House File 2429 - Introduced



                                       HOUSE FILE       
                                       BY  MASCHER


    Passed House,  Date               Passed Senate, Date             
    Vote:  Ayes        Nays           Vote:  Ayes        Nays         
                 Approved                            

                                      A BILL FOR

  1 An Act requiring certain health insurance policies to provide
  2    coverage for postpartum depression and psychosis screening and
  3    treatment and providing an applicability date.
  4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  5 TLSB 6215HH 81
  6 av/je/5

PAG LIN



  1  1    Section 1.  Section 514C.12, Code 2005, is amended by
  1  2 adding the following new subsection:
  1  3    NEW SUBSECTION.  1A.  a.  Notwithstanding section 514C.6, a
  1  4 person who provides an individual or group policy of accident
  1  5 or health insurance or individual or group hospital or health
  1  6 care service contract issued pursuant to chapter 509, 509A,
  1  7 514, or 514A, or an individual or group health maintenance
  1  8 organization contract issued and regulated under chapter 514B,
  1  9 which is delivered, amended, or renewed on or after July 1,
  1 10 2006, and which provides maternity benefits or newborn care
  1 11 benefits, shall provide coverage for screening for and
  1 12 treatment of postpartum depression and postpartum psychosis in
  1 13 accordance with guidelines adopted by rule by the
  1 14 commissioner.  The guidelines adopted by rule shall be
  1 15 consistent with or may adopt by reference the guidelines for
  1 16 screening for and treatment of postpartum depression and
  1 17 postpartum psychosis established by the national institute of
  1 18 mental health.
  1 19    b.  The guidelines adopted by rule by the commissioner
  1 20 shall also provide that hospitals and other health care
  1 21 facilities in the state shall provide new mothers and fathers
  1 22 and other family members, as appropriate, with written
  1 23 information about postpartum depression and postpartum
  1 24 psychosis, including symptoms, methods of coping with the
  1 25 illnesses, and treatment resources, upon the postdelivery
  1 26 departure of a new mother from the hospital or other health
  1 27 care facility.
  1 28    Sec. 2.  Section 514C.12, subsections 2 and 3, Code 2005,
  1 29 are amended to read as follows:
  1 30    2.  When performing utilization review of inpatient
  1 31 hospital services related to maternity and newborn care,
  1 32 including but not limited to length of postdelivery stay and
  1 33 postdischarge follow=up care, including screening for and
  1 34 treatment of postpartum depression and postpartum psychosis,
  1 35 any person who provides an individual or group policy of
  2  1 accident or health insurance or individual or group hospital
  2  2 or health care service contract issued pursuant to chapter
  2  3 509, 509A, 514, or 514A, or an individual or group health
  2  4 maintenance organization contract issued and regulated under
  2  5 chapter 514B, shall use the guidelines adopted by rule by the
  2  6 commissioner, and shall not deselect, require additional
  2  7 documentation, require additional utilization review,
  2  8 terminate services to, reduce payment to, or in any manner
  2  9 provide a disincentive to an attending physician solely on the
  2 10 basis that the attending physician provided or directed the
  2 11 provision of services in compliance with the guidelines
  2 12 adopted by rule.
  2 13    3.  Preauthorization or precertification for a hospital
  2 14 stay or for a postdischarge follow=up visit, including
  2 15 screening for or treatment of postpartum depression or
  2 16 postpartum psychosis, in accordance with the guidelines
  2 17 adopted by rule by the commissioner shall not be required.
  2 18                           EXPLANATION
  2 19    This bill requires certain health insurance policies to
  2 20 provide coverage for screening for and treatment of postpartum
  2 21 depression or postpartum psychosis in accordance with
  2 22 guidelines adopted by rule by the commissioner of insurance.
  2 23 The guidelines are required to be consistent with the
  2 24 guidelines for such screening and treatment established by the
  2 25 national institute of mental health.
  2 26    The bill also requires that the commissioner of insurance
  2 27 adopt rules requiring hospitals and other health care
  2 28 facilities to provide new mothers and fathers, and other
  2 29 appropriate family members, with written information about
  2 30 postpartum depression and psychosis, including symptoms,
  2 31 methods of coping with the illnesses, and treatment resources,
  2 32 upon postdelivery departure of a new mother from the hospital
  2 33 or health care facility.
  2 34    The bill prohibits an insurer from deselecting, requiring
  2 35 additional documentation, requiring additional utilization
  3  1 review, terminating services to, reducing payment to, or
  3  2 providing a disincentive to an attending physician solely on
  3  3 the basis that the attending physician directed the provision
  3  4 of services in compliance with guidelines for screening of and
  3  5 treatment for postpartum depression and psychosis.  The bill
  3  6 also prohibits preauthorization or precertification for a
  3  7 hospital stay or for a postdischarge follow=up visit for
  3  8 screening for or treatment of postpartum depression or
  3  9 psychosis as provided by rules adopted by the commissioner of
  3 10 insurance.
  3 11    The bill applies to individual or group insurance contracts
  3 12 issued pursuant to Code chapter 509, 509A, 514, or 514A, or
  3 13 individual or group contracts issued by a health maintenance
  3 14 organization pursuant to Code chapter 514B which are
  3 15 delivered, amended, or renewed on or after July 1, 2006.
  3 16 LSB 6215HH 81
  3 17 av:nh/je/5