Text: HF00541 Text: HF00543 Text: HF00500 - HF00599 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Section 1. NEW SECTION. 514K.1 SHORT TITLE.
1 2 This Act shall be known and may be cited as "The Children's
1 3 Health Insurance Coverage Accountability Act".
1 4 Sec. 2. NEW SECTION. 514K.2 DEFINITIONS.
1 5 As used in this chapter, unless the context otherwise
1 6 requires:
1 7 1. "Carrier" means an entity subject to the insurance laws
1 8 and regulations of this state, or subject to the jurisdiction
1 9 of the commissioner of insurance, that contracts or offers to
1 10 contract to provide, deliver, arrange for, or reimburse any of
1 11 the costs of health care services for children, including an
1 12 insurance company offering health insurance coverage, a health
1 13 maintenance organization, a nonprofit health service
1 14 corporation, or any entity providing a plan of health
1 15 insurance, health benefits, or health services.
1 16 2. "Child" means an individual who is under nineteen years
1 17 of age.
1 18 3. "Children with special health care needs" means those
1 19 children who have or are at elevated risk for chronic
1 20 physical, developmental, behavioral, or emotional conditions
1 21 and who also require health and related services of a type and
1 22 amount not usually required by children.
1 23 4. "Clinical peer" means, with respect to a review, a
1 24 health care professional who holds a nonrestricted license or
1 25 certificate in a state and in the same or similar specialty as
1 26 a licensee and who typically manages the pediatric medical
1 27 condition, procedure, or treatment under review.
1 28 5. "Emergency medical condition" means a medical condition
1 29 manifesting itself by acute symptoms of sufficient severity,
1 30 including severe pain, that a prudent layperson, who possesses
1 31 and average knowledge of health and medicine, could reasonably
1 32 expect absence of immediate medical attention to result in one
1 33 of the following:
1 34 a. Placing the health of the individual or, with respect
1 35 to a pregnant woman, the health of the woman or the fetus, in
2 1 serious jeopardy.
2 2 b. Serious impairment to bodily function.
2 3 c. Serious dysfunction of any bodily organ or part.
2 4 6. "Emergency services" means, with respect to an
2 5 individual enrolled with a health maintenance organization,
2 6 preferred provider organization, or organized delivery system,
2 7 covered inpatient and outpatient services that are furnished
2 8 by a provider that is qualified to furnish such services and
2 9 which services are needed to evaluate or stabilize an
2 10 emergency medical condition.
2 11 7. "Enrollee" means an individual for whom a carrier or
2 12 organized delivery system provides health insurance coverage.
2 13 8. "Expedited review" means a review process which results
2 14 in a decision no more than seventy-two hours after the review
2 15 is commenced.
2 16 9. "Grievance" means a written complaint submitted by or
2 17 on behalf of an enrollee.
2 18 10. "Health insurance coverage" means coverage issued by
2 19 an insurance company under chapter 509, a group health
2 20 contract issued by a health care services corporation under
2 21 chapter 514, a plan for health care services provided by a
2 22 health maintenance organization under chapter 514B or an
2 23 organized delivery system as defined in section 514E.1, or
2 24 issued or provided by any similar corporation or organization.
2 25 11. "Health care provider" means a clinic, hospital
2 26 physician organization, preferred provider organization,
2 27 independent practice association, or other appropriately
2 28 licensed provider of health care services or supplies.
2 29 12. "Health care professional" means a person licensed or
2 30 certified under state law to provide health care services and
2 31 who is operating within the scope of such licensure or
2 32 certification.
2 33 13. "Health care services" means services for the
2 34 diagnosis, prevention, or treatment of a health condition,
2 35 illness, injury, or disease.
3 1 14. "Organized delivery system" means organized delivery
3 2 system as defined in section 514E.1.
3 3 15. "Parent" means the father or mother of a child or the
3 4 legal guardian or custodian of a child.
3 5 16. "Participating professional" means a health care
3 6 professional who has entered into an agreement with a carrier
3 7 or organized delivery system to provide health care services
3 8 to an enrollee.
3 9 17. "Primary care professional" means a health care
3 10 professional under contract with a carrier or organized
3 11 delivery system, who has been designated to coordinate,
3 12 supervise, or provide ongoing care to an enrollee.
3 13 18. "Quality assurance" means the ongoing evaluation of
3 14 the quality of health care services provided to enrollees.
