Text: SSB03194 Text: SSB03196 Text: SSB03100 - SSB03199 Text: SSB Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Section 1. NEW SECTION. 422.11F NEUROBIOLOGICAL DISORDER
1 2 TAX CREDITS – SMALL EMPLOYER – INDIVIDUALS.
1 3 1. For purposes of this section, unless the context
1 4 otherwise requires:
1 5 a. "Benefit package of health care coverage that includes
1 6 coverage for neurobiological disorders" means coverage
1 7 benefits for treatment for neurobiological disorders based on
1 8 terms and conditions that are no more restrictive than the
1 9 terms and conditions for coverage benefits provided for other
1 10 health care conditions under the policy or contract, and
1 11 except that at a minimum the policy or contract shall allow
1 12 for thirty inpatient days and fifty-two outpatient visits
1 13 annually for treatment for neurobiological disorders.
1 14 b. "Eligible employer" means a small employer as defined
1 15 in section 513B.2, who offers to its employees in the tax year
1 16 a benefit package of health care coverage that includes
1 17 coverage for neurobiological disorders, and at least fifty
1 18 percent of its employees accepted such benefit package. For
1 19 purposes of this section, the determination of the percentage
1 20 of employees who have accepted the benefit package shall be
1 21 made as of the end of the employer's tax year.
1 22 c. "Eligible individual" means an individual who purchased
1 23 in the tax year health care coverage for the individual, the
1 24 individual's spouse, or the individual's dependents that
1 25 includes a minimum of ten thousand dollars' lifetime maximum
1 26 coverage for neurobiological disorders.
1 27 d. "Neurobiological disorder" means at least the
1 28 following:
1 29 (1) Schizophrenia.
1 30 (2) Schizo-affective disorders.
1 31 (3) Bipolar disorders.
1 32 (4) Major depressive disorders.
1 33 (5) Obsessive-compulsive disorders.
1 34 (6) Pervasive developmental disorders.
1 35 (7) Autistic disorder.
2 1 e. "Terms and conditions" means any lifetime or annual
2 2 payment limits, deductibles, copayments, coinsurance, out-of-
2 3 pocket limits, and any other cost-sharing requirements or
2 4 other financial component of benefits coverage that affects
2 5 the covered individual.
2 6 2. The taxes imposed by this division, less the credits
2 7 allowed under sections 422.12 and 422.12B, shall be reduced by
2 8 a neurobiological disorder employee benefit tax credit for
2 9 each eligible employer who offers health care coverage to its
2 10 employees that includes coverage for neurobiological disorders
2 11 equal to one percent of the amount of health insurance
2 12 premiums paid by the employer during the tax year for the
2 13 total number of employees who accept the health care benefit
2 14 coverage that includes coverage for neurobiological disorders.
2 15 a. If the credit is in excess of the employer's tax
2 16 liabilities, the excess is nonrefundable but may be credited
2 17 to the tax liability for the following ten years or until
2 18 depleted, whichever is earlier.
2 19 b. An individual may claim a neurobiological disorder
2 20 employee benefit tax credit allowed a small employer which is
2 21 a partnership, limited liability company, S corporation,
2 22 estate, or trust electing to have the income taxed directly to
2 23 the individual. The amount claimed by the individual shall be
2 24 based upon the pro rata share of the individual's earning of
2 25 the partnership, limited liability company, S corporation,
2 26 estate, or trust.
2 27 c. If a small employer elects to take the neurobiological
2 28 disorder employee benefit tax credit, the small employer shall
2 29 reduce, by the amount of the credit, the deduction for Iowa
2 30 tax purposes of the amount of the cost of health insurance
2 31 premiums paid by the employer during the tax year that
2 32 includes coverage for neurobiological disorders that is
2 33 deductible for federal tax purposes.
2 34 d. A policy or contract eligible for a tax credit under
2 35 this section may exclude entirely from coverage benefits for
3 1 the cost of providing the following:
3 2 (1) Marital, family, educational, developmental, or
3 3 training services.
3 4 (2) Care that is substantially custodial in nature.
