House Journal: Page 1374: Thursday, April 11, 2002
46 under this section shall at a minimum allow for thirty
47 inpatient days and fifty-two outpatient visits
48 annually. The policy or contract or plan may also
49 include deductibles, coinsurance, or copayments,
50 provided the amounts and extent of such deductibles,
Page 3
1 coinsurance, or copayments applicable to other medical
2 or surgical services coverage under the policy or
3 contract or plan are the same. It is not a violation
4 of this section if the policy or contract or plan
5 excludes entirely from coverage benefits for the cost
6 of providing the following:
7 a. Marital, family, educational, developmental, or
8 training services.
9 b. Care that is substantially custodial in nature.
10 c. Services and supplies that are not medically
11 necessary or clinically appropriate.
12 d. Experimental treatments.
13 9. This section applies to third-party payment
14 provider policies or contracts and plans established
15 pursuant to chapter 509A delivered, issued for
16 delivery, continued, or renewed in this state on or
17 after January 1, 2003."
18 2. Page 25, by inserting after line 17 the
19 following:
20 "Sec. . INSURANCE DIVISION STUDY.
21 1. The insurance division of the department of
22 commerce shall conduct a study to determine the impact
23 of providing coverage for substance abuse. The
24 division shall include in the study all of the
25 following:
26 a. An estimate of the impact of mandated coverage
27 for substance abuse treatment on health care coverage
28 benefit costs.
29 b. Actions taken by the division to ensure that
30 third-party payors subject to section 514C.21, if
31 enacted by this Act are in compliance, and that the
32 quality of and access to treatment for substance abuse
33 are not compromised by providing for coverage parity
34 with other coverage benefits provided for other health
35 or medical conditions under third-party payor
36 contracts or policies.
37 c. An analysis and comparison of the choices for
38 treatment of substance abuse with regard to level of
39 access, choice, and financial burden on the
40 individual.
41 d. Identification of any segments of the
42 population of this state that may be excluded from, or
43 have limited access to, treatment for substance abuse,
44 including the number of citizens that may be excluded
© 2002 Cornell College and
League of Women Voters of Iowa
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