Text: SF02033 Text: SF02035 Text: SF02000 - SF02099 Text: SF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Section 1. NEW SECTION. 514C.19 MANDATED COVERAGE FOR 1 2 DENTAL CARE ANESTHESIA AND CERTAIN HOSPITAL CHARGES. 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 shall provide coverage for anesthesia and 1 6 hospital charges related to the provision of dental care 1 7 services provided to any of the following covered individuals: 1 8 a. A child under five years of age. 1 9 b. An individual who is severely disabled. 1 10 c. An individual who has a medical condition that requires 1 11 hospitalization or general anesthesia for delivery of the 1 12 dental care services. 1 13 2. A policy or contract providing for third-party payment 1 14 or prepayment of health or medical expenses shall provide 1 15 coverage for general anesthesia and treatment rendered by a 1 16 dentist for conditions covered under such policy or contract, 1 17 whether the services are provided in a hospital or a dental 1 18 office. 1 19 3. Prior authorization of hospitalization for dental care 1 20 procedures may be required in the same manner that prior 1 21 authorization is required for hospitalization for other 1 22 coverage under the contract or policy. 1 23 4. This section applies to the following contracts or 1 24 policies delivered, issued for delivery, continued, or renewed 1 25 in this state on or after July 1, 2000: 1 26 a. Individual or group accident and sickness insurance 1 27 providing coverage on an expense-incurred basis. 1 28 b. An individual or group hospital or medical service 1 29 contract issued pursuant to chapter 509, 514, or 514A. 1 30 c. An individual or group health maintenance organization 1 31 contract regulated under chapter 514B. 1 32 d. An individual or group Medicare supplemental policy, 1 33 unless coverage pursuant to such policy is preempted by 1 34 federal law. 1 35 e. An organized delivery system licensed by the director 2 1 of public health. 2 2 EXPLANATION 2 3 This bill requires that a policy or contract providing for 2 4 third-party payment or prepayment of health or medical 2 5 expenses shall provide coverage for anesthesia and hospital 2 6 charges related to the provision of dental care services 2 7 provided to a child under five years of age; an individual who 2 8 is severely disabled; and an individual who has a medical 2 9 condition that requires hospitalization or general anesthesia 2 10 for the dental care services. 2 11 The bill requires that such policy or contract shall 2 12 provide coverage for general anesthesia and treatment rendered 2 13 by a dentist for conditions covered under such policy or 2 14 contract, whether the services are provided in a hospital or a 2 15 dental office. 2 16 The bill provides that prior authorization of 2 17 hospitalization for dental care procedures may be required in 2 18 the same manner that prior authorization is required for 2 19 hospitalization for other coverage under the contract or 2 20 policy. 2 21 LSB 5093XS 78 2 22 mj/cf/24
Text: SF02033 Text: SF02035 Text: SF02000 - SF02099 Text: SF Index Bills and Amendments: General Index Bill History: General Index
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