3 5 (3) Services and supplies that are not medically necessary
3 6 or clinically appropriate.
3 7 (4) Experimental treatments.
3 8 (5) Treatment for substance abuse.
3 9 e. A carrier or organized delivery system may manage the
3 10 benefits of a policy or contract for treatment of
3 11 neurobiological disorders that is eligible for a tax credit
3 12 under this section through common methods including, but not
3 13 limited to, providing payment of benefits or providing care
3 14 and treatment under a capitated payment system, prospective
3 15 reimbursement rate system, utilization control system,
3 16 incentive system for the use of least restrictive and least
3 17 costly levels of care, a preferred provider contract limiting
3 18 choice of specific providers, or any other system, method, or
3 19 organization designed to assure services are medically
3 20 necessary and clinically appropriate.
3 21 3. The taxes imposed by this division, less the credits
3 22 allowed under sections 422.12 and 422.12B, shall be reduced by
3 23 a neurobiological disorder insurance tax credit for each
3 24 eligible individual who purchases health care coverage that
3 25 includes a minimum of ten thousand dollars' lifetime maximum
3 26 coverage for neurobiological disorders equal to one percent of
3 27 the amount of health insurance premiums paid by the individual
3 28 for the health care coverage that includes the coverage for
3 29 neurobiological disorders.
3 30 a. If the credit is in excess of the individual's tax
3 31 liabilities, the excess is nonrefundable, but may be credited
3 32 to the individual's tax liability for the following ten years
3 33 or until depleted, whichever is earlier.
3 34 b. The amount of the credit taken pursuant to this
3 35 subsection shall not be considered in the computation of the
4 1 deduction for medical care expenses under section 213 of the
4 2 Internal Revenue Code.
4 3 Sec. 2. Section 422.33, Code Supplement 2001, is amended
4 4 by adding the following new subsection:
4 5 NEW SUBSECTION. 12. a. For purposes of this subsection,
4 6 unless the context otherwise requires:
4 7 (1) "Benefit package of health care coverage that includes
4 8 coverage for neurobiological disorders" means coverage
4 9 benefits for treatment for neurobiological disorders based on
4 10 terms and conditions that are no more restrictive than the
4 11 terms and conditions for coverage benefits provided for other
4 12 health care conditions under the policy or contract, and
4 13 except that at a minimum the policy or contract shall allow
4 14 for thirty inpatient days and fifty-two outpatient visits
4 15 annually for treatment for neurobiological disorders.
4 16 (2) "Eligible employer" means a small employer as defined
4 17 in section 513B.2, who offers to its employees in the tax year
4 18 a benefit package of health care coverage that includes
4 19 coverage for neurobiological disorders, and at least fifty
4 20 percent of its employees accepted such benefit package. For
4 21 purposes of this section, the determination of the percentage
4 22 of employees who have accepted the benefit package shall be
4 23 made as of the end of the employer's tax year.
4 24 (3) "Neurobiological disorder" means at least the
4 25 following:
4 26 (a) Schizophrenia.
4 27 (b) Schizo-affective disorders.
4 28 (c) Bipolar disorders.
4 29 (d) Major depressive disorders.
4 30 (e) Obsessive-compulsive disorders.
4 31 (f) Pervasive developmental disorders.
4 32 (g) Autistic disorder.
4 33 (4) "Terms and conditions" means any lifetime or annual
4 34 payment limits, deductibles, copayments, coinsurance, out-of-
4 35 pocket limits, and any other cost-sharing requirements or
5 1 other financial component of benefits coverage that affects
5 2 the covered individual.
5 3 b. The taxes imposed under this division shall be reduced
5 4 by a neurobiological disorder employee benefit tax credit for
5 5 each eligible employer who offers health care coverage to its
5 6 employees that includes coverage for neurobiological disorders
5 7 equal to one percent of the amount of health insurance
5 8 premiums paid by the employer during the tax year for the
5 9 total number of employees who accept the health care benefit
5 10 coverage that includes coverage for neurobiological disorders.
5 11 c. If the credit is in excess of the employer's tax
5 12 liabilities, the excess is nonrefundable but may be credited
5 13 to the tax liability for the following ten years or until
5 14 depleted, whichever is earlier.
