House File 492 - Introduced HOUSE FILE 492 BY BENNETT , BROWN-POWERS , HUNTER , ABDUL-SAMAD , KEARNS , T. TAYLOR , MEYER , RUNNING-MARQUARDT , FINKENAUER , and M. SMITH A BILL FOR An Act requiring health care benefit coverage for certain 1 preventive services, and including effective date and 2 applicability provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 2248YH (5) 87 pf/nh

H.F. 492 Section 1. NEW SECTION . 514C.31 Preventive services —— 1 coverage. 2 1. Notwithstanding the uniformity of treatment requirements 3 of section 514C.6, an individual or group policy, contract, 4 or plan providing for third-party payment or prepayment 5 of health or medical expenses shall provide coverage for 6 preventive services as specified in section 2713 of the 7 federal Patient Protection and Affordable Care Act, Pub. L. No. 8 111-148, without the imposition of copayments, deductibles, or 9 co-insurance on patients receiving these services. 10 2. The provisions of this section shall apply to all of the 11 following classes of third-party payment provider policies, 12 contracts, or plans delivered, issued for delivery, continued, 13 or renewed in this state: 14 a. Individual or group accident and sickness insurance 15 providing coverage on an expense-incurred basis. 16 b. An individual or group hospital or medical service 17 contract issued pursuant to chapter 509, 514, or 514A. 18 c. An individual or group health maintenance organization 19 contract regulated under chapter 514B. 20 d. An individual or group Medicare supplemental policy, 21 unless coverage pursuant to such policy is preempted by federal 22 law. 23 e. A plan established pursuant to chapter 509A for public 24 employees. 25 3. This section shall not apply to accident-only, specified 26 disease, short-term hospital or medical, hospital confinement 27 indemnity, credit, dental, vision, long-term care, basic 28 hospital, and medical-surgical expense coverage as defined 29 by the commissioner, disability income insurance coverage, 30 coverage issued as a supplement to liability insurance, 31 workers’ compensation or similar insurance, or automobile 32 medical payment insurance. 33 4. The commissioner of insurance shall adopt rules pursuant 34 to chapter 17A as necessary to administer this section. 35 -1- LSB 2248YH (5) 87 pf/nh 1/ 3

H.F. 492 Sec. 2. CONTINGENT IMPLEMENTATION. The implementation of 1 this Act is contingent upon the repeal of the federal Patient 2 Protection and Affordable Care Act, Pub. L. No. 111-148, in 3 a manner that does not replace the coverage for preventive 4 services as specified in section 2713 of the of the federal 5 Patient Protection and Affordable Care Act, Pub. L. No. 6 111-148, without the imposition of copayments, deductibles, 7 or co-insurance on patients receiving these services. The 8 commissioner of insurance shall notify the Iowa Code editor of 9 the effective date of such repeal. 10 Sec. 3. EFFECTIVE UPON ENACTMENT. This Act, being deemed of 11 immediate importance, takes effect upon enactment. 12 Sec. 4. APPLICABILITY. This Act applies to third-party 13 payment provider policies, contracts, and plans, as specified 14 in section 514C.31, as enacted in this Act, that are delivered, 15 issued for delivery, continued, or renewed in this state on 16 or after the effective date of the repeal of the federal 17 Patient Protection and Affordable Care Act, Pub. L. No. 18 111-148, in a manner that does not replace the coverage 19 for preventive services as specified in section 2713 of the 20 federal Patient Protection and Affordable Care Act, Pub. L. No. 21 111-148, without the imposition of copayments, deductibles, or 22 co-insurance on patients receiving these services as specified 23 by the commissioner of insurance in the notification of the 24 Iowa Code editor of such repeal. 25 EXPLANATION 26 The inclusion of this explanation does not constitute agreement with 27 the explanation’s substance by the members of the general assembly. 28 This bill provides that an individual or group policy, 29 contract, or plan providing for third-party payment or 30 prepayment of health or medical expenses shall provide coverage 31 for preventive services as specified in section 2713 of the 32 federal Patient Protection and Affordable Care Act, without 33 the imposition of copayments, deductibles, or co-insurance on 34 patients receiving these services. The bill specifies the 35 -2- LSB 2248YH (5) 87 pf/nh 2/ 3

H.F. 492 classes of third-party payment provider policies, contracts, or 1 plans delivered, issued for delivery, continued, or renewed in 2 this state to which the requirement is and is not applicable 3 and requires the commissioner of insurance to adopt rules to 4 administer the bill. 5 The bill takes effect upon enactment but implementation 6 of the bill is contingent upon the repeal of the federal 7 Patient Protection and Affordable Care Act in a manner that 8 does not replace the coverage for preventive services without 9 the imposition of copayments, deductibles, or co-insurance 10 on patients receiving these services. The commissioner of 11 insurance shall notify the Iowa Code editor of the effective 12 date of such repeal. 13 The bill is applicable to third-party payment provider 14 policies, contracts, and plans that are delivered, issued for 15 delivery, continued, or renewed in this state on or after the 16 effective date of the repeal of the federal Patient Protection 17 and Affordable Care Act in a manner that does not replace the 18 coverage for preventive services without the imposition of 19 copayments, deductibles, or co-insurance on patients receiving 20 these services, as specified by the commissioner of insurance 21 in the notification of the Iowa Code editor of such repeal. 22 -3- LSB 2248YH (5) 87 pf/nh 3/ 3