S.F. 374 Section 1. Section 514E.1, Code 2023, is amended by adding 1 the following new subsection: 2 NEW SUBSECTION . 5A. “Cost-sharing” means any coverage 3 limit, copayment, coinsurance, deductible, or other 4 out-of-pocket expense obligation. 5 Sec. 2. NEW SECTION . 514E.12 Health care services —— 6 payments. 7 On or after January 1, 2024, a provider of dialysis services 8 shall accept as payment in full from the association, for the 9 provision of health care services to an insured, an amount 10 equal to the amount that Medicare pays a provider of dialysis 11 services for provision of the same health care services. An 12 insured shall be responsible only for any cost-sharing imposed 13 on the insured by the insured’s association policy for the 14 health care services. 15 EXPLANATION 16 The inclusion of this explanation does not constitute agreement with 17 the explanation’s substance by the members of the general assembly. 18 This bill relates to health insurance provided under an 19 Iowa comprehensive health insurance association policy. The 20 bill requires a provider of dialysis services (provider) 21 to accept as payment in full from the association, for the 22 provision of health care services (services) to an insured, an 23 amount equal to the amount that Medicare pays a provider for 24 provision of the same services. An insured is only responsible 25 for any cost-sharing imposed on the insured by the insured’s 26 association policy. This applies to services provided by a 27 provider to an insured on or after January 1, 2024. 28 -1- LSB 2321XS (2) 90 ko/rn 1/ 1