5 15 d. If a small employer elects to take the neurobiological
5 16 disorder employee benefit tax credit, the small employer shall
5 17 reduce, by the amount of the credit, the deduction for Iowa
5 18 tax purposes of the amount of the cost of health insurance
5 19 premiums paid by the employer during the tax year that
5 20 includes coverage for neurobiological disorders that is
5 21 deductible for federal tax purposes.
5 22 e. A policy or contract eligible for a tax credit under
5 23 this subsection may exclude entirely from coverage benefits
5 24 for the cost of providing the following:
5 25 (1) Marital, family, educational, developmental, or
5 26 training services.
5 27 (2) Care that is substantially custodial in nature.
5 28 (3) Services and supplies that are not medically necessary
5 29 or clinically appropriate.
5 30 (4) Experimental treatments.
5 31 (5) Treatment for substance abuse.
5 32 f. A carrier or organized delivery system may manage the
5 33 benefits of a policy or contract for treatment of
5 34 neurobiological disorders that is eligible for a tax credit
5 35 under this subsection through common methods including, but
6 1 not limited to, providing payment of benefits or providing
6 2 care and treatment under a capitated payment system,
6 3 prospective reimbursement rate system, utilization control
6 4 system, incentive system for the use of least restrictive and
6 5 least costly levels of care, a preferred provider contract
6 6 limiting choice of specific providers, or any other system,
6 7 method, or organization designed to assure services are
6 8 medically necessary and clinically appropriate.
6 9 Sec. 3. Section 422.60, Code 2001, is amended by adding
6 10 the following new subsection:
6 11 NEW SUBSECTION. 4. a. For purposes of this subsection,
6 12 unless the context otherwise requires:
6 13 (1) "Benefit package of health care coverage that includes
6 14 coverage for neurobiological disorders" means coverage
6 15 benefits for treatment for neurobiological disorders based on
6 16 terms and conditions that are no more restrictive than the
6 17 terms and conditions for coverage benefits provided for other
6 18 health care conditions under the policy or contract, and
6 19 except that at a minimum the policy or contract shall allow
6 20 for thirty inpatient days and fifty-two outpatient visits
6 21 annually for treatment for neurobiological disorders.
6 22 (2) "Eligible employer" means a small employer as defined
6 23 in section 513B.2, who offers to its employees in the tax year
6 24 a benefit package of health care coverage that includes
6 25 coverage for neurobiological disorders, and at least fifty
6 26 percent of its employees accepted such benefit package. For
6 27 purposes of this section, the determination of the percentage
6 28 of employees who have accepted the benefit package shall be
6 29 made as of the end of the employer's tax year.
6 30 (3) "Neurobiological disorder" means at least the
6 31 following:
6 32 (a) Schizophrenia.
6 33 (b) Schizo-affective disorders.
6 34 (c) Bipolar disorders.
6 35 (d) Major depressive disorders.
7 1 (e) Obsessive-compulsive disorders.
7 2 (f) Pervasive developmental disorders.
7 3 (g) Autistic disorder.
7 4 (4) "Terms and conditions" means any lifetime or annual
7 5 payment limits, deductibles, copayments, coinsurance, out-of-
7 6 pocket limits, and any other cost-sharing requirements or
7 7 other financial component of benefits coverage that affects
7 8 the covered individual.
7 9 b. The taxes imposed under this division shall be reduced
7 10 by a neurobiological disorder employee benefit tax credit for
7 11 each eligible employer who offers health care coverage to its
7 12 employees that includes coverage for neurobiological disorders
7 13 equal to one percent of the amount of health insurance
7 14 premiums paid by the employer during the tax year for the
7 15 total number of employees who accept the health care benefit
7 16 coverage that includes coverage for neurobiological disorders.
7 17 c. If the credit is in excess of the employer's tax
7 18 liabilities, the excess is nonrefundable but may be credited
7 19 to the tax liability for the following ten years or until
7 20 depleted, whichever is earlier.
