Bill Text: IA HF175 | 2019-2020 | 88th General Assembly | Introduced
Bill Title: A bill for an act relating to insurance coverage for dispensing prescription contraceptives in certain quantities.
Spectrum: Partisan Bill (Democrat 17-0)
Status: (Introduced - Dead) 2019-01-31 - Introduced, referred to Commerce. H.J. 189. [HF175 Detail]
Download: Iowa-2019-HF175-Introduced.html
House
File
175
-
Introduced
HOUSE
FILE
175
BY
BENNETT
,
HUNTER
,
RUNNING-MARQUARDT
,
R.
SMITH
,
KACENA
,
OLDSON
,
FORBES
,
ANDERSON
,
McCONKEY
,
KURTH
,
LENSING
,
WINCKLER
,
STAED
,
MASCHER
,
DONAHUE
,
STECKMAN
,
and
EHLERT
A
BILL
FOR
An
Act
relating
to
insurance
coverage
for
dispensing
1
prescription
contraceptives
in
certain
quantities.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
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Section
1.
Section
514C.19,
Code
2019,
is
amended
to
read
1
as
follows:
2
514C.19
Prescription
contraceptive
coverage.
3
1.
For
purposes
of
this
section:
4
a.
“Dispense”
means
the
same
as
defined
in
section
155A.3.
5
b.
“Health
care
professional”
means
the
same
as
defined
in
6
section
514J.102.
7
c.
“Prescription
contraceptive”
means
a
medically
acceptable
8
oral
drug
or
contraceptive
patch
or
ring
that
is
used
to
9
prevent
pregnancy,
and
requires
a
prescription.
10
1.
2.
Notwithstanding
the
uniformity
of
treatment
11
requirements
of
section
514C.6
,
a
group
policy
,
or
contract
,
or
12
plan
providing
for
third-party
payment
or
prepayment
of
health
13
or
medical
expenses
shall
not
do
either
of
the
following:
14
a.
Exclude
or
restrict
benefits
for
a
prescription
15
contraceptive
drugs
or
prescription
contraceptive
devices
which
16
prevent
conception
and
which
are
contraceptive
that
is
approved
17
by
the
United
States
food
and
drug
administration,
or
a
generic
18
equivalents
equivalent
approved
as
substitutable
a
substitute
19
by
the
United
States
food
and
drug
administration,
if
such
20
policy
,
or
contract
,
or
plan
provides
benefits
a
benefit
for
21
any
other
outpatient
prescription
drugs
drug
or
devices
device
.
22
Such
policy,
contract,
or
plan
shall
provide
for
payment
to
a
23
health
care
professional
that
dispenses
any
of
the
following
to
24
a
covered
person:
25
(1)
A
three-month
supply
of
a
prescription
contraceptive
26
the
first
time
the
prescription
contraceptive
is
dispensed
to
27
the
covered
person.
28
(2)
A
twelve-month
supply
of
a
prescription
contraceptive
29
for
any
subsequent
dispensing
of
the
same
prescription
30
contraceptive
to
the
covered
person.
31
(3)
A
three-month
supply
of
a
prescription
vaginal
32
contraceptive
ring.
33
b.
Exclude
or
restrict
benefits
for
an
outpatient
34
contraceptive
services
which
are
service
that
is
provided
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for
the
purpose
of
preventing
conception
if
such
policy
,
1
or
contract
,
or
plan
provides
benefits
a
benefit
for
any
2
other
outpatient
services
service
provided
by
a
health
care
3
professional.
4
2.
3.
A
person
who
provides
a
group
policy
,
or
contract
,
or
5
plan
providing
for
third-party
payment
or
prepayment
of
health
6
or
medical
expenses
which
is
subject
to
subsection
1
2
shall
7
not
do
any
of
the
following:
8
a.
Deny
to
an
individual
eligibility,
or
continued
9
eligibility,
to
enroll
in
or
to
renew
coverage
under
the
terms
10
of
the
policy
,
or
contract
,
or
plan
because
of
the
individual’s
11
use
or
potential
use
of
such
a
prescription
contraceptive
12
drugs
drug
or
devices
device
,
or
use
or
potential
use
of
an
13
outpatient
contraceptive
services
service
.
