HF 556 (LSB 2286YH (3) 88)

HOUSE FILE 556

BY  KRESSIG, BROWN-POWERS, R. SMITH, and WESSEL-KROESCHELL

A BILL FOR

An Act relating to third-party payment of coverage benefits for mental health services delivered at a school. 
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  NEW SECTION.  514C.35  Mental health services provided at a school —— coverage.
   1.  As used in this section, unless the context otherwise requires:
   a.  “Facility”, “health care professional”, and “health care services” mean the same as defined in section 514J.102. 
   b.  “Mental health services” means services provided by a health care professional operating within the scope of the health care professional’s practice which address mental, emotional, medical, or behavioral conditions, illnesses, diseases, or problems.
   c.  “School” means a public or private school that provides premises for teaching any grade from kindergarten through grade twelve.
   2.  Notwithstanding the uniformity of treatment requirements of section 514C.6, a policy, contract, or plan providing for third-party payment or prepayment of health or medical expenses shall not discriminate between coverage benefits for mental health services that are provided in a facility and the same or similar mental health services that are provided at a school.
   3.  This section applies to the following classes of third-party payment provider policies, contracts, or plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2020:
   a.  Individual or group accident and sickness insurance providing coverage on an expense-incurred basis.
   b.  An individual or group hospital or medical service contract issued pursuant to chapter 509, 514, or 514A.
   c.  An individual or group health maintenance organization contract regulated under chapter 514B.
   d.  A plan established pursuant to chapter 509A for public employees.
   4.  This section shall not apply to accident-only, specified disease, short-term hospital or medical, hospital confinement indemnity, credit, dental, vision, Medicare supplement, long-term care, basic hospital and medical-surgical expense coverage as defined by the commissioner, disability income insurance coverage, coverage issued as a supplement to liability insurance, workers’ compensation or similar insurance, or automobile medical payment insurance.
   5.  The commissioner of insurance, in collaboration with the state board of education, may adopt rules pursuant to chapter 17A as necessary to administer this section.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill relates to third-party payment of coverage benefits for mental health services provided at a school. The bill defines “mental health services” as services provided by a health care professional operating within the scope of the health professional’s practice which address mental, emotional medical, or behavioral conditions, illnesses, diseases, or problems. “School” is defined in the bill as a public or private school that provides premises for teaching any grade from kindergarten through grade 12.
   The bill requires a policy, contract, or plan providing for third-party payment or prepayment of health or medical expenses to provide the same coverage for covered mental health services whether the mental health services are provided in a facility or provided at a school. “Facility” is defined in the bill. The commissioner of insurance, in collaboration with the state board of education, may adopt rules to administer the Code section.
   The bill is applicable to third-party payment provider policies, contracts, or plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2020, including individual or group accident and sickness insurance providing coverage on an expense-incurred basis, individual or group hospital or medical service contracts issued pursuant to Code chapter 509, 514, or 514A, individual or group health maintenance organization contracts regulated under Code chapter 514B, and plans established pursuant to Code chapter 509A for public employees.
   The bill does not apply to accident-only, specified disease, short-term hospital or medical, hospital confinement indemnity, credit, dental, vision, Medicare supplement, long-term care, basic hospital and medical-surgical expense coverage as defined by the commissioner, disability income insurance coverage, coverage issued as a supplement to liability insurance, workers’ compensation or similar insurance, or automobile medical payment insurance.