Text: S05276                            Text: S05278
Text: S05200 - S05299                   Text: S Index
Bills and Amendments: General Index     Bill History: General Index



Senate Amendment 5277

Amendment Text

PAG LIN
  1  1    Amend the amendment, S-5275, to Senate File 2322,
  1  2 as follows:
  1  3    #1.  By striking page 1, line 4 through page 4,
  1  4 line 13, and inserting the following:
  1  5    ""Section 1.  NEW SECTION.  514C.21  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 and substance
  1 11 abuse conditions based on rates, terms, and conditions
  1 12 which are no more restrictive than the rates, terms,
  1 13 and conditions for coverage benefits provided for
  1 14 other health or medical conditions under the policy or
  1 15 contract.
  1 16    b.  Coverage required under this section includes
  1 17 the following:
  1 18    (1)  For the treatment of mental illness, services
  1 19 provided by a licensed mental health professional, or
  1 20 services provided in a licensed hospital or health
  1 21 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 contracts or policies
  1 32 delivered, issued for delivery, continued, or renewed
  1 33 in this state on or after January 1, 2003:
  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 illness
  2  4 or substance abuse or other addictive disorder which
  2  5 is included in the diagnostic categories listed in the
  2  6 mental disorders section of the international
  2  7 classification of disease, as periodically revised.
  2  8    b.  "Rates, terms, and conditions" means lifetime
  2  9 payment limits, deductibles, copayments, coinsurance,
  2 10 and any other cost-sharing requirements, out-of-pocket
  2 11 limits, visit limitations, and any other financial
  2 12 component of benefits coverage that affects the
  2 13 covered individual.""
  2 14    #2.  Page 4, striking lines 16 and 17, and
  2 15 inserting the following:
  2 16    "#   .  Title page, line 2, by striking the words
  2 17 "neurobiological disorders," and inserting the
  2 18 following:  "mental health and substance abuse
  2 19 conditions, and"."
  2 20    #3.  By renumbering, redesignating, and correcting
  2 21 internal references as necessary.  
  2 22 
  2 23 
  2 24                               
  2 25 MARK SHEARER
  2 26 STEVEN D. HANSEN
  2 27 JACK HOLVECK
  2 28 MIKE CONNOLLY
  2 29 THOMAS FIEGEN
  2 30 AMANDA RAGAN
  2 31 TOM FLYNN
  2 32 PATRICK J. DELUHERY
  2 33 JOE BOLKCOM
  2 34 BILL FINK
  2 35 PATRICIA HARPER
  2 36 ROBERT E. DVORSKY
  2 37 JOHNIE HAMMOND
  2 38 MICHAEL E. GRONSTAL
  2 39 JOHN P. KIBBIE
  2 40 WALLY E. HORN
  2 41 DICK L. DEARDEN
  2 42 EUGENE S. FRAISE
  2 43 SF 2322.502 79
  2 44 jj/pj
     

Text: S05276                            Text: S05278
Text: S05200 - S05299                   Text: S Index
Bills and Amendments: General Index     Bill History: General Index

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