Text: H08047 Text: H08049 Text: H08000 - H08099 Text: H Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Amend House File 754 as follows: 1 2 #1. By striking everything after the enacting 1 3 clause and inserting the following: 1 4 "Section 1. NEW SECTION. 514C.19 MANDATED 1 5 COVERAGE FOR DENTAL CARE ANESTHESIA AND CERTAIN 1 6 HOSPITAL CHARGES. 1 7 1. Notwithstanding section 514C.6, and subject to 1 8 the terms and conditions of the policy or contract, a 1 9 policy or contract providing for third-party payment 1 10 or prepayment of health or medical expenses shall 1 11 provide coverage for the administration of general 1 12 anesthesia and hospital or ambulatory surgical center 1 13 charges related to the provision of dental care 1 14 services provided to any of the following covered 1 15 individuals: 1 16 a. A child under five years of age upon a 1 17 determination by a licensed dentist and the child's 1 18 treating physician licensed pursuant to chapter 148, 1 19 150, or 150A, that such child requires necessary 1 20 dental treatment in a hospital or ambulatory surgical 1 21 center due to a dental condition or a developmental 1 22 disability for which patient management in the dental 1 23 office has proved to be ineffective. 1 24 b. Any individual upon a determination by a 1 25 licensed dentist and the individual's treating 1 26 physician licensed pursuant to chapter 148, 150, or 1 27 150A, that such individual has one or more medical 1 28 conditions that would create significant or undue 1 29 medical risk for the individual in the course of 1 30 delivery of any necessary dental treatment or surgery 1 31 if not rendered in a hospital or ambulatory surgical 1 32 center. 1 33 2. Prior authorization of hospitalization or 1 34 ambulatory surgical center for dental care procedures 1 35 may be required in the same manner that prior 1 36 authorization is required for hospitalization for 1 37 other coverages under the contract or policy. 1 38 3. This section applies to the following classes 1 39 of third-party payment provider contracts or policies 1 40 delivered, issued for delivery, continued, or renewed 1 41 in this state on or after July 1, 2000: 1 42 a. Individual or group accident and sickness 1 43 insurance providing coverage on an expense-incurred 1 44 basis. 1 45 b. An individual or group hospital or medical 1 46 service contract issued pursuant to chapter 509, 514, 1 47 or 514A. 1 48 c. An individual or group health maintenance 1 49 organization contract regulated under chapter 514B. 1 50 d. Any other entity engaged in the business of 2 1 insurance, risk transfer, or risk retention, which is 2 2 subject to the jurisdiction of the commissioner. 2 3 e. A plan established pursuant to chapter 509A for 2 4 public employees. 2 5 f. An organized delivery system licensed by the 2 6 director of public health. 2 7 4. This section shall not apply to accident only, 2 8 specified disease, short-term hospital or medical, 2 9 hospital confinement indemnity, credit, dental, 2 10 vision, Medicare supplement, long-term care, basic 2 11 hospital and medical-surgical expense coverage as 2 12 defined by the commissioner, disability income 2 13 insurance coverage, coverage issued as a supplement to 2 14 liability insurance, workers' compensation or similar 2 15 insurance, or automobile medical payment insurance." 2 16 #2. Title page, by striking lines 2 and 3 and 2 17 inserting the following: "insurance, nonprofit health 2 18 service plans, and health maintenance organizations,". 2 19 2 20 2 21 2 22 COMMITTEE ON COMMERCE 2 23 METCALF of Polk, Chairperson 2 24 HF 754.301 78 2 25 mj/cf
Text: H08047 Text: H08049 Text: H08000 - H08099 Text: H Index Bills and Amendments: General Index Bill History: General Index
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