Text: S05532 Text: S05534 Text: S05500 - S05599 Text: S Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Amend House File 2545, as amended, passed, and
1 2 reprinted by the House, as follows:
1 3 #1. Page 33, by inserting after line 19 the
1 4 following:
1 5 "Sec. . NEW SECTION. 514C.19 MENTAL HEALTH
1 6 AND SUBSTANCE ABUSE TREATMENT COVERAGE.
1 7 1. a. Notwithstanding section 514C.6, a policy or
1 8 contract providing for third-party payment or
1 9 prepayment of health or medical expenses shall provide
1 10 coverage benefits for mental health conditions and
1 11 substance abuse and other addictive disorders based on
1 12 rates, terms, and conditions which are no more
1 13 restrictive than the rates, terms, and conditions for
1 14 coverage benefits provided for other health or medical
1 15 conditions under the policy or contract.
1 16 b. Coverage required under this section includes
1 17 the following:
1 18 (1) For the treatment of mental health conditions,
1 19 services provided by a licensed mental health
1 20 professional, or services provided in a licensed
1 21 hospital or health facility.
1 22 (2) For the treatment of substance abuse or other
1 23 addictive disorder, services provided by a qualified
1 24 professional as defined by rule of the Iowa department
1 25 of public health, a licensed health facility providing
1 26 a program for the treatment of substance abuse or
1 27 other addictive disorder approved by the Iowa
1 28 department of public health, or a licensed substance
1 29 abuse treatment and rehabilitation facility.
1 30 2. This section applies to the following classes
1 31 of third-party payment provider policies or contracts
1 32 delivered, issued for delivery, continued, or renewed
1 33 in this state on or after July 1, 2000:
1 34 a. Individual or group accident and sickness
1 35 insurance providing coverage on an expense-incurred
1 36 basis.
1 37 b. An individual or group hospital or medical
1 38 service contract issued pursuant to chapter 509, 514,
1 39 or 514A.
1 40 c. An individual or group health maintenance
1 41 organization contract regulated under chapter 514B.
1 42 d. An individual or group Medicare supplemental
1 43 policy, unless coverage pursuant to such policy is
1 44 preempted by federal law.
1 45 e. An organized delivery system licensed by the
1 46 director of public health.
1 47 f. Any other entity engaged in the business of
1 48 insurance, risk transfer, or risk retention, which is
1 49 subject to the jurisdiction of the commissioner.
1 50 3. For purposes of this section, unless the
2 1 context otherwise requires:
2 2 a. "Mental health or substance abuse condition"
2 3 means a condition or disorder involving mental
2 4 illness, or substance abuse or other addictive
2 5 disorder which is included in the diagnostic
2 6 categories listed in the mental disorders section of
2 7 the international classification of disease, as
2 8 periodically revised.
2 9 b. "Rates, terms, and conditions" means any
2 10 lifetime payment limit, deductible, copayment,
2 11 coinsurance, and any other cost-sharing requirement,
2 12 out-of-pocket limit, visit limitation, and any other
2 13 financial component of benefits coverage that affects
2 14 the covered individual."
2 15
2 16
2 17
2 18 JOHNIE HAMMOND
2 19 PATRICIA HARPER
2 20 HF 2545.226 78
2 21 mj/gg
Text: S05532 Text: S05534 Text: S05500 - S05599 Text: S Index Bills and Amendments: General Index Bill History: General Index
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