Text: HF00263 Text: HF00265 Text: HF00200 - HF00299 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Section 1. NEW SECTION. 514C.14 TREATMENT COVERAGE FOR
1 2 BONES OR JOINTS OF SKELETAL STRUCTURE.
1 3 1. Notwithstanding section 514C.6, a policy or contract
1 4 providing for third-party payment or prepayment of health or
1 5 medical expenses for diagnostic or surgical procedures
1 6 involving a bone or joint of the skeletal structure shall
1 7 provide coverage for the same diagnostic or surgical
1 8 procedure, excluding intraoral prosthetic devices, involving a
1 9 bone or joint of the face, neck, or head, if under the
1 10 accepted standards of practice of the provider rendering such
1 11 services, the procedure is medically necessary to treat a
1 12 condition caused by congenital deformity, disease, or injury.
1 13 2. This section applies to the following classes of third-
1 14 party payment provider contracts or policies delivered, issued
1 15 for delivery, continued, or renewed in this state on or after
1 16 July 1, 1999:
1 17 a. Individual or group accident and sickness insurance
1 18 providing coverage on an expense-incurred basis.
1 19 b. An individual or group hospital or medical service
1 20 contract issued pursuant to chapter 509, 514, or 514A.
1 21 c. An individual or group health maintenance organization
1 22 contract regulated under chapter 514B.
1 23 d. An individual or group Medicare supplemental policy,
1 24 unless coverage pursuant to such policy is preempted by
1 25 federal law.
1 26 e. Any other entity engaged in the business of insurance,
1 27 risk transfer, or risk retention, which is subject to the
1 28 jurisdiction of the commissioner.
1 29 f. An organized delivery system licensed by the director
1 30 of public health.
1 31 EXPLANATION
1 32 This bill provides that a policy or contract providing for
1 33 third-party payment or prepayment of health or medical
1 34 expenses for diagnostic or surgical procedures involving a
1 35 bone or joint of the skeletal structure shall provide coverage
2 1 for the same diagnostic or surgical procedure, excluding
2 2 intraoral prosthetic devices, involving a bone or joint of the
2 3 face, neck, or head, if under the accepted standards of
2 4 practice of the provider rendering such services, the
2 5 procedure is medically necessary to treat a condition caused
2 6 by congenital deformity, disease, or injury. The bill
2 7 provides that the required coverage applies to third-party
2 8 payment provider contracts or policies delivered, issued for
2 9 delivery, continued, or renewed in this state on or after July
2 10 1, 1999.
2 11 LSB 1694HH 78
2 12 mj/sc/14
Text: HF00263 Text: HF00265 Text: HF00200 - HF00299 Text: HF Index Bills and Amendments: General Index Bill History: General Index
© 1999 Cornell College and League of Women Voters of Iowa
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