing benefits, directly or indirectly, through stop-loss
     coverage to self-insured plans] and any other entity offering a
     service benefit plan.
        (h.1)  Obligations of employers.--Every employer doing
     business within this Commonwealth shall be obligated as follows:
            (1)  in any case in which a parent is required by a court
        order to provide health coverage for a child and the parent
        is eligible for family health coverage, the employer shall
        permit the insured parent to enroll any child who is
        otherwise eligible without regard to any enrollment season
        restrictions;
            (2)  if the insured parent is enrolled but fails to make
        application to obtain coverage for such child, to enroll the
        child under the family coverage upon application by the
        child's other parent, the domestic relations section or the
        Department of Public Welfare; and
            (3)  not to disenroll or eliminate coverage of any such
        child unless the employer is provided satisfactory written
        evidence that the court or administrative order is no longer
        in effect, the child is or will be enrolled in comparable
        health coverage which will take effect not later than the
        effective date of such disenrollment or the employer has
        eliminated family health coverage for all of its employees.
        (i)  Obligations of custodial parent.--The custodial parent
     shall comply with the insurer's existing claim procedures and
     present to the insurer one of the following documents:
            (1)  a copy of a court order [providing for payment of
        medical expenses and/or maintenance of medical insurance
        coverage on behalf of the child by the custodial parent; or]
        as defined in subsection (l); or
            (2)  a release signed by the insured permitting the
        insurer to communicate directly with the custodial parent.
        (j)  Enforcement of order.--The employee's share, if any, of
     premiums for health coverage shall be deducted by the employer
     and paid to the insurer or other entity providing health care
     coverage. If an obligated parent fails to comply with the order
     to provide health care coverage for a child [or], fails to pay
     medical expenses for a child or receives payment from a third
     party for the cost of medical services provided to such child
     and fails to reimburse the custodial parent or provider of
     services, the court shall:
            (1)  If, after a hearing, the failure or refusal is
        determined to have been willful, impose the penalties of
        section 4345(a) (relating to contempt for noncompliance with
        support order).
            (2)  Enter an order for a sum certain against the
        obligated parent for the cost of medical care for the child
        and for any premiums paid or provided for the child during
        any period in which the obligated parent failed or refused to
        provide coverage. Failure to comply with an order under this
        paragraph shall be subject to section 4348 (relating to
        attachment of income).
            (3)  Upon failure of the obligated parent to make this
        payment or reimburse the custodial parent and after
        compliance with due process requirements, treat the amount as
        arrearages.
        (k)  Enforcement against insurers.--Any insurer or other
     entity which violates the obligations imposed upon it under
     subsection (g) or (h) shall be civilly liable for damages and
     may be adjudicated in contempt and fined by the court.
        (l)  Definitions.--As used in this section, the following
     words and phrases shall have the meanings given to them in this
     subsection:
        "Child."  A child to whom a duty of child support is owed.
        "Health care coverage."  Coverage for medical, dental,
     orthodontic, optical, psychological, psychiatric or other health
     care services for a child. For the purposes of this section,
     medical assistance under Subarticle (f) of Article IV of the act
     of June 13, 1967 (P.L.31, No.21), known as the Public Welfare
     Code, shall not be considered health care coverage.
        "Insurer."  A corporation or person incorporated or doing
     business in this Commonwealth by virtue of the act of May 17,
     1921 (P.L.682, No.284), known as The Insurance Company Law of
     1921; a hospital plan corporation as defined in 40 Pa.C.S. Ch.
     61 (relating to hospital plan corporations); a professional
     health service plan corporation as defined in 40 Pa.C.S. Ch. 63
     (relating to professional health services plan corporations); a
     beneficial society subject to 40 Pa.C.S. Ch. 65 (relating to
     fraternal benefit societies); a health maintenance organization;
     or any other person, association, partnership, common-law trust,
     joint stock company, nonprofit corporation, profit corporation
     or other entity conducting an insurance business.
        "Medical child support order."  An order which relates to the
     child's right to receive certain health care coverage and which:
            (1)  includes the name and last known mailing address of
        the parent providing health care coverage and the name and
        last known mailing address of the child;
            (2)  includes a reasonable description of the type of
        coverage to be provided or includes the manner in which
        coverage is to be determined;
            (3)  designates the time period to which the order
        applies;
            (4)  if coverage is provided through a group health plan,
        designates each plan to which the order applies; and
            (5)  includes the name and address of the custodial
        parent.
      § 4342.  Expedited procedure.
        (a)  General rule.--The Supreme Court shall by general rule
     provide for expedited procedures for the determination of
     paternity and the determination and enforcement of support. The
     procedures shall include an office conference; a conference
     summary to the court by the hearing officer; an opportunity for
     the court to enter an order without hearing the parties; and an
     opportunity for the parties to demand a full hearing by the
     court.
