Text: H05785 Text: H05787 Text: H05700 - H05799 Text: H Index Bills and Amendments: General Index Bill History: General Index
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PAG LIN
1 1 Amend the amendment, H-5102, to House File 2298 as
1 2 follows:
1 3 #1. Page 1, line 3, by striking the word "clause."
1 4 and inserting the following: "clause and inserting
1 5 the following:
1 6 "Section 1. NEW SECTION. 514C.11 PATIENT ACCESS
1 7 TO TYPES OF PHYSICIANS UNDER MANAGED CARE HEALTH PLAN
1 8 OR INDEMNITY PLAN WITH LIMITED PROVIDER NETWORK.
1 9 Notwithstanding section 514C.6, a managed care
1 10 health plan or indemnity plan with a limited provider
1 11 network shall provide patients direct access to each
1 12 type of physician, as defined in section 135.1 and
1 13 licensed under chapter 148, 150A, or 151, and to each
1 14 audiologist as defined in section 147.151, each person
1 15 practicing osteopathy under chapter 150, each
1 16 acupuncturist registered under chapter 148E, each
1 17 physical therapist licensed under chapter 148A, each
1 18 occupational therapist licensed under chapter 148B,
1 19 each physician assistant licensed under chapter 148C,
1 20 each podiatrist licensed under chapter 149, each
1 21 registered or practical nurse licensed under chapter
1 22 152, each dietician licensed under chapter 152A, each
1 23 respiratory care practitioner licensed under chapter
1 24 152B, each massage therapist licensed under chapter
1 25 152C, each person engaged in the practice of optometry
1 26 pursuant to chapter 154, each hearing aid dealer
1 27 licensed under chapter 154A, each person engaged in
1 28 the practice of psychology subject to regulation under
1 29 chapter 154B, each person engaged in the practice of
1 30 licensed social work subject to regulation under
1 31 chapter 154C, each marital and family therapist
1 32 licensed under chapter 154D, and each pharmacist
1 33 licensed under chapter 155A. Such direct access to a
1 34 physician licensed under chapter 151 shall not be
1 35 conditioned upon a referral by a provider licensed
1 36 under another chapter. Access to a specialist may be
1 37 conditioned upon a referral by a primary care provider
1 38 licensed under chapter 148 or 150A, or a primary care
1 39 provider who is an audiologist as defined in section
1 40 147.151, a person engaged in the practice of
1 41 osteopathy under chapter 150, an acupuncturist
1 42 registered under chapter 148E, a physical therapist
1 43 licensed under chapter 148A, an occupational therapist
1 44 licensed under chapter 148B, a physician assistant
1 45 licensed under chapter 148C, a podiatrist licensed
1 46 under chapter 149, a registered or practical nurse
1 47 licensed under chapter 152, dietician licensed under
1 48 chapter 152A, a respiratory care practitioner licensed
1 49 under chapter 152B, a massage therapist licensed under
1 50 chapter 152C, a person engaged in the practice of
2 1 optometry pursuant to chapter 154, a hearing aid
2 2 dealer licensed under chapter 154A, a person engaged
2 3 in the practice of psychology and regulated under
2 4 chapter 154B, a person engaged in the practice of
2 5 licensed social work and regulated under chapter 154C,
2 6 a marital and family therapist licensed under chapter
2 7 154D, a pharmacist licensed under chapter 155A. If a
2 8 primary care provider determines that a referral
2 9 should be made to a provider licensed, registered, or
2 10 otherwise regulated under another chapter, a managed
2 11 care health plan or indemnity plan with a limited
2 12 provider network may require that the referral be made
2 13 first to a provider designated by the plan. Access to
2 14 a specialist may be subject to a different copayment
2 15 or deductible than access to a primary care provider.
2 16 Access to a nonparticipating provider may be
2 17 restricted or may be subject to different copayments,
2 18 deductibles, or premium rates, or may be excluded.
2 19 For purposes of this section, "managed care health
2 20 plan or indemnity plan with a limited provider
2 21 network" means a health maintenance organization,
2 22 organized delivery system, accountable health plan,
2 23 health care insurance plan which limits the number of
2 24 health care providers who can provide services under
2 25 the plan, preferred provider organization, exclusive
2 26 provider organization, restricted access network, or
2 27 similar health-care plan.""
2 28 #2. Title page, line 3, by striking the word
2 29 "physicians" and inserting the following:
2 30 "providers".
2 31
2 32
2 33
2 34 GRUNDBERG of Polk
2 35 HF 2298.251 76
2 36 mj/jj
Text: H05785 Text: H05787 Text: H05700 - H05799 Text: H Index Bills and Amendments: General Index Bill History: General Index
Iowa General Assembly
Search: House Bills and Amendments (76th General Assembly)
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