3 15 19. "Specialist" means, with respect to a condition,
3 16 disability, or disease, a health care professional or provider
3 17 that has extensive pediatric expertise through appropriate
3 18 training or experience to provide high-quality care in
3 19 treating the condition.
3 20 20. "Terminally ill" means that an enrollee has a medical
3 21 prognosis that the enrollee's life expectancy is six months or
3 22 less.
3 23 21. "Utilization review" means a program or process by
3 24 which an evaluation is made of the necessity, appropriateness,
3 25 and efficiency of the use of health care services, procedures,
3 26 or facilities provided or proposed to be provided to an
3 27 individual within this state. These standards do not apply to
3 28 requests by any person or provider for a clarification,
3 29 guarantee, or statement of an individual's health insurance
3 30 coverage or benefits provided under a health insurance policy,
3 31 nor to claims adjudication. Unless it is specifically stated,
3 32 verification of benefits, preauthorization, and prospective or
3 33 concurrent utilization review programs shall not be construed
3 34 in any context as a guarantee or statement of insurance
3 35 coverage or benefits for any individual under a health
4 1 insurance policy.
4 2 Sec. 3. NEW SECTION. 514K.3 FINDINGS.
4 3 The general assembly finds all of the following:
4 4 1. Children have health and development needs that are
4 5 markedly different than those of the adult population.
4 6 2. Children experience complex and continuing changes
4 7 during the continuum from birth to adulthood, and appropriate
4 8 health care services are essential during that continuum for
4 9 optimal development.
4 10 3. The majority of assessments of the effectiveness of
4 11 health care services and the impact of medical care on patient
4 12 outcomes and patient satisfaction focus on adults, not
4 13 children.
4 14 4. Health outcome measures must be appropriate to age,
4 15 gender, and level of development in order to be useful to
4 16 families and children.
4 17 5. Costly disorders during adulthood often originate
4 18 during childhood, making early access to effective health care
4 19 services during childhood essential.
4 20 6. Many chronic conditions, disabilities, and diseases
4 21 affect children. These children require health care services
4 22 provided by specialists who have in-depth knowledge about the
4 23 particular condition.
4 24 7. Children's patterns of illness, disability, and injury
4 25 differ dramatically from adults' patterns of illness,
4 26 disability, and injury.
4 27 Sec. 4. NEW SECTION. 514K.4 ACCESS TO CARE.
4 28 Notwithstanding section 514C.6, all of the following shall
4 29 apply to a carrier or organized delivery system:
4 30 1. If a carrier or organized delivery system requires or
4 31 provides for a parent enrollee to designate a participating
4 32 primary care professional for a child enrollee, all of the
4 33 following shall occur:
4 34 a. The carrier or organized delivery system shall permit
4 35 the parent enrollee to designate a health care professional
5 1 who specializes in pediatrics as the child enrollee's primary
5 2 care professional.
5 3 b. If such a parent enrollee has not designated such a
5 4 primary care professional for the child enrollee, the carrier
5 5 or organized delivery system shall consider appropriate
5 6 pediatric expertise when mandatorily assigning such a child
5 7 enrollee to a primary care professional.
5 8 2. Subsection 1 shall not be interpreted to waive any
5 9 requirements of coverage relating to medical necessity or
5 10 appropriateness with respect to coverage of health care
5 11 services.
5 12 3. If a child enrollee has a mental or physical condition,
5 13 disability, or disease of sufficient seriousness and
5 14 complexity to require diagnosis, evaluation, or treatment by a
5 15 specialist, the carrier or organized delivery system shall
5 16 make or provide for a referral to a specialist who has
5 17 extensive experience or training, and is available and
5 18 accessible to provide the treatment for such condition or
5 19 disease. Referral shall include the choice of a specialist
5 20 who is not a primary care professional participating in the
5 21 plan or a referral to a health care professional who is not a
5 22 participating professional as provided for under subsection 6,
5 23 if such a health care professional is not available within the
5 24 plan.
5 25 4. A carrier or organized delivery system is not required
5 26 under subsection 3 to provide for a referral to a specialist
5 27 who is not a participating health care professional, unless
5 28 the carrier or organized delivery system does not have an
5 29 appropriate specialist who is available and accessible to
5 30 treat the child enrollee's condition and who is a
5 31 participating professional with respect to such treatment.
