Bill Text: IA HF2489 | 2023-2024 | 90th General Assembly | Enrolled
Bill Title: A bill for an act relating to insurance coverage for supplemental and diagnostic breast examinations. (Formerly HF 71.) Effective date: 07/01/2024.
Spectrum: Committee Bill
Status: (Passed) 2024-05-08 - Fiscal note. [HF2489 Detail]
Download: Iowa-2023-HF2489-Enrolled.html
House
File
2489
-
Enrolled
House
File
2489
AN
ACT
RELATING
TO
INSURANCE
COVERAGE
FOR
SUPPLEMENTAL
AND
DIAGNOSTIC
BREAST
EXAMINATIONS.
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
Section
1.
NEW
SECTION
.
514C.4A
Supplemental
and
diagnostic
breast
examinations.
1.
As
used
in
this
section,
unless
the
context
otherwise
requires:
a.
“Breast
magnetic
resonance
imaging”
or
“breast
MRI”
means
an
examination
of
a
breast,
following
administration
of
intravenous
contrast,
using
a
powerful
magnetic
field,
radio
waves,
and
a
computer
to
produce
detailed
pictures
of
the
structures
within
the
breast.
b.
“Breast
ultrasound”
means
a
noninvasive
examination
of
a
breast
using
high-frequency
sound
waves
to
produce
detailed
images
of
the
breast.
c.
“Covered
person”
means
a
policyholder,
subscriber,
or
other
person
participating
in
a
policy,
contract,
or
plan
that
provides
for
third-party
payment
or
prepayment
of
health
or
medical
expenses.
House
File
2489,
p.
2
d.
“Diagnostic
breast
examination”
means
a
medically
necessary
and
appropriate
examination
of
the
breast
that
may
include
a
diagnostic
mammogram,
breast
magnetic
resonance
imaging,
breast
ultrasound,
or
other
breast
imaging,
and
that
is
performed
for
any
of
the
following
reasons:
(1)
To
evaluate
an
abnormality
seen
or
suspected
during
a
screening
examination
for
breast
cancer.
(2)
To
evaluate
an
abnormality
detected
by
another
means
of
examination.
e.
“Diagnostic
mammogram”
means
a
detailed
examination
of
a
breast
abnormality
using
X
ray.
f.
“Health
care
professional”
means
the
same
as
defined
in
section
514J.102.
g.
“Health
care
services”
means
services
for
the
diagnosis,
prevention,
treatment,
cure,
or
relief
of
a
health
condition,
illness,
injury,
or
disease.
h.
“Screening
mammogram”
means
an
examination
of
a
breast
that
aids
in
the
early
detection
and
diagnosis
of
breast
abnormalities
including
breast
cancer.
i.
“Supplemental
breast
examination”
means
a
medically
necessary
and
appropriate
examination
of
the
breast
that
may
include
breast
magnetic
resonance
imaging,
breast
ultrasound,
contrast-enhanced
mammography,
or
examination
for
dense
breast
tissue
as
described
by
the
breast
imaging
reporting
and
data
system
of
the
American
college
of
radiology,
and
that
is
performed
to
screen
for
breast
cancer
when
there
is
no
abnormality
seen
or
suspected
and
based
on
an
individual’s
personal
or
family
medical
history,
or
additional
factors
that
may
increase
the
individual’s
risk
of
breast
cancer.
2.
a.
Notwithstanding
the
uniformity
of
treatment
requirements
of
section
514C.6,
a
policy,
contract,
or
plan
providing
for
third-party
payment
or
prepayment
of
health
or
medical
expenses
shall
provide
coverage
for
supplemental
breast
examinations
and
diagnostic
breast
examinations.
b.
Coverage
required
under
this
section
shall
not
be
less
favorable
than
coverage
a
health
carrier
offers
for
screening
mammograms.
3.
a.
This
section
applies
to
the
following
classes
of
third-party
payment
provider
contracts,
policies,
or
plans
House
File
2489,
p.
3
delivered,
issued
for
delivery,
continued,
or
renewed
in
this
state
on
or
after
January
1,
2025:
(1)
Individual
or
group
accident
and
sickness
insurance
providing
coverage
on
an
expense-incurred
basis.
(2)
An
individual
or
group
hospital
or
medical
service
contract
issued
pursuant
to
chapter
509,
514,
or
514A.
(3)
An
individual
or
group
health
maintenance
organization
contract
regulated
under
chapter
514B.
(4)
A
plan
established
for
public
employees
pursuant
to
chapter
509A.
b.
This
section
shall
not
apply
to
accident-only,
specified
disease,
short-term
hospital
or
medical,
hospital
confinement
indemnity,
credit,
dental,
vision,
Medicare
supplement,
long-term
care,
basic
hospital
and
medical-surgical
expense
coverage
as
defined
by
the
commissioner
of
insurance,
disability
income
insurance
coverage,
coverage
issued
as
a
supplement
to
liability
insurance,
workers’
compensation
or
similar
insurance,
or
automobile
medical
payment
insurance.
4.
The
commissioner
of
insurance
may
adopt
rules
pursuant
to
chapter
17A
to
administer
this
section.
______________________________
PAT
GRASSLEY
Speaker
of
the
House
______________________________
AMY
SINCLAIR
President
of
the
Senate
I
hereby
certify
that
this
bill
originated
in
the
House
and
is
known
as
House
File
2489,
Ninetieth
General
Assembly.
______________________________
MEGHAN
NELSON
Chief
Clerk
of
the
House
Approved
_______________,
2024
______________________________
KIM
REYNOLDS
Governor
