House Journal: Page 1243: Tuesday, April 9, 2002
47 of health or medical expenses shall provide coverage
48 benefits for treatment for neurobiological disorders
49 and underlying co-morbidity based on rates, terms, and
50 conditions that are no more restrictive than the
Page 2
1 rates, terms, and conditions for coverage benefits
2 provided for other health or medical conditions under
3 the policy, contract, or plan.
4 b. Any restrictions or limitations with respect to
5 rates, terms, and conditions involving deductibles,
6 copayments, coinsurance, and any other cost-sharing
7 requirements shall be cumulative for coverage of
8 treatment for neurobiological disorders and underlying
9 co-morbidity and other health or medical conditions
10 under a policy, contract, or plan. A policy,
11 contract, or plan subject to this section shall not
12 impose an aggregate lifetime or annual limit on
13 treatment for neurobiological disorders and underlying
14 co-morbidity coverage benefits unless the policy,
15 contract, or plan imposes an aggregate lifetime or
16 annual limit on substantially all health or medical
17 coverage benefits. A policy, contract, or plan
18 subject to this section that imposes an aggregate
19 lifetime or annual limit on substantially all medical
20 and surgical coverage benefits shall not impose an
21 aggregate lifetime or annual limit on treatment for
22 neurobiological disorders and underlying co-morbidity
23 coverage benefits that is less than the aggregate
24 lifetime or annual limit imposed on substantially all
25 health or medical coverage benefits.
26 c. Coverage required under this section shall be
27 for the treatment of neurobiological disorders and
28 underlying co-morbidity, for services provided by a
29 health professional licensed under chapter 147A, 148,
30 150A, 152, 154B, 154C, or 154D, for services provided
31 in a hospital, clinic, office, community mental health
32 center, health care facility, outpatient treatment
33 facility, residential treatment facility, halfway
34 house, or similar facility for the provision of health
35 care services, and for services provided pursuant to
36 the comprehensive program for treatment for substance
37 abuse maintained by the department of public health
38 pursuant to section 125.12 in a hospital licensed
39 under chapter 135B or a facility licensed under
40 chapter 125.
41 3. This section applies to the following classes
42 of third-party payment provider policies, contracts,
43 or plans delivered, issued for delivery, continued, or
44 renewed in this state on or after January 1, 2003:
45 a. Individual or group accident and sickness
© 2002 Cornell College and
League of Women Voters of Iowa
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