14
b.
Provide
a
monetary
payment
or
rebate
to
a
covered
15
individual
to
encourage
such
individual
to
accept
less
than
the
16
minimum
benefits
provided
for
under
subsection
1
2
.
17
c.
Penalize
or
otherwise
reduce
or
limit
the
reimbursement
18
of
a
health
care
professional
because
such
professional
19
prescribes
a
contraceptive
drugs
drug
or
devices
device
,
or
20
provides
a
contraceptive
services
service
.
21
d.
Provide
incentives
an
incentive
,
monetary
or
otherwise,
22
to
a
health
care
professional
to
induce
such
professional
to
23
withhold
from
a
covered
individual
a
contraceptive
drugs
drug
24
or
devices
device
,
or
a
contraceptive
services
service
from
a
25
covered
individual
.
26
3.
4.
This
section
shall
not
be
construed
to
prevent
a
27
third-party
payor
from
including
deductibles,
coinsurance,
or
28
copayments
under
the
policy
,
or
contract,
or
plan
as
follows:
29
a.
A
deductible,
coinsurance,
or
copayment
for
benefits
a
30
benefit
for
a
prescription
contraceptive
drugs
drug
shall
not
31
be
greater
than
such
deductible,
coinsurance,
or
copayment
for
32
any
outpatient
prescription
drug
for
which
coverage
under
the
33
policy
,
or
contract
,
or
plan
is
provided.
34
b.
A
deductible,
coinsurance,
or
copayment
for
benefits
a
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benefit
for
a
prescription
contraceptive
devices
device
shall
1
not
be
greater
than
such
deductible,
coinsurance,
or
copayment
2
for
any
outpatient
prescription
device
for
which
coverage
under
3
the
policy
,
or
contract
,
or
plan
is
provided.
4
c.
A
deductible,
coinsurance,
or
copayment
for
benefits
a
5
benefit
for
an
outpatient
contraceptive
services
service
shall
6
not
be
greater
than
such
deductible,
coinsurance,
or
copayment
7
for
any
outpatient
health
care
services
service
for
which
8
coverage
under
the
policy
,
or
contract
,
or
plan
is
provided.
9
4.
5.
This
section
shall
not
be
construed
to
require
10
a
third-party
payor
under
a
policy
,
or
contract
,
or
plan
11
to
provide
benefits
a
benefit
for
an
experimental
or
12
investigational
contraceptive
drugs
drug
or
devices
device
,
or
13
experimental
or
investigational
contraceptive
services
service
,
14
except
to
the
extent
that
such
policy
,
or
contract
,
or
plan
15
provides
coverage
for
any
other
experimental
or
investigational
16
outpatient
prescription
drugs
drug
or
devices
device
,
or
17
experimental
or
investigational
outpatient
health
care
services
18
service
.
19
5.
6.
This
section
shall
not
be
construed
to
limit
or
20
otherwise
discourage
the
any
of
the
following:
21
a.
The
use
of
a
generic
equivalent
drugs
drug
approved
22
by
the
United
States
food
and
drug
administration
,
whenever
23
if
available
and
appropriate.
This
section
,
when
a
brand
24
name
drug
is
requested
by
a
covered
individual
and
a
suitable
25
generic
equivalent
is
available
and
appropriate,
shall
not
be
26
construed
to
prohibit
a
27
b.
A
third-party
payor
from
requiring
the
a
covered
28
individual
to
pay
a
deductible,
coinsurance,
or
copayment
29
consistent
with
subsection
3
4
,
in
addition
to
the
difference
30
of
the
cost
of
the
brand
name
drug
less
the
maximum
covered
31
amount
for
a
generic
equivalent.
32
7.
This
section
shall
not
be
construed
to
require
a
33
third-party
payor
to
provide
payment
to
a
health
care
34
professional
for
dispensing
a
prescription
contraceptive
to
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replace
a
prescription
contraceptive
that
has
been
dispensed
1
to
a
covered
person
and
that
has
been
misplaced,
stolen,
or
2
destroyed.
This
section
shall
not
be
construed
to
require
a
3
third-party
payor
to
replace
covered
prescriptions
that
are
4
misplaced,
stolen,
or
destroyed.
5
6.
8.
