Text: H08138 Text: H08140 Text: H08100 - H08199 Text: H Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Amend the amendment, H-8072, to House File 2302 as
1 2 follows:
1 3 #1. Page 21, line 3, by inserting after the word
1 4 "services," the following: "information on the
1 5 availability of mental health coverage as provided by
1 6 section 514C.21,".
1 7 #2. Page 21, by inserting after line 24 the
1 8 following:
1 9 "Sec. . NEW SECTION. 514C.21 MANDATED
1 10 COVERAGE FOR MENTAL HEALTH CONDITIONS.
1 11 1. For purposes of this section, unless the
1 12 context otherwise requires:
1 13 a. "Mental health condition" means a condition or
1 14 disorder involving mental illness, gambling addiction,
1 15 or alcohol or substance abuse, including those that
1 16 fall under any of the diagnostic categories listed in
1 17 the mental disorders section of the international
1 18 classification of disease, as periodically revised.
1 19 b. "Rates, terms, and conditions" means any
1 20 lifetime payment limits, deductibles, copayments,
1 21 coinsurance, and any other cost-sharing requirements,
1 22 out-of-pocket limits, visit limitations, and any other
1 23 financial component of benefits coverage that affects
1 24 the covered individual.
1 25 2. a. Notwithstanding section 514C.6, a policy or
1 26 contract providing for third-party payment or
1 27 prepayment of health or medical expenses shall provide
1 28 coverage benefits for mental health conditions based
1 29 on rates, terms, and conditions which are no more
1 30 restrictive than the rates, terms, and conditions for
1 31 coverage benefits provided for other health or medical
1 32 conditions under the policy or contract.
1 33 Additionally, any rates, terms, and conditions
1 34 involving deductibles, copayments, coinsurance, and
1 35 any other cost-sharing requirements shall be
1 36 cumulative for coverage of both mental health
1 37 conditions and other health or medical conditions
1 38 under the policy or contract.
1 39 b. Coverage required under this subsection shall
1 40 be as follows:
1 41 (1) For the treatment of mental illness, coverage
1 42 shall be for services provided by a licensed mental
1 43 health professional, or services provided in a
1 44 licensed hospital or health facility.
1 45 (2) For the treatment of alcohol or substance
1 46 abuse, coverage shall be for services provided by a
1 47 substance abuse counselor, as approved by the
1 48 department of human services, a licensed health
1 49 facility providing a program for the treatment of
1 50 alcohol or substance abuse approved by the department
2 1 of human services, or a substance abuse treatment and
2 2 rehabilitation facility, as licensed by the department
2 3 of public health pursuant to chapter 125.
2 4 3. This section applies to the following classes
2 5 of third-party payment provider contracts or policies
2 6 delivered, issued for delivery, continued, or renewed
2 7 in this state on or after January 1, 2005:
2 8 a. Individual or group accident and sickness
2 9 insurance providing coverage on an expense-incurred
2 10 basis.
2 11 b. An individual or group hospital or medical
2 12 service contract issued pursuant to chapter 509, 514,
2 13 or 514A.
2 14 c. A plan established pursuant to chapter 509A for
2 15 public employees.
2 16 d. An individual or group health maintenance
2 17 organization contract regulated under chapter 514B.
2 18 e. An individual or group Medicare supplemental
2 19 policy, unless coverage pursuant to such policy is
2 20 preempted by federal law.
2 21 f. Any other entity engaged in the business of
2 22 insurance, risk transfer, or risk retention, which is
2 23 subject to the jurisdiction of the commissioner.
2 24 g. An organized delivery system licensed by the
2 25 director of public health.
2 26 4. The commissioner shall adopt rules to
2 27 administer this section after consultation with the
2 28 mental health insurance advisory committee.
2 29 a. The commissioner shall appoint members to a
2 30 mental health insurance advisory committee. Members
2 31 shall include all sectors of society impacted by
2 32 issues associated with coverage of mental health
2 33 treatment by third-party payors including, but not
2 34 limited to, representatives of the insurance industry,
2 35 small and large employers, employee representatives
2 36 including labor, individual consumers, health care
2 37 providers, and other groups and individuals that may
2 38 be identified by the insurance division of the
2 39 department of commerce.
2 40 b. The committee shall meet upon the request of
2 41 the commissioner to review rules proposed under this
2 42 section by the commissioner, and to make suggestions
2 43 as appropriate."
2 44 #3. By renumbering as necessary.
2 45
2 46
2 47
2 48 JOCHUM of Dubuque
2 49
2 50
3 1
3 2 FREVERT of Palo Alto
3 3
3 4
3 5
3 6 GASKILL of Wapello
3 7
3 8
3 9
3 10 MASCHER of Johnson
3 11
3 12
3 13
3 14 WINCKLER of Scott
3 15
3 16
3 17
3 18 LENSING of Johnson
3 19
3 20
3 21
3 22 BERRY of Black Hawk
3 23
3 24
3 25
3 26 T. TAYLOR of Linn
3 27
3 28
3 29
3 30 SHOULTZ of Black Hawk
3 31
3 32
3 33
3 34 MERTZ of Kossuth
3 35
3 36
3 37
3 38 DAVITT of Warren
3 39
3 40
3 41
3 42 OSTERHAUS of Jackson
3 43 HF 2302.519 80
3 44 ec/pj
Text: H08138 Text: H08140 Text: H08100 - H08199 Text: H Index Bills and Amendments: General Index Bill History: General Index
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