7 21 d. If a small employer elects to take the neurobiological
7 22 disorder employee benefit tax credit, the small employer shall
7 23 reduce, by the amount of the credit, the deduction for Iowa
7 24 tax purposes of the amount of the cost of health insurance
7 25 premiums paid by the employer during the tax year that
7 26 includes coverage for neurobiological disorders that is
7 27 deductible for federal tax purposes.
7 28 e. A policy or contract eligible for a tax credit under
7 29 this subsection may exclude entirely from coverage benefits
7 30 for the cost of providing the following:
7 31 (1) Marital, family, educational, developmental, or
7 32 training services.
7 33 (2) Care that is substantially custodial in nature.
7 34 (3) Services and supplies that are not medically necessary
7 35 or clinically appropriate.
8 1 (4) Experimental treatments.
8 2 (5) Treatment for substance abuse.
8 3 f. A carrier or organized delivery system may manage the
8 4 benefits of a policy or contract for treatment of
8 5 neurobiological disorders that is eligible for a tax credit
8 6 under this subsection through common methods including, but
8 7 not limited to, providing payment of benefits or providing
8 8 care and treatment under a capitated payment system,
8 9 prospective reimbursement rate system, utilization control
8 10 system, incentive system for the use of least restrictive and
8 11 least costly levels of care, a preferred provider contract
8 12 limiting choice of specific providers, or any other system,
8 13 method, or organization designed to assure services are
8 14 medically necessary and clinically appropriate.
8 15 Sec. 4. NEW SECTION. 432.15 NEUROBIOLOGICAL DISORDER
8 16 EMPLOYEE BENEFIT TAX CREDIT – SMALL EMPLOYER.
8 17 1. For purposes of this subsection, unless the context
8 18 otherwise requires:
8 19 a. "Benefit package of health care coverage that includes
8 20 coverage for neurobiological disorders" means coverage
8 21 benefits for treatment for neurobiological disorders based on
8 22 terms and conditions that are no more restrictive than the
8 23 terms and conditions for coverage benefits provided for other
8 24 health care conditions under the policy or contract, and
8 25 except that at a minimum the policy or contract shall allow
8 26 for thirty inpatient days and fifty-two outpatient visits
8 27 annually for treatment for neurobiological disorders.
8 28 b. "Eligible employer" means a small employer as defined
8 29 in section 513B.2, who offers to its employees in the tax year
8 30 a benefit package of health care coverage that includes
8 31 coverage for neurobiological disorders, and at least fifty
8 32 percent of its employees accepted such benefit package. For
8 33 purposes of this subsection, the determination of the
8 34 percentage of employees who have accepted the benefit package
8 35 shall be made as of the end of the employer's tax year.
9 1 c. "Neurobiological disorder" means at least the
9 2 following:
9 3 (1) Schizophrenia.
9 4 (2) Schizo-affective disorders.
9 5 (3) Bipolar disorders.
9 6 (4) Major depressive disorders.
9 7 (5) Obsessive-compulsive disorders.
9 8 (6) Pervasive developmental disorders.
9 9 (7) Autistic disorder.
9 10 d. "Terms and conditions" means any lifetime or annual
9 11 payment limits, deductibles, copayments, coinsurance, out-of-
9 12 pocket limits, and any other cost-sharing requirements or
9 13 other financial component of benefits coverage that affects
9 14 the covered individual.
9 15 2. Taxes imposed under this chapter shall be reduced by a
9 16 neurobiological disorder employee benefit tax credit for each
9 17 eligible employer who offers health care coverage to its
9 18 employees that includes coverage for neurobiological disorders
9 19 equal to one percent of the amount of health insurance
9 20 premiums paid by the employer during the tax year for the
9 21 total number of employees who accept the health care benefit
9 22 coverage that includes coverage for neurobiological disorders.
9 23 3. If the credit is in excess of the employer's tax
9 24 liabilities, the excess is nonrefundable but may be credited
9 25 to the tax liability for the following ten years or until
9 26 depleted, whichever is earlier.
