Text: H01671 Text: H01673 Text: H01600 - H01699 Text: H Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Amend House File 732 as follows:
1 2 #1. Page 56, by inserting after line 19, the
1 3 following:
1 4 "Sec. . NEW SECTION. 514C.21 MANDATED
1 5 COVERAGE FOR MENTAL HEALTH CONDITIONS.
1 6 1. a. Notwithstanding section 514C.6, a policy or
1 7 contract providing for third-party payment or
1 8 prepayment of health or medical expenses shall provide
1 9 coverage benefits for mental health conditions based
1 10 on rates, terms, and conditions which are no more
1 11 restrictive than the rates, terms, and conditions for
1 12 coverage benefits provided for other health or medical
1 13 conditions under the policy or contract.
1 14 Additionally, any rates, terms, and conditions
1 15 involving deductibles, copayments, coinsurance, and
1 16 any other cost-sharing requirements shall be
1 17 cumulative for coverage of both mental health
1 18 conditions and other health or medical conditions
1 19 under the policy or contract.
1 20 b. Coverage required under this subsection shall
1 21 be as follows:
1 22 (1) For the treatment of mental illness, coverage
1 23 shall be for services provided by a licensed mental
1 24 health professional, or services provided in a
1 25 licensed hospital or health facility.
1 26 (2) For the treatment of alcohol or substance
1 27 abuse, coverage shall be for services provided by a
1 28 substance abuse counselor, as approved by the
1 29 department of human services, a licensed health
1 30 facility providing a program for the treatment of
1 31 alcohol or substance abuse approved by the department
1 32 of human services, or a licensed substance abuse
1 33 treatment and rehabilitation facility.
1 34 2. This section applies to the following classes
1 35 of third-party payment provider contracts or policies
1 36 delivered, issued for delivery, continued, or renewed
1 37 in this state on or after January 1, 2002:
1 38 a. Individual or group accident and sickness
1 39 insurance providing coverage on an expense-incurred
1 40 basis.
1 41 b. An individual or group hospital or medical
1 42 service contract issued pursuant to chapter 509, 514,
1 43 or 514A.
1 44 c. An individual or group health maintenance
1 45 organization contract regulated under chapter 514B.
1 46 d. An individual or group Medicare supplemental
1 47 policy, unless coverage pursuant to such policy is
1 48 preempted by federal law.
1 49 e. Any other entity engaged in the business of
1 50 insurance, risk transfer, or risk retention, which is
2 1 subject to the jurisdiction of the commissioner.
2 2 f. An organized delivery system licensed by the
2 3 director of public health.
2 4 3. For purposes of this section, unless the
2 5 context otherwise requires:
2 6 a. "Mental health condition" means a condition or
2 7 disorder involving mental illness or alcohol or
2 8 substance abuse that falls under any of the diagnostic
2 9 categories listed in the mental disorders section of
2 10 the international classification of disease, as
2 11 periodically revised.
2 12 b. "Rates, terms, and conditions" means any
2 13 lifetime payment limits, deductibles, copayments,
2 14 coinsurance, and any other cost-sharing requirements,
2 15 out-of-pocket limits, visit limitations, and any other
2 16 financial component of benefits coverage that affects
2 17 the covered individual."
2 18 #2. By renumbering as necessary.
2 19
2 20
2 21
2 22 JOCHUM of Dubuque
2 23
2 24
2 25
2 26 OSTERHAUS of Jackson
2 27 HF 732.310 79
2 28 jp/cf
Text: H01671 Text: H01673 Text: H01600 - H01699 Text: H Index Bills and Amendments: General Index Bill History: General Index
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