5 32 5. If a carrier or organized delivery system refers a
5 33 child enrollee to a nonparticipating specialist, health care
5 34 services provided pursuant to the referral shall be provided
5 35 at no additional cost to the enrollee beyond what the enrollee
6 1 would otherwise pay for health care services to such a
6 2 specialist who is a participating professional.
6 3 6. A carrier or organized delivery system shall have a
6 4 procedure under which a child enrollee, who has a condition or
6 5 disease that requires specialized medical care over a
6 6 prolonged period of time, shall receive a referral to a
6 7 pediatric specialist who is a participating professional. If
6 8 such a participating professional who is a pediatric
6 9 specialist is not available, the child enrollee shall be
6 10 referred to a health care professional who is not a
6 11 participating professional but who is qualified to provide the
6 12 health care services necessary for the condition and the
6 13 specialist shall be responsible for providing and coordinating
6 14 the child enrollee's primary and specialty care.
6 15 7. A carrier or organized delivery system shall have a
6 16 procedure by which a child enrollee, who has a condition,
6 17 disability, or disease that requires ongoing care from a
6 18 specialist, may request and obtain a standing referral to a
6 19 specialist for treatment of the condition. If the primary
6 20 care professional, in consultation with the medical director
6 21 of the carrier or organized delivery system and the
6 22 specialist, if any, determines that such a standing referral
6 23 is appropriate, the carrier or organized delivery system shall
6 24 authorize such a referral to such a specialist. A standing
6 25 referral permitted under this subsection shall be consistent
6 26 with a treatment plan.
6 27 8. A carrier or organized delivery system, with the
6 28 participation of a child enrollee's family, health care
6 29 providers, and health care professionals, shall develop a
6 30 treatment plan for a child enrollee who requires ongoing care
6 31 that covers a specified period of time, but in no event less
6 32 than a six-month period. Health care services provided under
6 33 the treatment plan shall not require additional approvals or
6 34 referrals.
6 35 9. The provisions of subsections 4 and 5 shall apply with
7 1 respect to referrals under subsection 7 in the same manner as
7 2 they apply to referrals under subsection 3.
7 3 10. A carrier or organized delivery system shall ensure
7 4 that a sufficient number, distribution, and variety of
7 5 qualified participating professionals are available so as to
7 6 ensure that all covered health care services, including
7 7 specialty services, are available and accessible to all child
7 8 enrollees in a timely manner.
7 9 11. If a carrier or organized delivery system provides any
7 10 emergency services benefits for child enrollees, the coverage
7 11 of emergency services furnished by the carrier or organized
7 12 delivery system shall be as follows:
7 13 a. A prior authorization determination shall not be
7 14 required.
7 15 b. The health care professional or provider furnishing
7 16 such services shall not be required to be a participating
7 17 professional with respect to such services.
7 18 c. No other term or condition of such coverage, other than
7 19 exclusion of benefits, or an affiliation or waiting period
7 20 otherwise permitted by law, shall be applied.
7 21 12. A carrier or organized delivery system shall not
7 22 impose any cost sharing for pediatric specialty services
7 23 provided under health insurance coverage to child enrollees in
7 24 amounts that exceed the cost sharing required for other
7 25 specialty care under the coverage.
7 26 13. A carrier or organized delivery system, in providing
7 27 health insurance coverage, shall ensure that the coverage
7 28 includes provision of health care services to child enrollees
7 29 with special health care needs. Appropriate procedures shall
7 30 be implemented to provide specialized health care services for
7 31 children with special health care needs. The development of
7 32 such procedures shall include participation by the families of
7 33 such children.
7 34 Sec. 5. NEW SECTION. 514K.5 CONTINUITY OF CARE BY
7 35 CARRIER OR ORGANIZED DELIVERY SYSTEM.
8 1 1. Notwithstanding section 514C.6, if a contract between a
8 2 carrier or organized delivery system and a participating
8 3 professional is terminated, other than by the carrier or
8 4 organized delivery system for failure to meet applicable
8 5 quality standards or for fraud, and a child enrollee is
8 6 undergoing a course of treatment from the participating
8 7 professional at the time of such termination, the carrier or
8 8 organized delivery system shall do all of the following:
8 9 a. Notify the parent enrollee of the termination.
8 10 b. Subject to subsection 3, permit the child enrollee to
8 11 continue the course of treatment with the participating
8 12 professional during a transitional period.