9 27 4. A policy or contract eligible for a tax credit under
9 28 this section may exclude entirely from coverage benefits for
9 29 the cost of providing the following:
9 30 a. Marital, family, educational, developmental, or
9 31 training services.
9 32 b. Care that is substantially custodial in nature.
9 33 c. Services and supplies that are not medically necessary
9 34 or clinically appropriate.
9 35 d. Experimental treatments.
10 1 e. Treatment for substance abuse.
10 2 5. A carrier or organized delivery system may manage the
10 3 benefits of a policy or contract for treatment of
10 4 neurobiological disorders eligible for a tax credit under this
10 5 section through common methods including, but not limited to,
10 6 providing payment of benefits or providing care and treatment
10 7 under a capitated payment system, prospective reimbursement
10 8 rate system, utilization control system, incentive system for
10 9 the use of least restrictive and least costly levels of care,
10 10 a preferred provider contract limiting choice of specific
10 11 providers, or any other system, method, or organization
10 12 designed to assure services are medically necessary and
10 13 clinically appropriate.
10 14 Sec. 5. INSURANCE DIVISION STUDY IN CONJUNCTION WITH STATE
10 15 AUDITOR.
10 16 1. The insurance division of the department of commerce,
10 17 in conjunction with the state auditor, shall conduct a study
10 18 of the cost of providing neurobiological disorder coverage
10 19 benefits in Iowa.
10 20 2. The study shall assess at least all of the following:
10 21 a. Identification of the costs attributed to treatment of
10 22 neurobiological disorders, and to underlying co-morbidity.
10 23 b. An estimate of the impact of mandated coverage on
10 24 health care coverage benefit costs and availability.
10 25 c. Actions taken by the division to ensure that third-
10 26 party payors subject to this Act are in compliance.
10 27 d. Identification of any segments of the population of
10 28 this state that may be excluded from, or have limited access
10 29 to, treatment, including the number of citizens that may be
10 30 excluded from, or have limited access to, treatment under
10 31 third-party payor policies or contracts provided by employers
10 32 who receive substantial revenue from public sources.
10 33 3. The insurance division shall submit a written report to
10 34 the general assembly on or before January 30, 2005.
10 35 Sec. 6. DEPARTMENT OF PUBLIC HEALTH STUDY.
11 1 1. The department of public health shall conduct a two-
11 2 year study of the mental health delivery system in Iowa,
11 3 beginning July 1, 2002.
11 4 2. The study shall include participation by at least all
11 5 of the following:
11 6 a. Representatives of professional health care groups
11 7 licensed or certified under chapters 147A, 148, 150A, 152,
11 8 154B, 154C, and 154D.
11 9 b. Representatives of associations or other groups
11 10 representing hospitals, clinics, community mental health
11 11 centers, community corrections and prison corrections, health
11 12 care facilities, outpatient treatment facilities, and any
11 13 other facility offering mental health services.
11 14 c. County supervisors, representatives from the department
11 15 of human services, judges, mental health advocates, and other
11 16 state or county officials involved in the provision of mental
11 17 health services.
11 18 d. Consumers, family members, and patients.
11 19 3. The participants in the study shall assess the relevant
11 20 issues facing the mental health delivery system in Iowa, and
11 21 shall prepare a report with recommendations for presentation
11 22 to the general assembly no later than November 1, 2004.
11 23 Sec. 7. EFFECTIVE DATES AND APPLICABILITY.
11 24 1. Except as provided in subsection 2, this Act takes
11 25 effect January 1, 2003. The tax credits for employers and
11 26 individuals created in this Act apply to tax years beginning
11 27 on or after January 1, 2003, and the requirements related to
11 28 affected insurance policies and contracts apply to policies
11 29 and contracts delivered, issued for delivery, continued, or
11 30 renewed in this state on or after January 1, 2003.
11 31 2. The sections of this Act requiring the insurance
11 32 division of the department of commerce and the department of
11 33 public health to conduct studies take effect July 1, 2002.
