House File 11 - Introduced HOUSE FILE 11 BY HUNTER A BILL FOR An Act relating to the provision of certain information for 1 insureds regarding external review of health care services 2 coverage decisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 1235YH (2) 86 av/nh
H.F. 11 Section 1. Section 514J.104, Code 2015, is amended by adding 1 the following new subsection: 2 NEW SUBSECTION . 6. a. An insurance card issued by a health 3 carrier for a health benefit plan providing for third-party 4 payment or prepayment of health care services subject to this 5 chapter shall contain the telephone number for a covered person 6 to obtain more information regarding initiation of the external 7 review process for adverse determinations or final adverse 8 determinations under this chapter. 9 b. The telephone number for a covered person to obtain more 10 information regarding initiation of the external review process 11 under this chapter shall also be posted in a prominent place in 12 the offices of health care professionals and in facilities. 13 EXPLANATION 14 The inclusion of this explanation does not constitute agreement with 15 the explanation’s substance by the members of the general assembly. 16 This bill amends Code section 514J.104, relating to notice 17 provisions concerning the external review process available to 18 individuals participating in a health benefit plan who receive 19 a determination from their health insurance carrier that 20 payment for a health care service that is a covered benefit has 21 been denied, reduced, or terminated. 22 The bill adds a requirement that a telephone number allowing 23 individuals to obtain more information about the external 24 review process be printed on the individual’s insurance 25 card, and be posted in a prominent place in health care 26 professionals’ offices and in certain health care facilities. 27 -1- LSB 1235YH (2) 86 av/nh 1/ 1