Text: H01582 Text: H01584 Text: H01500 - H01599 Text: H Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Amend the amendment, H-1183, to Senate File 276, as
1 2 amended, passed, and reprinted by the Senate, as
1 3 follows:
1 4 #1. Page 1, by inserting after line 2 the
1 5 following:
1 6 "# . Page 1, by inserting before line 1 the
1 7 following:
1 8 "Section 1. Section 509.3, subsection 6, Code
1 9 1999, is amended by striking the subsection.
1 10 Sec. . Section 514.7, unnumbered paragraph 3,
1 11 Code 1999, is amended by striking the unnumbered
1 12 paragraph.
1 13 Sec. . Section 514B.1, subsection 5, paragraph
1 14 c, Code 1999, is amended by striking the paragraph."
1 15 #2. Page 2, by striking line 13 and inserting the
1 16 following: "covered individual.
1 17 Sec. . NEW SECTION. 514C.19 MANDATED COVERAGE
1 18 FOR DENTAL CARE – ANESTHESIA AND CERTAIN HOSPITAL
1 19 CHARGES.
1 20 1. Notwithstanding section 514C.6, a policy or
1 21 contract providing for third-party payment or
1 22 prepayment of health or medical expenses shall provide
1 23 coverage for anesthesia and hospital charges related
1 24 to the provision of dental care services provided to
1 25 any of the following covered individuals:
1 26 a. A child under five years of age.
1 27 b. An individual who is severely disabled.
1 28 c. An individual who has a medical condition that
1 29 requires hospitalization or general anesthesia for
1 30 delivery of the dental care services.
1 31 2. A policy or contract providing for third-party
1 32 payment or prepayment of health or medical expenses
1 33 shall provide coverage for general anesthesia and
1 34 treatment rendered by a dentist for conditions covered
1 35 under such policy or contract, whether the services
1 36 are provided in a hospital or a dental office.
1 37 3. Prior authorization of hospitalization for
1 38 dental care procedures may be required in the same
1 39 manner that prior authorization is required for
1 40 hospitalization for other coverage under the contract
1 41 or policy.
1 42 4. This section applies to the following contracts
1 43 or policies delivered, issued for delivery, continued,
1 44 or renewed in this state on or after July 1, 1999:
1 45 a. Individual or group accident and sickness
1 46 insurance providing coverage on an expense-incurred
1 47 basis.
1 48 b. An individual or group hospital or medical
1 49 service contract issued pursuant to chapter 509, 514,
1 50 or 514A.
2 1 c. An individual or group health maintenance
2 2 organization contract regulated under chapter 514B.
2 3 d. An individual or group Medicare supplemental
2 4 policy, unless coverage pursuant to such policy is
2 5 preempted by federal law.
2 6 e. An organized delivery system licensed by the
2 7 director of public health.
2 8 Sec. . NEW SECTION. 514C.20 DIABETES
2 9 COVERAGE.
2 10 1. Notwithstanding the uniformity of treatment
2 11 requirements of section 514C.6, a policy or contract
2 12 providing for third-party payment or prepayment of
2 13 health or medical expenses shall provide coverage
2 14 benefits for the cost associated with equipment,
2 15 supplies, and self-management training and education
2 16 for the treatment of all types of diabetes mellitus
2 17 when prescribed by a physician licensed under chapter
2 18 148, 150, or 150A. Coverage benefits shall include
2 19 coverage for the cost associated with all of the
2 20 following:
2 21 a. Blood glucose meter and glucose strips for home
2 22 monitoring.
2 23 b. Payment for diabetes self-management training
2 24 and education only under all of the following
2 25 conditions:
2 26 (1) The physician managing the individual's
2 27 diabetic condition certifies that such services are
2 28 needed under a comprehensive plan of care related to
2 29 the individual's diabetic condition to ensure therapy
2 30 compliance or to provide the individual with necessary
2 31 skills and knowledge to participate in the management
2 32 of the individual's condition.
