Text: HF00525 Text: HF00527 Text: HF00500 - HF00599 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Section 1. NEW SECTION. 514C.13 DENTAL CARE TREATMEMT 1 2 ANESTHESIA 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 anesthesia and 1 7 hospital charges associated with dental care provided to a 1 8 covered insured or enrollee who is one of the following: 1 9 (1) A child under the age of five. 1 10 (2) A severely disabled person. 1 11 (3) A person who has a medical condition which requires 1 12 hospitalization or general anesthesia for dental care 1 13 treatment. 1 14 A third-party payor shall not require prior authorization 1 15 of hospitalization for dental care procedures which is 1 16 different than that required for hospitalization for other 1 17 covered diseases and conditions. 1 18 b. Notwithstanding the uniformity of treatment 1 19 requirements of section 514C.6, a policy or contract providing 1 20 for third-party payment or prepayment of health or medical 1 21 expenses shall provide coverage benefits for general 1 22 anesthesia and treatment provided by a dentist for a medical 1 23 condition covered by a policy or contract, regardless of 1 24 whether such services are provided in a hospital or dental 1 25 office. 1 26 2. This section applies to the following classes of third- 1 27 party payment provider contracts or policies delivered, issued 1 28 for delivery, continued, or renewed in this state on or after 1 29 July 1, 1997: 1 30 a. Individual or group accident and sickness insurance 1 31 providing coverage on an expense-incurred basis. 1 32 b. An individual or group hospital or medical service 1 33 contract issued pursuant to chapter 509, 514, or 514A. 1 34 c. An individual or group health maintenance organization 1 35 contract regulated under chapter 514B. 2 1 d. An individual or group Medicare supplemental policy, 2 2 unless coverage pursuant to such policy is preempted by 2 3 federal law. 2 4 e. An organized delivery system licensed by the director 2 5 of public health. 2 6 EXPLANATION 2 7 This bill provides that a third-party payor of health or 2 8 medical expenses shall provide coverage benefits to an insured 2 9 or enrollee for anesthesia and hospital charges associated 2 10 with dental care services received by an insured or enrollee 2 11 who is a child under the age of five, a severely disabled 2 12 person, a person who has a medical condition which requires 2 13 hospitalization or general anesthesia for dental care 2 14 treatment. The bill also provides that such contracts must 2 15 provide coverage benefits for general anesthesia and treatment 2 16 provided by a dentist for a medical condition covered by a 2 17 policy or contract, regardless of whether such services are 2 18 provided in a hospital or dental office. 2 19 This bill provides that the section applies to third-party 2 20 payor contracts or policies delivered, issued for delivery, 2 21 continued, or renewed in this state on or after July 1, 1997, 2 22 by an individual or group accident and sickness insurance 2 23 providing coverage on an expense-incurred basis; an individual 2 24 or group hospital or medical service contract issued pursuant 2 25 to chapter 509, 514, or 514A; an individual or group health 2 26 maintenance organization contract regulated under chapter 2 27 514B; an individual or group Medicare supplemental policy, 2 28 unless coverage pursuant to such policy is preempted by 2 29 federal law; and an organized delivery system licensed by the 2 30 director of public health. 2 31 LSB 2476HH 77 2 32 mj/jj/8
Text: HF00525 Text: HF00527 Text: HF00500 - HF00599 Text: HF Index Bills and Amendments: General Index Bill History: General Index
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