House File 234 - Introduced
HOUSE FILE
BY COMMITTEE ON HUMAN
RESOURCES
(SUCCESSOR TO HF 139)
(SUCCESSOR TO HSB 6)
Passed House, Date Passed Senate, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act requiring health insurance coverage for costs relating to
2 mental health conditions, including alcohol or substance abuse
3 treatment services.
4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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PAG LIN
1 1 Section 1. NEW SECTION. 514C.24 EQUALITY IN HEALTH CARE
1 2 COVERAGE AND VETERANS WELLNESS ACT.
1 3 1. This section shall be known and may be cited as the
1 4 "Equality in Health Care Coverage and Veterans Wellness Act".
1 5 2. For purposes of this section, unless the context
1 6 otherwise requires:
1 7 a. "Mental health condition" means a condition or disorder
1 8 involving mental illness or alcohol or substance abuse as
1 9 defined by the commissioner of insurance by rule, consistent
1 10 with the diagnostic categories listed in the mental disorders
1 11 section of the most recent version of the diagnostic and
1 12 statistical manual of mental disorders.
1 13 b. "Rates, terms, and conditions" means any lifetime
1 14 payment limits, deductibles, copayments, coinsurance, and any
1 15 other cost=sharing requirements, out=of=pocket limits, visit
1 16 limitations, and any other financial component of benefits
1 17 coverage that affects the covered individual.
1 18 3. a. Notwithstanding section 514C.6, a policy, contract,
1 19 or plan providing for third=party payment or prepayment of
1 20 health or medical expenses shall provide coverage benefits for
1 21 mental health conditions based on rates, terms, and conditions
1 22 which are no more restrictive than the rates, terms, and
1 23 conditions for coverage benefits provided for other health or
1 24 medical conditions under the policy, contract, or plan.
1 25 Additionally, any rates, terms, and conditions involving
1 26 deductibles, copayments, coinsurance, and any other
1 27 cost=sharing requirements shall be cumulative for coverage of
1 28 both mental health conditions and other health or medical
1 29 conditions under the policy, contract, or plan.
1 30 b. Coverage required under this subsection shall be as
1 31 follows:
1 32 (1) For the treatment of mental illness, coverage shall be
1 33 for services provided by a licensed mental health
1 34 professional, as defined in section 228.1, subsection 6, or
1 35 services provided in a licensed hospital or health facility.
2 1 (2) For the treatment of alcohol or substance abuse,
2 2 coverage shall be for services provided by a substance abuse
2 3 treatment and rehabilitation facility, as licensed by the
2 4 department of public health pursuant to chapter 125.
2 5 4. This section applies to the following classes of
2 6 third=party payment provider policies, contracts, or plans
2 7 delivered, issued for delivery, continued, or renewed in this
2 8 state on or after January 1, 2010:
2 9 a. Individual or group accident and sickness insurance
2 10 providing coverage on an expense=incurred basis.
2 11 b. An individual or group hospital or medical service
2 12 contract issued pursuant to chapter 509, 514, or 514A.
2 13 c. A plan established pursuant to chapter 509A for public
2 14 employees.
2 15 d. An individual or group health maintenance organization
2 16 contract regulated under chapter 514B.
2 17 e. Any other entity engaged in the business of insurance,
2 18 risk transfer, or risk retention, which is subject to the
2 19 jurisdiction of the commissioner.
2 20 f. An organized delivery system licensed by the director
2 21 of public health.
2 22 5. The division of mental health and disability services
2 23 of the department of human services and the division of
2 24 behavioral health of the department of public health shall
2 25 coordinate with the Iowa department of veterans affairs to
2 26 maximize access to mental health and substance abuse treatment
2 27 for veterans.
2 28 6. This section shall not apply to accident=only,
2 29 specified disease, short=term hospital or medical, hospital
2 30 confinement indemnity, credit, dental, vision, Medicare
2 31 supplement, long=term care, basic hospital and
2 32 medical=surgical expense coverage as defined by the
2 33 commissioner, disability income insurance coverage, coverage
2 34 issued as a supplement to liability insurance, workers'
2 35 compensation or similar insurance, or automobile medical
3 1 payment insurance.
3 2 Sec. 2. Section 514C.22, Code 2009, is repealed effective
3 3 January 1, 2010.
3 4 EXPLANATION
3 5 This bill creates new Code section 514C.24 entitled the
3 6 "Equality in Heath Care Coverage and Veterans Wellness Act"
3 7 and provides that, effective January 1, 2010, a policy,
3 8 contract, or plan providing for third=party payment or
3 9 prepayment of health or medical expenses must provide coverage
3 10 benefits for mental health conditions based on rates, terms,
3 11 and conditions which are no more restrictive than the rates,
3 12 terms, and conditions associated with coverage benefits
3 13 provided for other conditions under the policy, contract, or
3 14 plan. "Mental health condition" means a condition or disorder
3 15 involving mental illness or alcohol or substance abuse as
3 16 defined by the commissioner of insurance, by rule, consistent
3 17 with the diagnostic categories listed in the mental disorders
3 18 section of the most recent version of the diagnostic and
3 19 statistical manual of mental disorders.
3 20 The bill also requires the division of mental health and
3 21 disability services of the department of human services and
3 22 the division of behavioral health of the department of public
3 23 health to coordinate with the Iowa department of veterans
3 24 affairs to maximize access to mental health and substance
3 25 abuse treatment for veterans.
3 26 Code section 514C.22, which currently mandates coverage for
3 27 certain biologically based mental illnesses, is repealed
3 28 effective January 1, 2010.
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