Text: HF02278 Text: HF02280 Text: HF02200 - HF02299 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Section 1. Section 514J.3A, Code 2003, is amended to read
1 2 as follows:
1 3 514J.3A NOTICE.
1 4 1. An insurance card issued by a carrier or organized
1 5 delivery system for a policy or contract providing for third-
1 6 party payment or prepayment of health or medical expenses
1 7 subject to this section shall contain the telephone number for
1 8 an insured to obtain more information regarding initiation of
1 9 the external review process for coverage decisions under this
1 10 chapter.
1 11 2. The telephone number for an insured to obtain more
1 12 information regarding initiation of the external review
1 13 process in this chapter shall also be posted in a prominent
1 14 place in the office of a private practitioner or group of
1 15 practitioners who are health care providers as defined in
1 16 section 135.61, or an institutional health care facility as
1 17 defined in section 135.61.
1 18 3. When a claim is denied in whole or in part based on
1 19 medical necessity, the carrier or organized delivery system
1 20 shall provide a notice in writing to the enrollee of the
1 21 internal appeal mechanism provided under the carrier or
1 22 organized delivery system's plan or policy.
1 23 4. At the time of a coverage decision, the carrier or
1 24 organized delivery system shall notify the enrollee in writing
1 25 of the right to have the coverage decision reviewed under the
1 26 external review process.
1 27 EXPLANATION
1 28 This bill amends Code section 514J.3A, relating to notice
1 29 provisions for the external process for health care coverage
1 30 decisions under Code chapter 514J. The bill adds a
1 31 requirement that the phone number for an insured to obtain
1 32 more information about the external review process be printed
1 33 on the insured's insurance card, and be posted in a prominent
1 34 place in health care facilities.
1 35 LSB 5864HH 80
2 1 av/sh/8
Text: HF02278 Text: HF02280 Text: HF02200 - HF02299 Text: HF Index Bills and Amendments: General Index Bill History: General Index
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