8 13 2. Except as otherwise provided in this section, the
8 14 transitional period under this section shall extend for at
8 15 least one of the following:
8 16 a. Sixty days from the date of the notice to the enrollee
8 17 of the health care professional's termination in the case of a
8 18 primary care professional.
8 19 b. One hundred twenty days from such date in the case of
8 20 another health care professional.
8 21 3. The transitional period under this section for
8 22 institutional or inpatient care from a health care
8 23 professional shall extend until the discharge or termination
8 24 of the period of institutionalization and shall include
8 25 reasonable follow-up care related to the institutionalization
8 26 and shall also include institutional care scheduled prior to
8 27 the date of termination of the health care professional
8 28 status.
8 29 4. If a child enrollee has entered the second trimester of
8 30 pregnancy at the time of a health care professional's
8 31 termination of participation, and the health care professional
8 32 was treating the pregnancy before the date of the termination,
8 33 the transitional period under this section with respect to the
8 34 health care professional's treatment of the pregnancy shall
8 35 extend through the provision of postpartum care directly
9 1 related to the delivery.
9 2 5. If a child enrollee was determined to be terminally ill
9 3 at the time of a health care professional's termination of
9 4 participation, and the health care professional was treating
9 5 the terminal illness before the date of termination, the
9 6 transitional period under this section shall extend for the
9 7 remainder of the child enrollee's life for care directly
9 8 related to the treatment of the terminal illness.
9 9 6. A carrier or organized delivery system may condition
9 10 coverage of continued treatment by a health care professional
9 11 during a transitional period under subsection 1, paragraph
9 12 "b", upon all of the following terms and conditions:
9 13 a. The health care professional agrees to continue to
9 14 accept reimbursement from the carrier or organized delivery
9 15 system at the rates applicable prior to the start of the
9 16 transitional period as payment in full.
9 17 b. The health care professional agrees to adhere to the
9 18 quality assurance standards of the carrier or organized
9 19 delivery system and to provide to the carrier or organized
9 20 delivery system necessary medical information related to the
9 21 care provided.
9 22 c. The health care professional agrees otherwise to adhere
9 23 to the policies and procedures, of the carrier or organized
9 24 delivery system, including procedures regarding referrals and
9 25 obtaining prior authorization and providing services pursuant
9 26 to a treatment plan approved by the carrier or organized
9 27 delivery system.
9 28 Sec. 6. NEW SECTION. 514K.6 CONTINUOUS QUALITY
9 29 IMPROVEMENT.
9 30 1. A carrier or organized delivery system shall establish
9 31 and maintain an ongoing, internal quality assurance program
9 32 that at a minimum meets all of the following requirements:
9 33 a. Establishes and measures a set of health care services,
9 34 functional assessments, structure, processes and outcomes, and
9 35 quality indicators that are unique to children and based on
10 1 nationally accepted standards or guidelines of health care
10 2 services.
10 3 b. Maintains written protocols consistent with recognized
10 4 clinical guidelines or current consensus in the pediatric
10 5 field, to be used for purposes of internal utilization review,
10 6 with periodic updating and evaluation by pediatric specialists
10 7 of protocols to determine effectiveness in controlling
10 8 utilization.
10 9 c. Provides for peer review by health care professionals
10 10 of the structure, processes, and outcomes related to the
10 11 provision of health care services, including pediatric review
10 12 of pediatric cases.
10 13 d. Includes, in member satisfaction surveys, questions on
10 14 child and family satisfaction and experience with health care
10 15 services, including health care services to children with
10 16 special needs.
10 17 e. Monitors and evaluates the continuity of health care
10 18 services with respect to children.
10 19 f. Includes pediatric measures that are directed at
10 20 meeting the needs of at-risk children and children with
10 21 chronic conditions, disabilities, and severe illnesses.
10 22 g. Maintains written guidelines to ensure the availability
10 23 of medications appropriate for children.
10 24 h. Uses focused studies of health care services received
10 25 by children with certain types of chronic conditions and
10 26 disabilities and focused studies of specialized services used
10 27 by children with chronic conditions and disabilities.
10 28 i. Monitors access to pediatric specialty services.
10 29 j. Monitors patient satisfaction with child health care
10 30 professionals.
10 31 2. A carrier or organized delivery system shall conduct
10 32 utilization review activities that meet, at a minimum, the
10 33 requirements of this section.
