Senate File 2409 - Introduced SENATE FILE 2409 BY QUIRMBACH A BILL FOR An Act relating to health insurance provided under an Iowa 1 comprehensive health insurance association policy, and 2 including applicability provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 6182XS (3) 88 ko/rn

S.F. 2409 Section 1. Section 514E.1, Code 2020, is amended by adding 1 the following new subsections: 2 NEW SUBSECTION . 5A. “Cost sharing” means any coverage 3 limit, copayment, coinsurance, deductible, or other 4 out-of-pocket expense obligation. 5 NEW SUBSECTION . 9A. “Health care professional” means the 6 same as defined in section 514J.102. 7 Sec. 2. NEW SECTION . 514E.12 Health care services —— 8 payments. 9 A health care professional shall accept as payment in full 10 from the association, for the provision of health care services 11 to an insured, an amount equal to the amount that Medicare 12 pays a health care professional for provision of the same 13 health care services. An insured shall be responsible only 14 for any cost sharing imposed on the insured by the insured’s 15 association policy for the health care services. 16 Sec. 3. NEW SECTION . 514E.13 Application for coverage —— 17 restrictions. 18 Any provider of dialysis services shall be prohibited from 19 directly or indirectly assisting an individual with enrollment 20 in an association policy if the individual is eligible for any 21 other health plan coverage. 22 Sec. 4. APPLICABILITY. The section of this Act enacting 23 section 514E.12 applies to health care services provided by a 24 health care professional to an insured on or after January 1, 25 2021. 26 EXPLANATION 27 The inclusion of this explanation does not constitute agreement with 28 the explanation’s substance by the members of the general assembly. 29 This bill relates to health insurance provided under an Iowa 30 comprehensive health insurance association policy. The bill 31 requires a health care professional to accept as payment in 32 full from the association, for the provision of health care 33 services to an insured, an amount equal to the amount that 34 Medicare pays a health care professional for provision of the 35 -1- LSB 6182XS (3) 88 ko/rn 1/ 2

S.F. 2409 same health care services. An insured is only responsible 1 for any cost sharing imposed on the insured by the insured’s 2 association policy. This applies to health care services 3 provided by a health care professional to an insured on or 4 after January 1, 2021. 5 The bill prohibits any provider of dialysis services from 6 directly or indirectly assisting an individual with enrollment 7 in an association policy if the individual is eligible for any 8 other health plan coverage. 9 -2- LSB 6182XS (3) 88 ko/rn 2/ 2