        * * *
        (e)  Default.--The court shall enter a default order
     establishing paternity and enforcing support upon a showing that
     the defendant has been properly served and has not appeared.
        Section 2.  Section 4343(c) of Title 23 is amended to read:
      § 4343.  Paternity.
        * * *
        (c)  Genetic tests.--
            (1)  Upon the request of any party to an action to
        establish paternity, the court shall require the child and
        the parties to submit to genetic tests.
            (2)  Genetic test results [shall be considered prima
        facie evidence of paternity.] indicating a 99% or greater
        probability that the alleged father is the father of the
        child shall create a presumption of paternity which may be
        rebutted only by clear and convincing evidence that the
        results of the genetic tests are not reliable in that
        particular case.
            (3)  To ensure the integrity of the specimen and that the
        proper chain of custody has been maintained, the genetic
        tests of the biological mother, the child or children in
        question and the alleged father should be conducted by an
        established genetic-testing laboratory in the course of its
        regularly conducted business activity, and certified records
        should be issued. The certified records shall be admissible
        into evidence without further foundation, authentication or
        proof of accuracy if no objection is made within ten days
        prior to trial. The laboratory must be certified by either
        the American Association of Blood Banks or the American
        Association for Histocompatibility and Immunogenetics.
            (4)  A fee for performing genetic tests may be imposed on
        any individual who is not a recipient of public assistance.
        The amount of the fee will be in accordance with applicable
        Federal regulation.
            (5)  A determination of paternity made by another state,
        whether through judicial proceedings, administrative
        proceedings or by acknowledgment of paternity, shall be given
        full faith and credit in the courts of this Commonwealth.
            (6)  A determination of nonpaternity made by another
        state with respect to a public assistance recipient shall not
        be binding upon the Department of Public Welfare unless the
        defendant shows that the Department of Public Welfare had
        actual notice of the proceedings, including the date and time
        of any trial, and a fair opportunity to participate in all
        material proceedings through counsel of its own choice.
        Section 3.  Section 5103(a) and (b) of Title 23 are amended
     and the section is amended by adding subsections to read:
      § 5103.  Acknowledgment and claim of paternity.
        (a)  Acknowledgment of paternity.--The father of a child born
     to an unmarried woman may file with the Department of [Health]
     Public Welfare, on forms prescribed by [it] subsection (c), an
     acknowledgment of paternity of the child which shall include the
     consent of the mother of the child, supported by her affidavit.
     [The department shall, upon receipt of the acknowledgment,
     proceed as provided in section 603(a) of the act of June 29,
     1953 (P.L.304, No.66), known as the Vital Statistics Law of
     1953, and] In such case, the father shall have all the rights
     and duties as to the child which he would have had if he had
     been married to the mother at the time of the birth of the
     child, and the child shall have all the rights and duties as to
     the father which the child would have had if the father had been
     married to the mother at the time of birth. [The acknowledgment
     may also provide for the assumption by the child of the surname
     of the father or other name desired by the parents.]
        (b)  Claim of paternity.--If the mother of the child fails or
     refuses to join in the acknowledgment of paternity provided for
     in subsection (a), the Department of [Health] Public Welfare
     shall index it as a claim of paternity. The filing and indexing
     of a claim of paternity shall not confer upon the putative
     father any rights as to the child except that the putative
     father shall be entitled to notice of any proceeding brought to
     terminate any parental rights as to the child.
        * * *
        (d)  Conclusive evidence.--An acknowledgment of paternity
     shall constitute conclusive evidence of paternity in any action
     to establish support. An acknowledgment of paternity may be set
     aside by the court only upon clear and convincing evidence that
     the defendant was unaware of the fact that he was acknowledging
     paternity when the acknowledgment was signed.
        (e)  Transfer.--The Department of Health shall transfer to
     the Department of Public Welfare all acknowledgments or claims
     of paternity filed with the Department of Health under prior
     statutes.
        (f)  Certifications.--The Department of Public Welfare shall
     provide necessary certifications under Part III (relating to
     adoption) as to whether any acknowledgment or claim of paternity
     has been filed in regard to any child who is a prospective
     adoptive child.
        Section 4.  The provisions of this act are severable. If any
     provision of this act or its application to any person or
     circumstance is held invalid, the invalidity shall not affect
     other provisions or applications of this act which can be given
     effect without the invalid provision or application.
        Section 5.  The amendment of 23 Pa.C.S. §§ 4326, 4343 and
     5103 shall apply to all actions pending on the effective date of
     this act.
        Section 6.  This act shall take effect immediately.

     APPROVED--The 16th day of December, A. D. 1994.

     ROBERT P. CASEY