Text: HSB00047                          Text: HSB00049
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House Study Bill 48

Bill Text

PAG LIN
  1  1    Section 1.  NEW SECTION.  514C.21  MANDATED COVERAGE FOR
  1  2 NEUROBIOLOGICAL DISORDERS AND UNDERLYING CO-MORBIDITY.
  1  3    1.  For purposes of this section, unless the context
  1  4 otherwise requires:
  1  5    a.  "Co-morbidity" means the coexistence of conditions or
  1  6 diagnosable disorders such as neurobiological disorders and
  1  7 substance abuse.
  1  8    b.  "Neurobiological disorder" means the following:
  1  9    (1)  Schizophrenia and other psychotic disorders.
  1 10    (2)  Affective disorders.
  1 11    (3)  Anxiety disorders.
  1 12    (4)  Pervasive developmental disorders.
  1 13    (5)  Attention deficit hyperactivity disorder and related
  1 14 disorders.
  1 15    (6)  Disorders identified in childhood and adolescence.
  1 16    The commissioner, by rule, shall identify the
  1 17 neurobiological disorders covered by this definition,
  1 18 consistent with the guidelines provided in the most recent
  1 19 edition of the American psychiatric association's diagnostic
  1 20 and statistical manual of mental disorders, as such
  1 21 definitions may be amended from time to time.  The
  1 22 commissioner may adopt the definitions provided in the manual
  1 23 by reference.
  1 24    c.  "Rates, terms, and conditions" means any lifetime or
  1 25 annual payment limits, deductibles, copayments, coinsurance,
  1 26 and any other cost-sharing requirements, out-of-pocket limits,
  1 27 visit limitations, and any other financial component of
  1 28 benefits coverage that affects the covered individual.
  1 29    d.  "Substance abuse" means a pattern of pathological use
  1 30 of alcohol or a drug that causes impairment in social or
  1 31 occupational functioning, or that produces physiological
  1 32 dependency evidenced by physical tolerance or by physical
  1 33 symptoms when the alcohol or drug is withdrawn.
  1 34    2.  a.  Notwithstanding the uniformity of treatment
  1 35 requirements of section 514C.6, a policy, contract, or plan
  2  1 providing for third-party payment or prepayment of health or
  2  2 medical expenses shall provide coverage benefits for treatment
  2  3 for neurobiological disorders and underlying co-morbidity
  2  4 based on rates, terms, and conditions that are no more
  2  5 restrictive than the rates, terms, and conditions for coverage
  2  6 benefits provided for other health or medical conditions under
  2  7 the policy, contract, or plan.
  2  8    b.  Any restrictions or limitations with respect to rates,
  2  9 terms, and conditions involving deductibles, copayments,
  2 10 coinsurance, and any other cost-sharing requirements shall be
  2 11 cumulative for coverage of treatment for neurobiological
  2 12 disorders and underlying co-morbidity and other health or
  2 13 medical conditions under a policy, contract, or plan.  A
  2 14 policy, contract, or plan subject to this section shall not
  2 15 impose an aggregate lifetime or annual limit on treatment for
  2 16 neurobiological disorders and underlying co-morbidity coverage
  2 17 benefits unless the policy, contract, or plan imposes an
  2 18 aggregate lifetime or annual limit on substantially all health
  2 19 or medical coverage benefits.  A policy, contract, or plan
  2 20 subject to this section that imposes an aggregate lifetime or
  2 21 annual limit on substantially all health or medical coverage
  2 22 benefits shall not impose an aggregate lifetime or annual
  2 23 limit on treatment for neurobiological disorders and
  2 24 underlying co-morbidity coverage benefits that is less than
  2 25 the aggregate lifetime or annual limit imposed on
  2 26 substantially all health or medical coverage benefits.
  2 27    c.  Coverage required under this section shall be for the
  2 28 treatment of neurobiological disorders and underlying co-
  2 29 morbidity, for services provided by a health professional
  2 30 licensed under chapter 147A, 148, 150A, 152, 154B, 154C, 154D,
  2 31 155, or 155A for services provided in a hospital, clinic,
  2 32 office, community mental health center, health care facility,
  2 33 outpatient treatment facility, residential treatment facility,
  2 34 halfway house, or similar facility for the provision of health
  2 35 care services, and for services provided pursuant to the
  3  1 comprehensive program for treatment for substance abuse
  3  2 maintained by the department of public health pursuant to
  3  3 section 125.12 in a hospital licensed under chapter 135B or a
  3  4 facility licensed under chapter 125.
  3  5    3.  This section applies to the following classes of third-
  3  6 party payment provider policies, contracts, or plans
  3  7 delivered, issued for delivery, continued, or renewed in this
  3  8 state on or after January 1, 2004:
