HF 26 (LSB 1241YH (3) 85)

HOUSE FILE 26

BY  HUNTER

A BILL FOR

An Act relating to the provision of certain information for insureds regarding external review of health care services coverage decisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 514J.104, Code 2013, is amended by adding the following new subsection:
   NEW SUBSECTION.  6.
  a.  An insurance card issued by a health carrier for a health benefit plan providing for third-party payment or prepayment of health care services subject to this chapter shall contain the telephone number for a covered person to obtain more information regarding initiation of the external review process for adverse determinations or final adverse determinations under this chapter.
   b.  The telephone number for a covered person to obtain more information regarding initiation of the external review process under this chapter shall also be posted in a prominent place in the offices of health care professionals and in facilities.
EXPLANATION
   This bill amends Code section 514J.104, relating to notice provisions concerning the external review process available to individuals participating in a health benefit plan who receive a determination from their health insurance carrier that payment for a health care service that is a covered benefit has been denied, reduced, or terminated.
   The bill adds a requirement that a telephone number allowing individuals to obtain more information about the external review process be printed on the individual’s insurance card, and be posted in a prominent place in health care professionals’ offices and in certain health care facilities.