House File 2061 - Introduced HOUSE FILE 2061 BY HEATON and HEDDENS A BILL FOR An Act relating to third-party payment of services provided by 1 physical therapists and occupational therapists. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 5686HH (4) 85 av/rj
H.F. 2061 Section 1. NEW SECTION . 514C.30 Services provided by a 1 physical therapist. 2 1. Notwithstanding the uniformity of treatment requirements 3 of section 514C.6, a policy, contract, or plan providing 4 for third-party payment or prepayment of health or medical 5 expenses shall not impose a copayment or coinsurance amount 6 on an insured for services provided by a physical therapist 7 licensed pursuant to chapter 148A or by an occupational 8 therapist licensed pursuant to chapter 148B that is greater 9 than the copayment or coinsurance amount imposed on the insured 10 for services provided by a person engaged in the practice of 11 medicine and surgery or osteopathic medicine and surgery under 12 chapter 148 for the same or a similar diagnosed condition even 13 if a different nomenclature is used to describe the condition 14 for which the services are provided. 15 2. This section applies to the following classes of 16 third-party payment provider policies, contracts, or plans 17 delivered, issued for delivery, continued, or renewed in this 18 state on or after July 1, 2014: 19 a. Individual or group accident and sickness insurance 20 providing coverage on an expense-incurred basis. 21 b. An individual or group hospital or medical service 22 contract issued pursuant to chapter 509, 514, or 514A. 23 c. An individual or group health maintenance organization 24 contract regulated under chapter 514B. 25 d. A plan established pursuant to chapter 509A for public 26 employees. 27 e. An organized delivery system licensed by the director of 28 public health. 29 3. This section shall not apply to accident-only, 30 specified disease, short-term hospital or medical, hospital 31 confinement indemnity, credit, dental, vision, Medicare 32 supplement, long-term care, basic hospital and medical-surgical 33 expense coverage as defined by the commissioner, disability 34 income insurance coverage, coverage issued as a supplement 35 -1- LSB 5686HH (4) 85 av/rj 1/ 2
H.F. 2061 to liability insurance, workers’ compensation or similar 1 insurance, or automobile medical payment insurance. 2 EXPLANATION 3 The inclusion of this explanation does not constitute agreement with 4 the explanation’s substance by the members of the general assembly. 5 This bill provides that a policy, contract, or plan 6 providing for third-party payment or prepayment of health or 7 medical expenses shall not impose a copayment or coinsurance 8 amount on an insured for services provided by a physical 9 therapist or occupational therapist that is greater than the 10 copayment or coinsurance amount imposed on the insured for 11 services rendered by a person engaged in the practice of 12 medicine and surgery or osteopathic medicine and surgery for 13 the same or a similar diagnosed condition even if a different 14 nomenclature is used to describe the condition for which the 15 services are provided. 16 The bill applies to specified individual and group policies, 17 contracts, and plans that are issued for delivery, continued, 18 or renewed in this state on or after July 1, 2014. 19 -2- LSB 5686HH (4) 85 av/rj 2/ 2