10 34 a. A utilization review program shall be conducted in a
10 35 manner which is consistent with written policies and
11 1 procedures that govern all aspects of the program.
11 2 b. A utilization review program shall utilize written
11 3 clinical review criteria specific to children and developed
11 4 pursuant to the program with the input of appropriate health
11 5 care professionals, including pediatricians, nonprimary care
11 6 pediatric specialists, and other child health care
11 7 professionals.
11 8 c. A utilization review program shall be administered by
11 9 qualified health care professionals, including health care
11 10 professionals with pediatric expertise who shall oversee
11 11 review decisions.
11 12 3. A utilization review program shall provide for the
11 13 conduct of utilization review activities only through
11 14 personnel who are qualified and, to the extent required, who
11 15 have received appropriate pediatric or child health training
11 16 in the conduct of such activities under the program.
11 17 4. A utilization review program shall provide that
11 18 clinical peers shall evaluate the clinical appropriateness of
11 19 adverse clinical outcomes and divergent clinical options.
11 20 Sec. 7. NEW SECTION. 514K.7 APPEALS AND GRIEVANCE
11 21 MECHANISMS FOR CHILD ENROLLEES.
11 22 1. A carrier or organized delivery system shall establish
11 23 and maintain a system for the resolution of complaints and
11 24 appeals made regarding all aspects of such coverage. The
11 25 system shall include an expedited review procedure for appeals
11 26 made on behalf of a child enrollee in situations in which the
11 27 time frame of a standard appeal would jeopardize the life,
11 28 health, or development of the child.
11 29 2. The commissioner of insurance and the director of
11 30 public health shall adopt rules which establish an external
11 31 review process for an enrollee to appeal a denial of coverage,
11 32 based on medical necessity. The rules shall include
11 33 provisions for a timely review, including provisions for
11 34 expedited review for situations where delay could pose a
11 35 serious threat to the enrollee. The rules shall also require
12 1 the review to be conducted by an independent review
12 2 organization which includes clinical peers.
12 3 Sec. 8. NEW SECTION. 514K.8 ACCOUNTABILITY THROUGH
12 4 DISTRIBUTION OF INFORMATION.
12 5 1. A carrier or organized delivery system shall provide to
12 6 each enrollee, at the time of enrollment and on an annual
12 7 basis, and shall make available to each prospective enrollee
12 8 upon request, a prospectus containing information that allows
12 9 the enrollee to determine the performance of the carrier or
12 10 organized delivery system.
12 11 2. The commissioner and the director of public health
12 12 shall adopt rules establishing the format and content of
12 13 information to be included in the prospectus. The information
12 14 shall include, but is not limited to:
12 15 a. Quality assessment data.
12 16 b. The type, frequency, and outcomes of and the procedure
12 17 for filing enrollee complaints and grievances.
12 18 c. Covered and excluded benefits.
12 19 d. Compensation arrangements with participating health
12 20 care providers and participating professionals.
12 21 EXPLANATION
12 22 This bill establishes a new Code chapter 514K, which
12 23 establishes standards for health care quality improvement for
12 24 children with health insurance coverage. The Code chapter may
12 25 be referred to as "The Children's Health Insurance Coverage
12 26 Accountability Act".
12 27 The bill provides findings of the general assembly,
12 28 including that children's health care needs are unique, that
12 29 appropriate health care during childhood is essential for
12 30 optimal development, that assessments used in measuring the
12 31 effectiveness of health care generally focus on adults and not
12 32 on children, that health outcome measures should be
12 33 appropriate to age, gender, and level of development to be
12 34 useful, that disorders of adulthood often originate in
12 35 childhood, that children often require the care of
13 1 specialists, and that children's patterns of illnesses,
13 2 disabilities, and injuries differ from adults' patterns.
13 3 The bill provides definitions used throughout the chapter.
