Senate Amendment 5232


PAG LIN




     1  1    Amend House File 2145, as passed by the House, as
     1  2 follows:
     1  3 #1.  Page 2, by inserting after line 3 the
     1  4 following:
     1  5    <Sec.    .  NEW SECTION.  514C.24  COVERAGE FOR
     1  6 PROSTHETIC DEVICES.
     1  7    1.  Notwithstanding the uniformity of treatment
     1  8 requirements of section 514C.6, a policy or contract
     1  9 providing for third=party payment or prepayment of
     1 10 health or medical expenses shall provide coverage
     1 11 benefits for prosthetic devices when prescribed by a
     1 12 physician licensed under chapter 148, 150, or 150A.
     1 13 Such coverage benefits for prosthetic devices shall
     1 14 provide coverage for prosthetic devices that, at a
     1 15 minimum, equals the coverage and payment for
     1 16 prosthetic devices provided under federal laws for
     1 17 health insurance for the aged and disabled pursuant to
     1 18 42 U.S.C. } 1395k, 13951, and 1395m, and 42 C.F.R. }
     1 19 414.202, 414.210, 414.228, and 410.100, as applicable.
     1 20    2.  a.  This section applies to the following
     1 21 classes of third=party payment provider contracts or
     1 22 policies delivered, issued for delivery, continued, or
     1 23 renewed in this state on or after July 1, 2008:
     1 24    (1)  Individual or group accident and sickness
     1 25 insurance providing coverage on an expense=incurred
     1 26 basis.
     1 27    (2)  An individual or group hospital or medical
     1 28 service contract issued pursuant to chapter 509, 514,
     1 29 or 514A.
     1 30    (3)  An individual or group health maintenance
     1 31 organization contract regulated under chapter 514B.
     1 32    (4)  A plan established pursuant to chapter 509A
     1 33 for public employees.
     1 34    (5)  An organized delivery system licensed by the
     1 35 director of public health.
     1 36    b.  This section shall not apply to accident only,
     1 37 specified disease, short=term hospital or medical,
     1 38 hospital confinement indemnity, credit, dental,
     1 39 vision, Medicare supplement, long=term care, basic
     1 40 hospital and medical=surgical expense coverage as
     1 41 defined by the commissioner, disability income
     1 42 insurance coverage, coverage issued as a supplement to
     1 43 liability insurance, workers' compensation or similar
     1 44 insurance, or automobile medical payment insurance.>
     1 45 #2.  Title page, line 1, by striking the words <to
     1 46 require> and inserting the following:  <relating to
     1 47 health insurance mandates by requiring>.
     1 48 #3.  Title page, line 3, by inserting after the
     1 49 word <virus> the following:  <, and requiring health
     1 50 insurance coverage for certain prosthetic devices.>
     2  1 #4.  By renumbering as necessary.
     2  2
     2  3
     2  4                               
     2  5 RICH OLIVE
     2  6 HF 2145.502 82
     2  7 av/nh/10675

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