House File 185 - Introduced



                                       HOUSE FILE       
                                       BY  KRESSIG


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

                                      A BILL FOR

  1 An Act requiring health care benefit coverage for certain
  2    prosthetic devices and providing an applicability date.
  3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  4 TLSB 1942YH 82
  5 av/gg/14

PAG LIN



  1  1    Section 1.  NEW SECTION.  514C.23  COVERAGE FOR PROSTHETIC
  1  2 DEVICES.
  1  3    1.  Notwithstanding the uniformity of treatment
  1  4 requirements of section 514C.6, a policy or contract providing
  1  5 for third=party payment or prepayment of health or medical
  1  6 expenses shall provide coverage benefits for prosthetic
  1  7 devices when prescribed by a physician licensed under chapter
  1  8 148, 150, or 150A.  Such coverage benefits for prosthetic
  1  9 devices shall provide coverage for prosthetic devices that, at
  1 10 a minimum, equals the coverage and payment for prosthetic
  1 11 devices provided under federal laws for health insurance for
  1 12 the aged and disabled pursuant to 42 U.S.C. } 1395k, 13951,
  1 13 and 1395m, and 42 C.F.R. } 414.202, 414.210, 414.228, and
  1 14 410.100, as applicable.
  1 15    2.  a.  This section applies to the following classes of
  1 16 third=party payment provider contracts or policies delivered,
  1 17 issued for delivery, continued, or renewed in this state on or
  1 18 after July 1, 2007:
  1 19    (1)  Individual or group accident and sickness insurance
  1 20 providing coverage on an expense=incurred basis.
  1 21    (2)  An individual or group hospital or medical service
  1 22 contract issued pursuant to chapter 509, 514, or 514A.
  1 23    (3)  An individual or group health maintenance organization
  1 24 contract regulated under chapter 514B.
  1 25    (4)  A plan established pursuant to chapter 509A for public
  1 26 employees.
  1 27    (5)  An organized delivery system licensed by the director
  1 28 of public health.
  1 29    b.  This section shall not apply to accident only,
  1 30 specified disease, short=term hospital or medical, hospital
  1 31 confinement indemnity, credit, dental, vision, Medicare
  1 32 supplement, long=term care, basic hospital and medical=
  1 33 surgical expense coverage as defined by the commissioner,
  1 34 disability income insurance coverage, coverage issued as a
  1 35 supplement to liability insurance, workers' compensation or
  2  1 similar insurance, or automobile medical payment insurance.
  2  2                           EXPLANATION
  2  3    This bill provides that despite the uniformity of treatment
  2  4 requirements of Code section 514C.6, an individual or group
  2  5 policy or contract providing for third=party payments of
  2  6 health or medical expenses is required to provide coverage
  2  7 benefits for prosthetic devices that provide, at a minimum,
  2  8 coverage for prosthetic devices equal to the coverage that is
  2  9 provided for under federal laws for the aged and disabled.
  2 10 The bill applies to such contracts or policies delivered,
  2 11 issued for delivery, continued, or renewed in this state on or
  2 12 after July 1, 2007.
  2 13 LSB 1942YH 82
  2 14 av:rj/gg/14