Text: H08097 Text: H08099 Text: H08000 - H08099 Text: H Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Amend House File 2302 as follows:
1 2 #1. Page 27, line 5, by inserting after the word
1 3 "services," the following: "information on the
1 4 availability of mental health coverage as provided by
1 5 section 514C.21,".
1 6 #2. Page 27, by inserting after line 25 the
1 7 following:
1 8 "Sec. . NEW SECTION. 514C.21 MANDATED
1 9 COVERAGE FOR MENTAL HEALTH CONDITIONS.
1 10 1. For purposes of this section, unless the
1 11 context otherwise requires:
1 12 a. "Mental health condition" means a condition or
1 13 disorder involving mental illness, gambling addiction,
1 14 or alcohol or substance abuse, including those that
1 15 fall under any of the diagnostic categories listed in
1 16 the mental disorders section of the international
1 17 classification of disease, as periodically revised.
1 18 b. "Rates, terms, and conditions" means any
1 19 lifetime payment limits, deductibles, copayments,
1 20 coinsurance, and any other cost-sharing requirements,
1 21 out-of-pocket limits, visit limitations, and any other
1 22 financial component of benefits coverage that affects
1 23 the covered individual.
1 24 2. a. Notwithstanding section 514C.6, a policy or
1 25 contract providing for third-party payment or
1 26 prepayment of health or medical expenses shall provide
1 27 coverage benefits for mental health conditions based
1 28 on rates, terms, and conditions which are no more
1 29 restrictive than the rates, terms, and conditions for
1 30 coverage benefits provided for other health or medical
1 31 conditions under the policy or contract.
1 32 Additionally, any rates, terms, and conditions
1 33 involving deductibles, copayments, coinsurance, and
1 34 any other cost-sharing requirements shall be
1 35 cumulative for coverage of both mental health
1 36 conditions and other health or medical conditions
1 37 under the policy or contract.
1 38 b. Coverage required under this subsection shall
1 39 be as follows:
1 40 (1) For the treatment of mental illness, coverage
1 41 shall be for services provided by a licensed mental
1 42 health professional, or services provided in a
1 43 licensed hospital or health facility.
1 44 (2) For the treatment of alcohol or substance
1 45 abuse, coverage shall be for services provided by a
1 46 substance abuse counselor, as approved by the
1 47 department of human services, a licensed health
1 48 facility providing a program for the treatment of
1 49 alcohol or substance abuse approved by the department
1 50 of human services, or a substance abuse treatment and
2 1 rehabilitation facility, as licensed by the department
2 2 of public health pursuant to chapter 125.
2 3 3. This section applies to the following classes
2 4 of third-party payment provider contracts or policies
2 5 delivered, issued for delivery, continued, or renewed
2 6 in this state on or after January 1, 2005:
2 7 a. Individual or group accident and sickness
2 8 insurance providing coverage on an expense-incurred
2 9 basis.
2 10 b. An individual or group hospital or medical
2 11 service contract issued pursuant to chapter 509, 514,
2 12 or 514A.
2 13 c. A plan established pursuant to chapter 509A for
2 14 public employees.
2 15 d. An individual or group health maintenance
2 16 organization contract regulated under chapter 514B.
2 17 e. An individual or group Medicare supplemental
2 18 policy, unless coverage pursuant to such policy is
2 19 preempted by federal law.
2 20 f. Any other entity engaged in the business of
2 21 insurance, risk transfer, or risk retention, which is
2 22 subject to the jurisdiction of the commissioner.
2 23 g. An organized delivery system licensed by the
2 24 director of public health.
2 25 4. The commissioner shall adopt rules to
2 26 administer this section after consultation with the
2 27 mental health insurance advisory committee.
2 28 a. The commissioner shall appoint members to a
2 29 mental health insurance advisory committee. Members
2 30 shall include all sectors of society impacted by
2 31 issues associated with coverage of mental health
2 32 treatment by third-party payors including, but not
2 33 limited to, representatives of the insurance industry,
2 34 small and large employers, employee representatives
2 35 including labor, individual consumers, health care
2 36 providers, and other groups and individuals that may
2 37 be identified by the insurance division of the
2 38 department of commerce.
2 39 b. The committee shall meet upon the request of
2 40 the commissioner to review rules proposed under this
2 41 section by the commissioner, and to make suggestions
2 42 as appropriate."
2 43 #3. By renumbering as necessary.
2 44
2 45
2 46
2 47 JOCHUM of Dubuque
2 48
2 49
2 50
3 1 GASKILL of Wapello
3 2
3 3
3 4
3 5 KUHN of Floyd
3 6
3 7
3 8
3 9 GREIMANN of Story
3 10
3 11
3 12
3 13 MASCHER of Johnson
3 14
3 15
3 16
3 17 WINCKLER of Scott
3 18
3 19
3 20
3 21 LENSING of Johnson
3 22
3 23
3 24
3 25 BERRY of Black Hawk
3 26
3 27
3 28
3 29 T. TAYLOR of Linn
3 30
3 31
3 32
3 33 BUKTA of Clinton
3 34
3 35
3 36
3 37 MURPHY of Dubuque
3 38
3 39
3 40
3 41 SHOULTZ of Black Hawk
3 42
3 43
3 44
3 45 MERTZ of Kossuth
3 46
3 47
3 48
3 49 DAVITT of Warren
3 50
4 1
4 2
4 3 OSTERHAUS of Jackson
4 4
4 5
4 6
4 7 MILLER of Webster
4 8 HF 2302.325 80
4 9 ec/cf
Text: H08097 Text: H08099 Text: H08000 - H08099 Text: H Index Bills and Amendments: General Index Bill History: General Index
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