2 33 (2) The diabetic self-management training and
2 34 education program is certified by the Iowa department
2 35 of public health. The department shall consult with
2 36 the American diabetes association, Iowa affiliate, in
2 37 developing the standards for certification of diabetes
2 38 education programs as follows:
2 39 (a) Initial training shall cover up to ten hours
2 40 of initial outpatient diabetes self-management
2 41 training within a continuous twelve-month period for
2 42 each individual that meets any of the following
2 43 conditions:
2 44 (i) A new onset of diabetes.
2 45 (ii) Poor glycemic control as evidenced by a
2 46 glycosylated hemoglobin of nine and five-tenths or
2 47 more in the ninety days before attending the training.
2 48 (iii) A change in treatment regimen from no
2 49 diabetes medications to any diabetes medication, or
2 50 from oral diabetes medication to insulin.
3 1 (iv) High risk for complications based on poor
3 2 glycemic control; documented acute episodes of severe
3 3 hypoglycemia or acute severe hyperglycemia occurring
3 4 in the past year during which the individual needed
3 5 third-party assistance for either emergency room
3 6 visits or hospitalization.
3 7 (v) High risk based on documented complications of
3 8 a lack of feeling in the foot or other foot
3 9 complications such as foot ulcer or amputation, pre-
3 10 proliferative or proliferative retinopathy or prior
3 11 laser treatment of the eye, or kidney complications
3 12 related to diabetes, such as macroalbuminuria or
3 13 elevated creatinine.
3 14 (b) An individual who receives the initial
3 15 training shall be eligible for a single follow-up
3 16 training session of up to one hour each year.
3 17 2. a. This section applies to the following
3 18 classes of third-party payment provider contracts or
3 19 policies delivered, issued for delivery, continued, or
3 20 renewed in this state on or after July 1, 1999:
3 21 (1) Individual or group accident and sickness
3 22 insurance providing coverage on an expense-incurred
3 23 basis.
3 24 (2) An individual or group hospital or medical
3 25 service contract issued pursuant to chapter 509, 514,
3 26 or 514A.
3 27 (3) An individual or group health maintenance
3 28 organization contract regulated under chapter 514B.
3 29 (4) Any other entity engaged in the business of
3 30 insurance, risk transfer, or risk retention, which is
3 31 subject to the jurisdiction of the commissioner.
3 32 (5) A plan established pursuant to chapter 509A
3 33 for public employees.
3 34 (6) An organized delivery system licensed by the
3 35 director of public health.
3 36 b. This chapter shall not apply to accident only,
3 37 specified disease, short-term hospital or medical,
3 38 hospital confinement indemnity, credit, dental,
3 39 vision, Medicare supplement, long-term care, basic
3 40 hospital coverage, medical and surgical coverage,
3 41 disability income insurance coverage, coverage issued
3 42 as a supplement to liability insurance, workers'
3 43 compensation or similar insurance, or automobile
3 44 medical payment insurance.""
3 45 #3. Page 2, line 16, by inserting after the word
3 46 "coverage," the following: "anesthesia and certain
3 47 hospital charges associated with dental care services,
3 48 diabetes coverage,".
3 49 #4. By renumbering as necessary.
3 50
4 1
4 2
4 3 JOCHUM of Dubuque
4 4 SF 276.305 78
4 5 mj/cf
Text: H01582 Text: H01584 Text: H01500 - H01599 Text: H Index Bills and Amendments: General Index Bill History: General Index
© 2000 Cornell College and League of Women Voters of Iowa
Comments about this site or page?
webmaster@legis.iowa.gov.
Please remember that the person listed above does not vote on bills. Direct all comments concerning legislation to State Legislators.
Last update: Fri Mar 3 13:35:02 CST 2000
URL: /DOCS/GA/78GA/Legislation/H/01500/H01583/000303.html
jhf