Bill Text: IA HF11 | 2015-2016 | 86th General Assembly | Introduced

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Bill Title: A bill for an act relating to the provision of certain information for insureds regarding external review of health care services coverage decisions.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2015-01-21 - Subcommittee, Cownie, Oldson, and Soderberg. H.J. 134. [HF11 Detail]

Download: Iowa-2015-HF11-Introduced.html

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House File 11 - Introduced




                                 HOUSE FILE       
                                 BY  HUNTER

                                      A BILL FOR

  1 An Act relating to the provision of certain information for
  2    insureds regarding external review of health care services
  3    coverage decisions.
  4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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PAG LIN



  1  1    Section 1.  Section 514J.104, Code 2015, is amended by adding
  1  2 the following new subsection:
  1  3    NEW SUBSECTION.  6.  a.  An insurance card issued by a health
  1  4 carrier for a health benefit plan providing for third=party
  1  5 payment or prepayment of health care services subject to this
  1  6 chapter shall contain the telephone number for a covered person
  1  7 to obtain more information regarding initiation of the external
  1  8 review process for adverse determinations or final adverse
  1  9 determinations under this chapter.
  1 10    b.  The telephone number for a covered person to obtain more
  1 11 information regarding initiation of the external review process
  1 12 under this chapter shall also be posted in a prominent place in
  1 13 the offices of health care professionals and in facilities.
  1 14                           EXPLANATION
  1 15 The inclusion of this explanation does not constitute agreement with
  1 16 the explanation's substance by the members of the general assembly.
  1 17    This bill amends Code section 514J.104, relating to notice
  1 18 provisions concerning the external review process available to
  1 19 individuals participating in a health benefit plan who receive
  1 20 a determination from their health insurance carrier that
  1 21 payment for a health care service that is a covered benefit has
  1 22 been denied, reduced, or terminated.
  1 23    The bill adds a requirement that a telephone number allowing
  1 24 individuals to obtain more information about the external
  1 25 review process be printed on the individual's insurance
  1 26 card, and be posted in a prominent place in health care
  1 27 professionals' offices and in certain health care facilities.
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