House File 311 - Enrolled




                                             HOUSE FILE 311

                             AN ACT
 REQUIRING HEALTH CARE BENEFIT COVERAGE FOR CERTAIN MEDICALLY
    NECESSARY PROSTHETIC DEVICES AND PROVIDING AN APPLICABILITY
    DATE.

 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  NEW SECTION.  514C.24  COVERAGE FOR PROSTHETIC
 DEVICES.
    1.  Notwithstanding the uniformity of treatment
 requirements of section 514C.6, a policy, contract, or plan
 providing for third=party payment or prepayment of health or
 medical expenses shall provide coverage benefits for medically
 necessary prosthetic devices when prescribed by a physician
 licensed under chapter 148.  Such coverage benefits for
 medically necessary prosthetic devices shall provide coverage
 for medically necessary prosthetic devices, that at a minimum,
 equals the coverage and payment for medically necessary
 prosthetic devices provided under the most recent federal laws
 for health insurance for the aged and disabled pursuant to 42
 U.S.C. } 1395k, 13951, and 1395m, and 42 C.F.R. } 410.100,
 414.202, 414.210, and 414.228, as applicable.  For the
 purposes of this section, "prosthetic device" means an
 artificial limb device to replace, in whole or in part, an arm
 or leg.
    2.  a.  This section applies to the following classes of
 third=party payment provider policies, contracts, or plans
 delivered, issued for delivery, continued, or renewed in this
 state on or after July 1, 2009:
    (1)  Individual or group accident and sickness insurance
 providing coverage on an expense=incurred basis.
    (2)  An individual or group hospital or medical service
 contract issued pursuant to chapter 509, 514, or 514A.
    (3)  An individual or group health maintenance organization
 contract regulated under chapter 514B.
    (4)  A plan established pursuant to chapter 509A for public
 employees.
    (5)  An organized delivery system licensed by the director
 of public health.
    b.  This section shall not apply to accident only,
 specified disease, short=term hospital or medical, hospital
 confinement indemnity, credit, dental, vision, Medicare
 supplement, long=term care, basic hospital and medical=
 surgical expense coverage as defined by the commissioner,
 disability income insurance coverage, coverage issued as a
 supplement to liability insurance, workers' compensation or
 similar insurance, or automobile medical payment insurance.
    3.  Notwithstanding subsection 1, a policy, contract, or
 plan providing for third=party payment or prepayment of health
 or medical expenses that is issued for use in connection with
 a health savings account as authorized under Title XII of the
 Medicare Prescription Drug, Improvement, and Modernization Act
 of 2003, Pub. L. No. 108=173, may impose the same deductibles
 and out=of=pocket limits on the prosthetics coverage benefits
 required in this section that apply to substantially all
 health, medical, and surgical coverage benefits under the
 policy, contract, or plan.


                                                             
                               PATRICK J. MURPHY
                               Speaker of the House


                                                             
                               JOHN P. KIBBIE
                               President of the Senate

    I hereby certify that this bill originated in the House and
 is known as House File 311, Eighty=third General Assembly.


                                                             
                               MARK BRANDSGARD
                               Chief Clerk of the House
 Approved                , 2009


                            
 CHESTER J. CULVER
 Governor

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