Senate File 421 - Enrolled

PAG LIN



  1  1                                             SENATE FILE 421
  1  2
  1  3                             AN ACT
  1  4 RELATING TO WORKERS' COMPENSATION LAWS BY REGULATING INSURANCE
  1  5    POLICY EXCLUSIONS AND DEBT COLLECTION PRACTICES.
  1  6
  1  7 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  1  8
  1  9    Section 1.  Section 85.1, subsection 6, Code 2007, is
  1 10 amended to read as follows:
  1 11    6.  Employers may with respect to an employee or a
  1 12 classification of employees exempt from coverage provided by
  1 13 this chapter pursuant to subsection 1, 2, or 3, 4, or 5, other
  1 14 than the employee or classification of employees with respect
  1 15 to whom a rule of liability or a method of compensation is
  1 16 established by the Congress of the United States, assume a
  1 17 liability for compensation imposed upon employers by this
  1 18 chapter, for the benefit of employees within the coverage of
  1 19 this chapter, by the purchase of valid workers' compensation
  1 20 insurance that does not specifically including exclude the
  1 21 employee or classification of employees.  The purchase of and
  1 22 acceptance by an employer of valid workers' compensation
  1 23 insurance applicable to the employee or classification of
  1 24 employees constitutes an assumption by the employer of
  1 25 liability without any further act on the part of the employer,
  1 26 but only with respect to the employee or classification of
  1 27 employees as are within the coverage of the workers'
  1 28 compensation insurance contract and only for the time period
  1 29 in which the insurance contract is in force.  Upon an election
  1 30 of such coverage, the employee or classification of employees
  1 31 shall accept compensation in the manner provided by this
  1 32 chapter and the employer shall be relieved from any other
  1 33 liability for recovery of damage, or other compensation for
  1 34 injury.
  1 35    Sec. 2.  Section 85.27, subsections 3 and 6, Code 2007, are
  2  1 amended to read as follows:
  2  2    3.  Notwithstanding section 85.26, subsection 4, charges
  2  3 believed to be excessive or unnecessary may be referred by the
  2  4 employer, insurance carrier, or health service provider to the
  2  5 workers' compensation commissioner for determination, and the
  2  6 commissioner may utilize the procedures provided in sections
  2  7 86.38 and 86.39, or set by rule, and conduct such inquiry as
  2  8 the commissioner deems necessary.  Any health service provider
  2  9 charges not in dispute shall be paid directly to the health
  2 10 service provider prior to utilization of procedures provided
  2 11 in sections 86.38 and 86.39 or set by rule.  A health service
  2 12 provider rendering treatment to an employee whose injury is
  2 13 compensable under this section agrees to be bound by such
  2 14 charges as allowed by the workers' compensation commissioner
  2 15 and shall not recover in law or equity any amount in excess of
  2 16 charges set by the commissioner.  When a dispute under chapter
  2 17 85, 85A, or 85B regarding reasonableness of a fee for medical
  2 18 services arises between a health service provider and an
  2 19 employer or insurance carrier, the health service provider,
  2 20 employer, or insurance carrier shall not seek payment from the
  2 21 injured employee.  A health service provider shall not seek
  2 22 payment for fees in dispute from the insurance carrier or
  2 23 employer until the commissioner finds, pursuant to informal
  2 24 dispute resolution procedures established by rule by the
  2 25 commissioner, that the disputed amount is reasonable.  This
  2 26 section does not affect the responsibility of an insurance
  2 27 carrier or an employer to pay amounts not in dispute or a
  2 28 health service provider's right to receive payment from an
  2 29 employee's nonoccupational plan as provided in section 85.38,
  2 30 subsection 2.
  2 31    6.  While a contested case proceeding for determination of
  2 32 liability for workers' compensation benefits is pending before
  2 33 the workers' compensation commissioner relating to an injury
  2 34 alleged to have given rise to treatment, no debt collection,
  2 35 as defined by section 537.7102, shall be undertaken against an
  3  1 employee or the employee's dependents for the collection of
  3  2 charges for that treatment rendered an employee by any health
  3  3 service provider.  If debt collection is undertaken after a
  3  4 creditor receives actual notice that a contested case
  3  5 proceeding for determination of liability for workers'
  3  6 compensation benefits is pending, such debt collection shall
  3  7 constitute a prohibited practice under section 537.7103, and
  3  8 the employee or the employee's dependents are entitled to the
  3  9 remedies provided in section 537.5201.  However, the health
  3 10 service provider may send one itemized written bill to the
  3 11 employee setting forth the amount of the charges in connection
  3 12 with the treatment after notification of the contested case
  3 13 proceeding.
  3 14    Sec. 3.  Section 537.5301, subsection 4, Code 2007, is
  3 15 amended to read as follows:
  3 16    4.  A person who willfully and knowingly violates the
  3 17 provisions of section 537.7103 is guilty of a serious
  3 18 misdemeanor.  However, this subsection is not applicable to a
  3 19 violation of section 537.7103, subsection 7.
  3 20    Sec. 4.  Section 537.7103, Code 2007, is amended by adding
  3 21 the following new subsection:
  3 22    NEW SUBSECTION.  7.  A debt collector shall not collect or
  3 23 attempt to collect charges from an employee or an employee's
  3 24 dependents for treatment rendered the employee by any health
  3 25 service provider, after receiving actual notice that a
  3 26 contested case proceeding for determination of liability of
  3 27 workers' compensation benefits is pending as provided in
  3 28 section 85.27, subsection 6.
  3 29
  3 30
  3 31                                                             
  3 32                               JOHN P. KIBBIE
  3 33                               President of the Senate
  3 34
  3 35
  4  1                                                             
  4  2                               PATRICK J. MURPHY
  4  3                               Speaker of the House
  4  4
  4  5    I hereby certify that this bill originated in the Senate and
  4  6 is known as Senate File 421, Eighty=second General Assembly.
  4  7
  4  8
  4  9                                                             
  4 10                               MICHAEL E. MARSHALL
  4 11                               Secretary of the Senate
  4 12 Approved                , 2007
  4 13
  4 14
  4 15                                
  4 16 CHESTER J. CULVER
  4 17 Governor