11 34 EXPLANATION
11 35 This bill provides for two different kinds of tax credits:
12 1 one for small employers who offer small group health care
12 2 coverage for employees that includes coverage for
12 3 neurobiological disorders, and one for individuals who
12 4 purchase health care coverage for the individual, the
12 5 individual's spouse or dependents that includes a minimum ten
12 6 thousand dollars' lifetime maximum coverage for
12 7 neurobiological disorders. Tax credit provisions for small
12 8 employers are created in Code sections 422.11F, 422.33,
12 9 422.60, and 432.15. The tax credit for individuals is in Code
12 10 section 422.11F, subsection 3. The bill defines
12 11 "neurobiological disorder" as at least the following
12 12 psychiatric illnesses: schizophrenia, schizo-affective
12 13 disorders, bipolar disorders, major depressive disorders,
12 14 obsessive-compulsive disorders, pervasive developmental
12 15 disorders, and autistic disorder.
12 16 "Benefit package of health care coverage that includes
12 17 coverage for neurobiological disorders" is defined to mean
12 18 terms and conditions for neurobiological conditions that are
12 19 no more restrictive than the terms and conditions for coverage
12 20 benefits for other health care conditions under the policy or
12 21 contract, except that at a minimum the policy or contract
12 22 shall allow for 30 inpatient days and 52 outpatient visits
12 23 annually for treatment for neurobiological disorders. The
12 24 bill also provides definitions for "eligible employer",
12 25 "eligible individual", and "terms and conditions".
12 26 A small employer qualifies for the tax credit only if 50
12 27 percent of the employees accept the benefit package that
12 28 includes coverage for neurobiological disorders. The amount
12 29 of the tax credit is equal to 1 percent of the premium for
12 30 individuals; for small employers that amount is 1 percent of
12 31 the premiums for the total number of employees accepting the
12 32 coverage that includes coverage for neurobiological disorders.
12 33 Tax credit in excess of liability is nonrefundable but may be
12 34 carried forward to future years. If a small employer or
12 35 individual elects to take the tax credit, the amount of the
13 1 credit may not also be considered a deductible expense.
13 2 For small employers, the bill provides that a policy or
13 3 contract eligible for a tax credit under the bill may exclude
13 4 coverage for marital, family, educational, developmental, or
13 5 training services; custodial care; care that is not medically
13 6 necessary or clinically appropriate; experimental treatment;
13 7 and treatment for substance abuse. The bill also provides for
13 8 small employers that a carrier or organized delivery system
13 9 may manage the benefits provided through common methods
13 10 including, but not limited to, providing payment of benefits
13 11 or providing care and treatment under a capitated payment
13 12 system, prospective reimbursement rate system, utilization
13 13 control system, incentive system for the use of least
13 14 restrictive and least costly levels of care, a preferred
13 15 provider contract limiting choice of specific providers, or
13 16 any other system, method, or organization designed to assure
13 17 services are medically necessary and clinically appropriate.
13 18 The bill requires a joint study by the insurance division
13 19 and state auditor regarding the costs of providing
13 20 neurobiological disorder coverage benefits to be submitted to
13 21 the general assembly by January 30, 2005. The bill also
13 22 requires a two-year study of the mental health delivery system
13 23 coordinated by the department of public health, for
13 24 presentation to the general assembly by November 1, 2004.
13 25 The bill takes effect January 1, 2003, and the tax credits
13 26 apply to tax years beginning on or after January 1, 2003; the
13 27 insurance requirements apply to policies or contracts
13 28 delivered, issued for delivery, continued, or renewed in this
13 29 state on or after January 1, 2003; and the study requirements
13 30 take effect July 1, 2002.
13 31 LSB 7138SC 79
13 32 jj/sh/8.5
Text: SSB03194 Text: SSB03196 Text: SSB03100 - SSB03199 Text: SSB Index Bills and Amendments: General Index Bill History: General Index
© 2002 Cornell College and League of Women Voters of Iowa
Comments about this site or page?
webmaster@legis.iowa.gov.
Please remember that the person listed above does not vote on bills. Direct all comments concerning legislation to State Legislators.
Last update: Wed Mar 27 03:30:52 CST 2002
URL: /DOCS/GA/79GA/Legislation/SSB/03100/SSB03195/020326.html
jhf