13 4 The bill requires that a carrier of health insurance or an
13 5 organized delivery system health insurance coverage allow a
13 6 parent enrollee to designate as a primary health care
13 7 professional for the parent enrollee's child a person who
13 8 specializes in pediatrics, if the enrollee is required to
13 9 select a primary health care professional; requires that the
13 10 carrier or organized delivery system make or provide for a
13 11 referral to a specialist who has extensive experience or
13 12 training if a child enrollee has a mental or physical
13 13 condition, disability, or disease of sufficient seriousness
13 14 and complexity to require a specialist's care (this includes
13 15 referral to a nonparticipating specialist if no such
13 16 participating professional exists); provides that if a child
13 17 enrollee is referred to a nonparticipating specialist, the
13 18 cost to the enrollee shall be the same as the cost of a
13 19 participating specialist; requires a carrier or organized
13 20 delivery system to have a procedure for referral of a child
13 21 enrollee who has a condition or disease that requires
13 22 specialized medical care over a prolonged period of time to
13 23 receive a referral to a pediatric specialist for the condition
13 24 and that this specialist may provide and coordinate the
13 25 child's primary and specialty care; requires a carrier or
13 26 organized delivery system to have a procedure by which a child
13 27 enrollee who has a condition, disability, or disease that
13 28 requires ongoing care from a specialist to request and obtain
13 29 a standing referral to the specialist for treatment of the
13 30 condition; requires that the carrier or organized delivery
13 31 system, with the participation of the family and health care
13 32 providers and professionals, is to develop a treatment plan
13 33 for a child enrollee who requires ongoing care that covers at
13 34 least a six-month period and additional approval and referrals
13 35 are not necessary for the duration of the treatment plan;
14 1 requires the carrier or organized delivery system to ensure
14 2 that a sufficient number, distribution, and variety of
14 3 qualified participating professionals are available to ensure
14 4 that all covered health care services are available and
14 5 accessible to all child enrollees in a timely manner; requires
14 6 that if emergency services coverage is provided, the carrier
14 7 or organized delivery system shall cover emergency services
14 8 without prior authorization determination, whether or not the
14 9 health care professional furnishing the services is a
14 10 participating professional, and without regard to any other
14 11 term or condition other than exclusion of benefits, or an
14 12 affiliation or waiting period otherwise permitted by law;
14 13 prohibits a carrier or organized delivery system from imposing
14 14 any cost sharing for pediatric specialty services provided in
14 15 amounts that exceed the cost sharing required for other
14 16 specialty care; and requires a carrier or organized delivery
14 17 system to ensure that coverage provides special consideration
14 18 for the provision of services to enrollee children with
14 19 special health care needs.
14 20 The bill addresses continuity of care by requiring that if
14 21 a contract between a carrier or organized delivery system and
14 22 a health care professional is terminated and a child enrollee
14 23 is undergoing a course of treatment from the health care
14 24 professional at the time of termination, the carrier or
14 25 organized delivery system is to notify the enrollee and permit
14 26 the child enrollee to continue with the health care
14 27 professional during a transition period specified in the bill.
14 28 The bill specifies continuation of care for child enrollees
14 29 who are pregnant women or terminally ill persons.
14 30 The bill requires a carrier or organized delivery system to
14 31 establish and maintain an ongoing, internal quality assurance
14 32 program and specifies the minimum requirements for such a
14 33 program. The bill also requires the conducting of utilization
14 34 review activities.
14 35 The bill requires the establishment of a system to provide
15 1 for the resolution of complaints and appeals, including an
15 2 external appeals process and an expedited appeals, process, on
15 3 behalf of a child enrollee if the time frame of a standard
15 4 appeal would jeopardize the life, health, or development of
15 5 the child. The bill also directs the commissioner of
15 6 insurance and the director of public health to develop an
15 7 external review process to be used by enrollees to appeal a
15 8 denial of coverage based on medical necessity.
15 9 The bill requires carriers of health insurance coverage and
15 10 organized delivery systems to make a prospectus available to
15 11 enrollees and prospective enrollees. The bill directs the
15 12 commissioner of insurance and the director of public health to
15 13 adopt rules regarding the content of the prospectus including
15 14 but not limited to quality assessment data, the type,
15 15 frequency and outcomes of and the procedures for filing an
15 16 appeal or grievance, covered and excluded benefits, and
15 17 compensation arrangements with participating professionals and
15 18 providers.
15 19 LSB 1531YH 78
15 20 pf/cf/24
Text: HF00541 Text: HF00543 Text: HF00500 - HF00599 Text: HF Index Bills and Amendments: General Index Bill History: General Index
© 1999 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: Wed Jan 12 05:55:23 CST 2000
URL: /DOCS/GA/78GA/Legislation/HF/00500/HF00542/990308.html
jhf