SF 374 (LSB 2321XS (2) 90)

SENATE FILE 374

BY  QUIRMBACH

A BILL FOR

An Act relating to dialysis services provided under an Iowa comprehensive health insurance association policy.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 514E.1, Code 2023, is amended by adding the following new subsection:
   NEW SUBSECTION.  5A.  “Cost-sharing” means any coverage limit, copayment, coinsurance, deductible, or other out-of-pocket expense obligation.
    Sec. 2.  NEW SECTION.  514E.12  Health care services —— payments.
   On or after January 1, 2024, a provider of dialysis services shall accept as payment in full from the association, for the provision of health care services to an insured, an amount equal to the amount that Medicare pays a provider of dialysis services for provision of the same health care services. An insured shall be responsible only for any cost-sharing imposed on the insured by the insured’s association policy for the health care services.
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 health insurance provided under an Iowa comprehensive health insurance association policy. The bill requires a provider of dialysis services (provider) to accept as payment in full from the association, for the provision of health care services (services) to an insured, an amount equal to the amount that Medicare pays a provider for provision of the same services. An insured is only responsible for any cost-sharing imposed on the insured by the insured’s association policy. This applies to services provided by a provider to an insured on or after January 1, 2024.