Bill Text: IA HF2188 | 2017-2018 | 87th General Assembly | Introduced
Bill Title: A bill for an act relating to health insurance coverage for mammograms and including effective date and applicability provisions.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2018-02-01 - Introduced, referred to Commerce. H.J. 187. [HF2188 Detail]
Download: Iowa-2017-HF2188-Introduced.html
House File 2188 - Introduced HOUSE FILE BY RUNNING=MARQUARDT A BILL FOR 1 An Act relating to health insurance coverage for mammograms and 2 including effective date and applicability provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: TLSB 5484YH (2) 87 ko/rj PAG LIN 1 1 Section 1. Section 514C.4, Code 2018, is amended to read as 1 2 follows: 1 3 514C.4 Mandated coverage for mammography. 1 4 1. As used in this section: 1 5 a. "Health care professional" means the same as defined in 1 6 section 514J.102. 1 7 b. "Mammogram" means a radiographic image obtained using a 1 8 procedure, including two=dimensional mammography or three= 1 9 dimensional mammography, as recommended by a woman's health 1 10 care professional. 1 111.2. a. A policy or contract providing for third=party 1 12 payment or prepayment of health or medical expenses shall 1 13 provide minimum mammography examination coverage, including, 1 14 but not limited to, the following classes of third=party 1 15 payment provider contracts or policies delivered, issued for 1 16 delivery, continued, or renewed in this state. 1 17 (1) Individual or group accident and sickness insurance 1 18 providing coverage on an expense=incurred basis. 1 19 (2) An individual or group hospital or medical service 1 20 contract issued pursuant to chapter 509, 514, or 514A. 1 21 (3) An individual or group health maintenance organization 1 22 contract regulated under chapter 514B. 1 23 (4) An individual or group Medicare supplemental policy, 1 24 unless coverage pursuant to such policy is preempted by federal 1 25 law. 1 26 b. A long=term care policy or contract is specifically 1 27 excluded from regulation under this section. 1 282.3. As used in this section, "minimum mammography 1 29 examination coverage" means benefits which are better than or 1 30 equal to the following minimum requirements: 1 31 a. One baseline mammogram for any woman who is thirty=five 1 32 through thirty=nine years of age, or more frequent mammograms 1 33 if recommended by the woman'sphysicianhealth care 1 34 professional. 1 35 b. A mammogram every two years for any woman who is 2 1 forty through forty=nine years of age, or more frequently if 2 2 recommended by the woman'sphysicianhealth care professional. 2 3 c. A mammogram every year for any woman who is fifty years 2 4 of age or older, or more frequently if recommended by the 2 5 woman'sphysicianhealth care professional. 2 63.4. Mammogram benefits may be subject to any policy or 2 7 contract provisions which apply generally to other services 2 8 covered by the policy or contract. 2 94.5. The commissioner of insurance shall adopt rules under 2 10 chapter 17A necessary to implement this section. 2 11 Sec. 2. EFFECTIVE DATE. This Act, being deemed of immediate 2 12 importance, takes effect upon enactment. 2 13 Sec. 3. APPLICABILITY. This Act applies to the classes of 2 14 third=party payment provider contracts or policies specified 2 15 in section 514C.4, as amended by this Act, that are delivered, 2 16 issued for delivery, continued, or renewed in this state on or 2 17 after July 1, 2018. 2 18 EXPLANATION 2 19 The inclusion of this explanation does not constitute agreement with 2 20 the explanation's substance by the members of the general assembly. 2 21 This bill relates to insurance coverage for a mammogram as 2 22 recommended by a woman's health care professional. 2 23 The bill defines "mammogram" as a radiographic image 2 24 obtained using a procedure, including two=dimensional 2 25 mammography or three=dimensional mammography, as recommended by 2 26 a woman's health care professional. The bill does not change 2 27 the minimum mammography examination coverage requirements. The 2 28 bill requires, however, that the insurance coverage apply to 2 29 two=dimensional mammograms and three=dimensional mammograms. 2 30 The bill also allows a woman's health care professional, 2 31 defined to include licensed health care practitioners other 2 32 than a woman's physician, to recommend a mammogram. 2 33 The bill applies to the classes of third=party payment 2 34 provider contracts or policies specified in Code section 514C.4 2 35 that are delivered, issued for delivery, continued, or renewed 3 1 in this state on or after July 1, 2018. LSB 5484YH (2) 87 ko/rj