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
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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
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