  3  9    a.  Individual or group accident and sickness insurance
  3 10 providing coverage on an expense-incurred basis.
  3 11    b.  An individual or group hospital or medical service
  3 12 contract issued pursuant to chapter 509, 514, or 514A.
  3 13    c.  A plan established pursuant to chapter 509A for public
  3 14 employees.
  3 15    d.  An individual or group health maintenance organization
  3 16 contract regulated under chapter 514B.
  3 17    e.  An individual or group Medicare supplemental policy,
  3 18 unless coverage pursuant to such policy is preempted by
  3 19 federal law.
  3 20    f.  Any other entity engaged in the business of insurance,
  3 21 risk transfer, or risk retention, which is subject to the
  3 22 jurisdiction of the commissioner.
  3 23    g.  An organized delivery system licensed by the director
  3 24 of public health.
  3 25    4.  The commissioner shall adopt rules pursuant to chapter
  3 26 17A to administer this section.
  3 27    Sec. 2.  INSURANCE DIVISION STUDY IN CONJUNCTION WITH STATE
  3 28 AUDITOR.
  3 29    1.  The insurance division of the department of commerce,
  3 30 in conjunction with the auditor of state, shall conduct a
  3 31 study of the cost of providing neurobiological disorder
  3 32 coverage benefits in Iowa.
  3 33    2.  The study shall assess at least all of the following:
  3 34    a.  Identification of the costs attributed to treatment of
  3 35 neurobiological disorders, and to underlying co-morbidity.
  4  1    b.  An estimate of the impact of mandated coverage on
  4  2 health care coverage benefit costs and availability.
  4  3    c.  Actions taken by the division to ensure that third-
  4  4 party payors subject to this Act are in compliance.
  4  5    d.  Identification of any segments of the population of
  4  6 this state that may be excluded from, or have limited access
  4  7 to, treatment, including the number of citizens that may be
  4  8 excluded from, or have limited access to, treatment under
  4  9 third-party payor policies or contracts provided by employers
  4 10 who receive substantial revenue from public sources.
  4 11    3.  The insurance division shall submit a written report of
  4 12 the results of the study to the general assembly on or before
  4 13 January 30, 2006.
  4 14    Sec. 3.  DEPARTMENT OF PUBLIC HEALTH STUDY.
  4 15    1.  The department of public health shall conduct a two-
  4 16 year study of the mental health delivery system in Iowa,
  4 17 beginning July 1, 2003.
  4 18    2.  The study shall include participation by at least all
  4 19 of the following:
  4 20    a.  Representatives of professional health care groups
  4 21 licensed under chapters 147A, 148, 150A, 152, 154B, 154C,
  4 22 154D, 155, and 155A.
  4 23    b.  Representatives of associations or other groups
  4 24 representing hospitals, clinics, community mental health
  4 25 centers, community corrections and prison corrections, health
  4 26 care facilities, outpatient treatment facilities, and any
  4 27 other facility offering mental health services.
  4 28    c.  County supervisors, representatives from the department
  4 29 of human services, judges, mental health advocates, and other
  4 30 state or county officials involved in the provision of mental
  4 31 health services.
  4 32    d.  Consumers, family members, and patients.
  4 33    3.  The participants in the study shall assess the relevant
  4 34 issues facing the mental health delivery system in Iowa, and
  4 35 shall prepare a report with recommendations for presentation
  5  1 to the general assembly no later than November 1, 2005.  
  5  2                           EXPLANATION
  5  3    This bill creates new Code section 514C.21 and provides
  5  4 that a policy, contract, or plan providing for third-party
  5  5 payment or prepayment of health or medical expenses must
  5  6 provide coverage benefits for neurobiological disorders and
  5  7 underlying co-morbidity based on rates, terms, and conditions
  5  8 that are no more restrictive than the rates, terms, and
  5  9 conditions associated with coverage benefits provided for
  5 10 other conditions under the policy, contract, or plan.
  5 11    The bill requires a joint study by the insurance division
  5 12 and auditor of state regarding the costs of providing
  5 13 neurobiological disorder coverage benefits to be submitted to
  5 14 the general assembly by January 30, 2006.  The bill also
  5 15 requires a two-year study of the mental health delivery system
  5 16 coordinated by the department of public health for
  5 17 presentation to the general assembly by November 1, 2005.  
  5 18 LSB 1248HC 80
  5 19 jj/sh/8
     

Text: HSB00047                          Text: HSB00049
Text: HSB00000 - HSB00099               Text: HSB Index
Bills and Amendments: General Index     Bill History: General Index

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