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
Iowa General Assembly
Search: House Bills and Amendments (77th General Assembly)
© 1997 Cornell College and League of Women Voters of Iowa
Comments? webmaster@legis.iowa.gov.
Last update: Thu Feb 20 03:40:30 CST 1997
URL: /DOCS/GA/77GA/Legislation/HF/00100/HF00184/970210.html
jhf