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Text: HF00525                           Text: HF00527
Text: HF00500 - HF00599                 Text: HF Index
Bills and Amendments: General Index     Bill History: General Index



House File 526

Partial Bill History

Bill Text

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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