House
File
443
-
Introduced
HOUSE
FILE
443
BY
A.
MEYER
A
BILL
FOR
An
Act
relating
to
health
insurance
coverage
for
assertive
1
community
treatment
services.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
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Section
1.
NEW
SECTION
.
514C.37
Assertive
community
1
treatment
services
——
coverage.
2
1.
As
used
in
this
section,
unless
the
context
otherwise
3
requires:
4
a.
“Covered
person”
means
a
policyholder,
subscriber,
5
enrollee,
or
other
individual
participating
in
a
health
benefit
6
plan.
7
b.
“Dependent”
means
a
dependent
of
a
covered
person.
8
c.
“Health
benefit
plan”
means
the
same
as
defined
in
9
section
510B.1.
10
2.
Notwithstanding
the
uniformity
of
treatment
requirements
11
of
section
514C.6,
a
health
benefit
plan
shall
provide
coverage
12
for
assertive
community
treatment
services
for
a
dependent
13
who
receives
assertive
community
treatment
services
from
an
14
assertive
community
treatment
provider
that
is
enrolled
in,
and
15
in
good
standing
with,
the
medical
assistance
program
under
16
chapter
249A.
17
3.
a.
This
section
applies
to
the
following
classes
of
18
third-party
payment
provider
contracts,
policies,
or
plans
19
delivered,
issued
for
delivery,
continued,
or
renewed
in
this
20
state
on
or
after
January
1,
2026:
21
(1)
Individual
or
group
accident
and
sickness
insurance
22
providing
coverage
on
an
expense-incurred
basis.
23
(2)
An
individual
or
group
hospital
or
medical
service
24
contract
issued
pursuant
to
chapter
509,
514,
or
514A.
25
(3)
An
individual
or
group
health
maintenance
organization
26
contract
regulated
under
chapter
514B.
27
(4)
A
plan
established
for
public
employees
pursuant
to
28
chapter
509A.
29
b.
This
section
shall
not
apply
to
accident-only,
specified
30
disease,
short-term
hospital
or
medical,
hospital
confinement
31
indemnity,
credit,
dental,
vision,
Medicare
supplement,
32
long-term
care,
basic
hospital
and
medical-surgical
expense
33
coverage
as
defined
by
the
commissioner
of
insurance,
34
disability
income
insurance
coverage,
coverage
issued
as
a
35
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supplement
to
liability
insurance,
workers’
compensation
or
1
similar
insurance,
or
automobile
medical
payment
insurance.
2
4.
The
commissioner
of
insurance
may
adopt
rules
pursuant
to
3
chapter
17A
to
administer
this
section.
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
relates
to
insurance
coverage
for
assertive
8
community
treatment
services.
9
The
bill
requires
a
health
benefit
plan
to
provide
coverage
10
for
assertive
community
treatment
services
for
a
dependent,
as
11
defined
in
the
bill,
who
receives
services
from
an
assertive
12
community
treatment
provider
that
is
enrolled
in,
and
in
good
13
standing
with,
the
medical
assistance
program
under
Code
14
chapter
249A.
15
The
bill
applies
to
third-party
payment
providers
enumerated
16
in
the
bill.
The
bill
specifies
the
types
of
specialized
17
health-related
insurance
which
are
not
subject
to
the
bill.
18
The
commissioner
of
insurance
may
adopt
rules
to
administer
19
the
bill.
20
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