Bill Text: IA HF543 | 2019-2020 | 88th General Assembly | Introduced
Bill Title: A bill for an act relating to third-party payment of coverage benefits for mental health and disability regional core services.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2019-02-27 - Introduced, referred to Human Resources. H.J. 368. [HF543 Detail]
Download: Iowa-2019-HF543-Introduced.html
House
File
543
-
Introduced
HOUSE
FILE
543
BY
MASCHER
A
BILL
FOR
An
Act
relating
to
third-party
payment
of
coverage
benefits
for
1
mental
health
and
disability
regional
core
services.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
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543
Section
1.
NEW
SECTION
.
514C.35
Coverage
for
mental
health
1
and
disability
regional
core
services.
2
1.
Notwithstanding
the
uniformity
of
treatment
requirements
3
of
section
514C.6,
a
policy,
contract,
or
plan
providing
for
4
third-party
payment
or
prepayment
of
health
or
medical
expenses
5
shall
provide
coverage
benefits
for
medically
necessary
mental
6
health
and
disability
regional
core
services
pursuant
to
7
section
331.397.
8
2.
The
coverage
benefits
provided
pursuant
to
subsection
1
9
shall
be
based
on
rates,
terms,
and
conditions
that
are
no
more
10
restrictive
than
the
rates,
terms,
and
conditions
for
coverage
11
benefits
provided
for
other
health
or
medical
conditions
under
12
the
policy,
contract,
or
plan.
In
addition,
any
rates,
terms,
13
and
conditions
involving
deductibles,
copayments,
coinsurance,
14
and
any
other
cost-sharing
requirements
shall
be
cumulative
15
for
coverage
of
both
the
mental
health
and
disability
regional
16
core
services
and
other
health
or
medical
conditions
under
the
17
policy,
contract,
or
plan.
18
3.
This
section
applies
to
the
following
classes
of
19
third-party
payment
provider
policies,
contracts,
or
plans
20
delivered,
issued
for
delivery,
continued,
or
renewed
in
this
21
state
on
or
after
January
1,
2020:
22
a.
Individual
or
group
accident
and
sickness
insurance
23
providing
coverage
on
an
expense-incurred
basis.
24
b.
An
individual
or
group
hospital
or
medical
service
25
contract
issued
pursuant
to
chapter
509,
514,
or
514A.
26
c.
An
individual
or
group
health
maintenance
organization
27
contract
regulated
under
chapter
514B.
28
d.
A
plan
established
pursuant
to
chapter
509A
for
public
29
employees.
30
4.
This
section
shall
not
apply
to
accident-only,
31
specified
disease,
short-term
hospital
or
medical,
hospital
32
confinement
indemnity,
credit,
dental,
vision,
Medicare
33
supplement,
long-term
care,
basic
hospital
and
medical-surgical
34
expense
coverage
as
defined
by
the
commissioner,
disability
35
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3
H.F.
543
income
insurance
coverage,
coverage
issued
as
a
supplement
1
to
liability
insurance,
workers’
compensation
or
similar
2
insurance,
or
automobile
medical
payment
insurance.
3
5.
The
commissioner
of
insurance
shall
adopt
rules
pursuant
4
to
chapter
17A
as
necessary
to
administer
this
section.
5
EXPLANATION
6
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
7
the
explanation’s
substance
by
the
members
of
the
general
assembly.
8
This
bill
relates
to
third-party
payment
of
coverage
9
benefits
for
mental
health
and
disability
regional
core
10
services.
11
The
bill
requires
a
policy,
contract,
or
plan
providing
for
12
third-party
payment
or
prepayment
of
health
or
medical
expenses
13
to
provide
coverage
benefits
for
medically
necessary
mental
14
health
and
disability
regional
core
services
pursuant
to
Code
15
section
331.397.
16
The
coverage
benefits
must
be
based
on
rates,
terms,
and
17
conditions
that
are
no
more
restrictive
than
those
for
coverage
18
benefits
provided
for
other
health
or
medical
conditions
under
19
the
policy,
contract,
or
plan.
Any
deductibles,
copayments,
20
coinsurance,
and
any
other
cost-sharing
requirements
shall
21
be
cumulative
for
coverage
of
both
the
mental
health
and
22
disability
regional
core
services
and
other
health
or
medical
23
conditions
under
the
policy,
contract,
or
plan.
24
The
bill
is
applicable
to
third-party
payment
provider
25
policies,
contracts,
or
plans
delivered,
issued
for
delivery,
26
continued,
or
renewed
in
this
state
on
or
after
January
1,
27
2020,
including
individual
or
group
accident
and
sickness
28
insurance
providing
coverage
on
an
expense-incurred
basis,
an
29
individual
or
group
hospital
or
medical
service
contract
issued
30
pursuant
to
Code
chapter
509,
514,
or
514A,
an
individual
or
31
group
health
maintenance
organization
contract
regulated
under
32
Code
chapter
514B,
and
a
plan
established
pursuant
to
Code
33
chapter
509A
for
public
employees.
34
The
bill
does
not
apply
to
accident-only,
specified
disease,
35
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2147YH
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88
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2/
3
H.F.
543
short-term
hospital
or
medical,
hospital
confinement
indemnity,
1
credit,
dental,
vision,
Medicare
supplement,
long-term
care,
2
basic
hospital
and
medical-surgical
expense
coverage
as
defined
3
by
the
commissioner,
disability
income
insurance
coverage,
4
coverage
issued
as
a
supplement
to
liability
insurance,
5
workers’
compensation
or
similar
insurance,
or
automobile
6
medical
payment
insurance.
7
The
commissioner
of
insurance
shall
adopt
rules
as
necessary
8
to
administer
the
requirements
of
the
bill.
9
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2147YH
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3/
3
