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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