Text: HF00477 Text: HF00479 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 EMERGENCY MEDICAL
1 2 SERVICE COVERAGE.
1 3 1. 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 to an insured or
1 7 enrollee for covered services received by the insured or
1 8 enrollee on an emergency basis outside of the third-party
1 9 payor's established service area.
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 3. For purposes of this section, "established service
1 26 area" means as defined in section 513C.3.
1 27 EXPLANATION
1 28 This bill provides that a third-party payor of health or
1 29 medical expenses shall provide coverage benefits to an insured
1 30 or enrollee for covered services received by the insured or
1 31 enrollee on an emergency basis outside of the third-party
1 32 payor's established service area. This bill provides that the
1 33 section applies to the third-party payor contracts or policies
1 34 delivered, issued for delivery, continued, or renewed in this
1 35 state on or after July 1, 1997, by an individual or group
2 1 accident and sickness insurance providing coverage on an
2 2 expense-incurred basis; an individual or group hospital or
2 3 medical service contract issued pursuant to chapter 509, 514,
2 4 or 514A; an individual or group health maintenance
2 5 organization contract regulated under chapter 514B; an
2 6 individual or group Medicare supplemental policy, unless
2 7 coverage pursuant to such policy is preempted by federal law;
2 8 and an organized delivery system licensed by the director of
2 9 public health.
2 10 LSB 2415YH 77
2 11 mj/sc/14
Text: HF00477 Text: HF00479 Text: HF00400 - HF00499 Text: HF Index Bills and Amendments: General Index Bill History: General Index
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