Senate
Study
Bill
1094
-
Introduced
SENATE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
HUMAN
RESOURCES
BILL
BY
CHAIRPERSON
MATHIS)
A
BILL
FOR
An
Act
relating
to
third-party
payment
of
services
provided
by
1
physical
therapists,
occupational
therapists,
and
speech
2
pathologists.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
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_____
Section
1.
NEW
SECTION
.
514C.30
Services
provided
1
by
a
physical
therapist,
occupational
therapist,
or
speech
2
pathologist.
3
1.
Notwithstanding
the
uniformity
of
treatment
requirements
4
of
section
514C.6,
a
policy,
contract,
or
plan
providing
5
for
third-party
payment
or
prepayment
of
health
or
medical
6
expenses
shall
not
impose
a
copayment
or
coinsurance
amount
7
on
an
insured
for
services
provided
by
a
physical
therapist
8
licensed
pursuant
to
chapter
148A,
by
an
occupational
therapist
9
licensed
pursuant
to
chapter
148B,
or
by
a
speech
pathologist
10
licensed
pursuant
to
154F
that
is
greater
than
the
copayment
or
11
coinsurance
amount
imposed
on
the
insured
for
services
provided
12
by
a
person
engaged
in
the
practice
of
medicine
and
surgery
13
or
osteopathic
medicine
and
surgery
under
chapter
148
for
the
14
same
or
a
similar
diagnosed
condition
even
if
a
different
15
nomenclature
is
used
to
describe
the
condition
for
which
the
16
services
are
provided.
17
2.
This
section
applies
to
the
following
classes
of
18
third-party
payment
provider
policies,
contracts,
or
plans
19
delivered,
issued
for
delivery,
continued,
or
renewed
in
this
20
state
on
or
after
July
1,
2015:
21
a.
Individual
or
group
accident
and
sickness
insurance
22
providing
coverage
on
an
expense-incurred
basis.
23
b.
An
individual
or
group
hospital
or
medical
service
24
contract
issued
pursuant
to
chapter
509,
514,
or
514A.
25
c.
An
individual
or
group
health
maintenance
organization
26
contract
regulated
under
chapter
514B.
27
d.
A
plan
established
pursuant
to
chapter
509A
for
public
28
employees.
29
e.
An
organized
delivery
system
licensed
by
the
director
of
30
public
health.
31
3.
This
section
shall
not
apply
to
accident-only,
32
specified
disease,
short-term
hospital
or
medical,
hospital
33
confinement
indemnity,
credit,
dental,
vision,
Medicare
34
supplement,
long-term
care,
basic
hospital
and
medical-surgical
35
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2
S.F.
_____
expense
coverage
as
defined
by
the
commissioner,
disability
1
income
insurance
coverage,
coverage
issued
as
a
supplement
2
to
liability
insurance,
workers’
compensation
or
similar
3
insurance,
or
automobile
medical
payment
insurance.
4
EXPLANATION
5
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
6
the
explanation’s
substance
by
the
members
of
the
general
assembly.
7
This
bill
provides
that
a
policy,
contract,
or
plan
8
providing
for
third-party
payment
or
prepayment
of
health
or
9
medical
expenses
shall
not
impose
a
copayment
or
coinsurance
10
amount
on
an
insured
for
services
provided
by
a
physical
11
therapist,
occupational
therapist,
or
speech
pathologist
that
12
is
greater
than
the
copayment
or
coinsurance
amount
imposed
on
13
the
insured
for
services
rendered
by
a
person
engaged
in
the
14
practice
of
medicine
and
surgery
or
osteopathic
medicine
and
15
surgery
for
the
same
or
a
similar
diagnosed
condition
even
if
a
16
different
nomenclature
is
used
to
describe
the
condition
for
17
which
the
services
are
provided.
18
The
bill
applies
to
specified
individual
and
group
policies,
19
contracts,
and
plans
that
are
issued
for
delivery,
continued,
20
or
renewed
in
this
state
on
or
after
July
1,
2015.
21
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