Text: HF00183 Text: HF00185 Text: HF00100 - HF00199 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Section 1. NEW SECTION. 514C.13 PROVIDERS OF HEALTH CARE 1 2 SERVICES – CONTRACT – PROHIBITION. 1 3 1. A contract between a provider of health care services 1 4 and an insurer shall not restrict the provider's discussions 1 5 with a covered individual and shall not prohibit a provider 1 6 from providing any information to a covered individual 1 7 relating to the contract between the insurer and the provider 1 8 or relating to the services or benefits to which a covered 1 9 individual may be entitled. Areas of discussion or provision 1 10 of information which shall not be restricted or prohibited 1 11 include, but are not limited to, treatment options, payment 1 12 policies, and terms and conditions of the contract between the 1 13 insurer and the provider. Additionally, the contract shall 1 14 not require that a provider support the insurer's philosophy 1 15 or concepts regarding the provision of health care services 1 16 and shall not prohibit the provider from expressing the 1 17 provider's opinion of the insurer. The commissioner of 1 18 insurance or director of public health shall apply appropriate 1 19 licensure sanctions to any insurer in violation of this 1 20 section. 1 21 2. For the purposes of this section: 1 22 a. "Health care services" means services included in the 1 23 furnishing to any individual of medical or dental care, or 1 24 hospitalization, or incident to the furnishing of such care or 1 25 hospitalization, as well as the furnishing to any person of 1 26 all other services for the purposes of preventing, 1 27 alleviating, curing, or healing human illness, injury, or 1 28 physical disability. 1 29 b. "Insurer" means a person who provides an individual or 1 30 group policy of accident or health insurance or individual or 1 31 group hospital or health care service contract issued pursuant 1 32 to chapter 509, 509A, 514, or 514A, an individual or group 1 33 health maintenance organization contract issued and regulated 1 34 under chapter 514B, an individual or group preferred provider 1 35 organization contract issued and regulated under chapter 514F, 2 1 or a contract of an individual or group organized delivery 2 2 system licensed by the director of public health under chapter 2 3 513C covering individuals for health care services. 2 4 EXPLANATION 2 5 This bill prohibits an insurer in the contract between the 2 6 provider of health care services and the insurer from 2 7 restricting discussions between the provider and a covered 2 8 individual and from prohibiting the provision of information 2 9 to a covered individual relating to the contract or relating 2 10 to the services or benefits to which a covered individual may 2 11 be entitled. Additionally, the bill prohibits the contract 2 12 from requiring a provider's support of the philosophy or 2 13 concepts of the insurer and prohibits the provider from 2 14 expressing the provider's opinion of the insurer. Licensure 2 15 sanctions could be applied to violations of the bill. 2 16 LSB 1265HH 77 2 17 pf/cf/24
Text: HF00183 Text: HF00185 Text: HF00100 - HF00199 Text: HF Index Bills and Amendments: General Index Bill History: General Index
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