A
person
who
provides
an
individual
policy
,
or
6
contract
,
or
plan
providing
for
third-party
payment
or
7
prepayment
of
health
or
medical
expenses
shall
make
available
8
a
coverage
provision
that
satisfies
the
requirements
in
9
subsections
1
2
through
5
7
in
the
same
manner
as
such
10
requirements
are
applicable
to
a
group
policy
,
or
contract
,
or
11
plan
under
those
subsections.
The
policy
,
or
contract
,
or
plan
12
shall
provide
that
the
individual
policyholder
may
reject
the
13
coverage
provision
at
the
option
of
the
policyholder.
14
7.
9.
a.
This
section
applies
shall
apply
to
the
following
15
classes
of
third-party
payment
provider
policies,
contracts
or
16
policies
,
and
plans
delivered,
issued
for
delivery,
continued,
17
or
renewed
in
this
state
on
or
after
July
1,
2000
2019
:
18
(1)
Individual
or
group
accident
and
sickness
insurance
19
providing
coverage
on
an
expense-incurred
basis.
20
(2)
An
individual
or
group
hospital
or
medical
service
21
contract
issued
pursuant
to
chapter
509
,
514
,
or
514A
.
22
(3)
An
individual
or
group
health
maintenance
organization
23
contract
regulated
under
chapter
514B
.
24
(4)
Any
other
entity
engaged
in
the
business
of
insurance,
25
risk
transfer,
or
risk
retention,
which
is
subject
to
the
26
jurisdiction
of
the
commissioner.
27
(5)
A
plan
established
pursuant
to
chapter
509A
for
public
28
employees.
29
b.
This
section
shall
not
apply
to
accident-only,
30
specified
disease,
short-term
hospital
or
medical,
hospital
31
confinement
indemnity,
credit,
dental,
vision,
Medicare
32
supplement,
long-term
care,
basic
hospital
and
medical-surgical
33
expense
coverage
as
defined
by
the
commissioner,
disability
34
income
insurance
coverage,
coverage
issued
as
a
supplement
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to
liability
insurance,
workers’
compensation
or
similar
1
insurance,
or
automobile
medical
payment
insurance.
2
EXPLANATION
3
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
4
the
explanation’s
substance
by
the
members
of
the
general
assembly.
5
This
bill
relates
to
insurance
coverage
for
a
prescription
6
contraceptive
dispensed
by
a
health
care
professional
to
a
7
covered
person
in
a
three-month
or
12-month
quantity.
The
bill
8
defines
“health
care
professional”
as
a
physician
or
other
9
health
care
practitioner
licensed,
accredited,
registered,
or
10
certified
to
perform
specified
health
care
services
consistent
11
with
state
law.
12
The
bill
amends
prescription
contraceptive
coverage
13
provisions
to
specifically
require
that
a
policy,
contract,
14
or
plan
providing
for
third-party
payment
or
prepayment
of
15
health
or
medical
expenses
provide
for
payment
to
a
health
16
care
professional
that
dispenses
a
three-month
supply
of
a
17
prescription
contraceptive
the
first
time
it
is
dispensed
to
a
18
covered
person,
and
payment
when
a
12-month
supply
of
the
same
19
prescription
contraceptive
is
subsequently
dispensed
to
the
20
same
covered
person.
The
bill
also
provides
for
payment
to
a
21
health
care
professional
for
dispensing
a
three-month
supply
of
22
a
prescription
vaginal
contraceptive
ring.
23
The
bill
shall
not
be
construed
to
require
a
third-party
24
payor
to
provide
payment
to
a
health
care
professional
25
for
dispensing
a
prescription
contraceptive
to
replace
a
26
prescription
contraceptive
that
has
been
dispensed
and
has
been
27
misplaced,
lost,
or
stolen.
28
The
bill
applies
to
third-party
payment
provider
contracts,
29
policies,
and
plans
delivered,
issued
for
delivery,
continued,
30
or
renewed
in
this
state
on
or
after
July
1,
2019,
by
the
31
third-party
payment
providers
enumerated
in
the
bill.
32
The
bill
specifies
the
types
of
specialized
health-related
33
insurance
which
are
not
subject
to
the
coverage
requirements
34
of
the
bill.
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