Senate File 508 - Reprinted SENATE FILE BY COMMITTEE ON COMMERCE (SUCCESSOR TO SSB 1076) Passed Senate, Date Passed House, Date Vote: Ayes Nays Vote: Ayes Nays Approved A BILL FOR 1 An Act requiring health care benefit coverage for certain 2 prosthetic devices and providing an applicability date. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 1942SV 82 5 av/gg/14 PAG LIN 1 1 Section 1. NEW SECTION. 514C.23 COVERAGE FOR PROSTHETIC 1 2 DEVICES. 1 3 1. Notwithstanding the uniformity of treatment 1 4 requirements of section 514C.6, a policy or contract providing 1 5 for third=party payment or prepayment of health or medical 1 6 expenses shall provide coverage benefits for medically 1 7 necessary prosthetic devices when prescribed by a physician 1 8 licensed under chapter 148, 150, or 150A. Such coverage 1 9 benefits for medically necessary prosthetic devices shall 1 10 provide coverage for medically necessary prosthetic devices 1 11 that, at a minimum, equals the coverage and payment for 1 12 medically necessary prosthetic devices provided under federal 1 13 laws for health insurance for the aged and disabled pursuant 1 14 to 42 U.S.C. } 1395k, 13951, and 1395m, and 42 C.F.R. } 1 15 414.202, 414.210, 414.228, and 410.100, as applicable. For 1 16 the purposes of this section, "prosthetic device" means an 1 17 artificial limb device to replace, in whole or in part, an arm 1 18 or leg. 1 19 2. a. This section applies to the following classes of 1 20 third=party payment provider contracts or policies delivered, 1 21 issued for delivery, continued, or renewed in this state on or 1 22 after July 1, 2007: 1 23 (1) Individual or group accident and sickness insurance 1 24 providing coverage on an expense=incurred basis. 1 25 (2) An individual or group hospital or medical service 1 26 contract issued pursuant to chapter 509, 514, or 514A. 1 27 (3) An individual or group health maintenance organization 1 28 contract regulated under chapter 514B. 1 29 (4) A plan established pursuant to chapter 509A for public 1 30 employees. 1 31 (5) An organized delivery system licensed by the director 1 32 of public health. 1 33 b. This section shall not apply to accident only, 1 34 specified disease, short=term hospital or medical, hospital 1 35 confinement indemnity, credit, dental, vision, Medicare 2 1 supplement, long=term care, basic hospital and medical= 2 2 surgical expense coverage as defined by the commissioner, 2 3 disability income insurance coverage, coverage issued as a 2 4 supplement to liability insurance, workers' compensation or 2 5 similar insurance, or automobile medical payment insurance. 2 6 SF 508 2 7 av:rj/cc/26