Text: HF00450 Text: HF00452 Text: HF00400 - HF00499 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Section 1. NEW SECTION. 514C.13 PHENYLKETONURIA
1 2 COVERAGE.
1 3 1. a. Notwithstanding the uniformity of treatment
1 4 requirements of section 514C.6, a policy or contract providing
1 5 for third-party payment or prepayment of health or medical
1 6 expenses shall provide coverage benefits for the costs
1 7 associated with specialty and medically required foods
1 8 required by an insured or enrollee as a result of a diagnosis
1 9 of phenylketonuria.
1 10 2. This section applies to the following classes of third-
1 11 party payment provider contracts or policies delivered, issued
1 12 for delivery, continued, or renewed in this state on or after
1 13 July 1, 1997:
1 14 a. Individual or group accident and sickness insurance
1 15 providing coverage on an expense-incurred basis.
1 16 b. An individual or group hospital or medical service
1 17 contract issued pursuant to chapter 509, 514, or 514A.
1 18 c. An individual or group health maintenance organization
1 19 contract regulated under chapter 514B.
1 20 d. An individual or group Medicare supplemental policy,
1 21 unless coverage pursuant to such policy is preempted by
1 22 federal law.
1 23 e. An organized delivery system licensed by the director
1 24 of public health.
1 25 EXPLANATION
1 26 This bill provides that a third-party payor of health or
1 27 medical expenses shall provide coverage benefits to an insured
1 28 or enrollee for the costs associated with specialty and
1 29 medical foods required by an insured and enrollee as a result
1 30 of a diagnosis of phenylketonuria.
1 31 This bill provides that the section applies to the third-
1 32 party payor contracts or policies delivered, issued for
1 33 delivery, continued, or renewed in this state on or after July
1 34 1, 1997, by an individual or group accident and sickness
1 35 insurance providing coverage on an expense-incurred basis; an
2 1 individual or group hospital or medical service contract
2 2 issued pursuant to chapter 509, 514, or 514A; an individual or
2 3 group health maintenance organization contract regulated under
2 4 chapter 514B; an individual or group Medicare supplemental
2 5 policy, unless coverage pursuant to such policy is preempted
2 6 by federal law; and an organized delivery system licensed by
2 7 the director of public health.
2 8 LSB 2337HH 77
2 9 mj/sc/14
Text: HF00450 Text: HF00452 Text: HF00400 - HF00499 Text: HF Index Bills and Amendments: General Index Bill History: General Index
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