House File 651 - Introduced
HOUSE FILE
BY JOCHUM
Passed House, Date Passed Senate, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to continuity of care for cancer treatment and
2 providing an effective date and retroactive applicability.
3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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PAG LIN
1 1 Section 1. Section 514C.17, subsections 1 and 2, Code
1 2 2005, are amended to read as follows:
1 3 1. Except as provided under subsection 2 or 3, if a
1 4 carrier, as defined in section 513B.2, an organized delivery
1 5 system authorized under 1993 Iowa Acts, chapter 158, or a plan
1 6 established pursuant to chapter 509A for public employees,
1 7 terminates its contract with a participating health care
1 8 provider, a covered individual who is undergoing a specified
1 9 course of treatment for cancer or a terminal illness, or a
1 10 related condition, with the recommendation of the covered
1 11 individual's treating physician licensed under chapter 148,
1 12 150, or 150A, may continue to receive coverage for treatment
1 13 received from the covered individual's physician for cancer or
1 14 the terminal illness, or a related condition, for a period of
1 15 up to ninety days. Payment for covered benefits and benefit
1 16 levels shall be according to the terms and conditions of the
1 17 contract in effect for the covered individual prior to the
1 18 termination of the contract except upon agreement of the
1 19 covered individual.
1 20 2. A covered person individual who makes a change in
1 21 health plans involuntarily may request that the new health
1 22 plan cover services of the covered person's individual's
1 23 treating physician licensed under chapter 148, 150, or 150A,
1 24 who is not a participating health care provider under the new
1 25 health plan, if the covered person individual is undergoing a
1 26 specified course of treatment for cancer or a terminal
1 27 illness, or a related condition. Continuation of such
1 28 coverage shall continue for up to ninety days. Payment for
1 29 covered benefits and benefit levels shall be according to the
1 30 terms and conditions of the contract in effect for the covered
1 31 individual prior to that individual's involuntary change in
1 32 health plans.
1 33 Sec. 2. EFFECTIVE DATE AND RETROACTIVE APPLICABILITY.
1 34 This Act, being deemed of immediate importance, takes effect
1 35 upon enactment and is retroactively applicable to January 1,
2 1 2004.
2 2 EXPLANATION
2 3 This bill provides that when an insurance carrier,
2 4 organized delivery system, or group insurer under Code chapter
2 5 509A terminates its contract with a participating health care
2 6 provider, a covered individual who is undergoing treatment for
2 7 cancer or a related condition may continue to receive coverage
2 8 for treatment received from that person's physician. The bill
2 9 provides that payment for covered benefits and benefit levels
2 10 shall be according to the terms and conditions of the contract
2 11 in effect for the covered individual prior to the termination
2 12 of the contract except upon agreement of the covered
2 13 individual.
2 14 The bill provides that when a covered individual makes an
2 15 involuntary change in health plans, that individual may
2 16 request that the new health plan continue to cover services
2 17 for treatment of cancer or a related condition and payment for
2 18 covered benefits and benefits levels shall be according to the
2 19 terms and conditions of the contract in effect prior to the
2 20 covered individual's involuntary change in health plans.
2 21 The bill takes effect upon enactment and is retroactively
2 22 applicable to January 1, 2004.
2 23 LSB 2600YH 81
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