Text: SF02068 Text: SF02070 Text: SF02000 - SF02099 Text: SF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Section 1. NEW SECTION. 514F.6 STANDING REFERRAL. 1 2 1. A third-party payor shall not deny coverage for 1 3 services provided by a specialist which are covered under a 1 4 policy or contract or plan provided by the third-party payor 1 5 solely because such services are provided under a standing 1 6 referral given to the patient by the patient's primary care 1 7 physician. 1 8 2. For purposes of this section, unless the context 1 9 otherwise requires: 1 10 a. "Physician" means a person who is licensed under 1 11 chapter 148, 150, or 150A. 1 12 b. "Standing referral" means a referral given by a 1 13 physician to a patient to see a specialist. Such referral is 1 14 deemed to permit the patient to see the specialist under the 1 15 referral as deemed necessary by the patient. 1 16 c. "Third-party payor" means a carrier, as defined in 1 17 section 513B.2; an organized delivery system authorized under 1 18 1993 Iowa Acts, chapter 158, and licensed by the director of 1 19 public health; or a plan established pursuant to chapter 509A 1 20 for public employees. 1 21 EXPLANATION 1 22 This bill provides that a third-party payor shall not deny 1 23 coverage for services provided by a specialist which are 1 24 covered under a policy or contract or plan provided by the 1 25 third-party payor if such services are provided under a 1 26 standing referral given to the patient by the patient's 1 27 primary care physician. The bill defines "standing referral" 1 28 as a referral given by a physician to a patient to see a 1 29 specialist, and that is deemed to permit the patient to see 1 30 the specialist under the referral as deemed necessary by the 1 31 patient. 1 32 LSB 5214XS 78 1 33 mj/cls/14
Text: SF02068 Text: SF02070 Text: SF02000 - SF02099 Text: SF Index Bills and Amendments: General Index Bill History: General Index
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