Bill Text: IA SF290 | 2023-2024 | 90th General Assembly | Introduced


Bill Title: A bill for an act relating to insurance coverage for health care services related to the prevention of ovarian cancer.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced) 2023-02-23 - Subcommittee recommends passage. []. [SF290 Detail]

Download: Iowa-2023-SF290-Introduced.html
Senate File 290 - Introduced SENATE FILE 290 BY SWEENEY A BILL FOR An Act relating to insurance coverage for health care services 1 related to the prevention of ovarian cancer. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 2147XS (3) 90 ko/rn
S.F. 290 Section 1. SHORT TITLE. This Act shall be known as 1 “Barbara’s Bill”. 2 Sec. 2. NEW SECTION . 514C.36 Ovarian cancer prevention —— 3 coverage. 4 1. As used in this section, unless the context otherwise 5 requires: 6 a. “At risk for ovarian cancer” means any of the following: 7 (1) A family history that includes any of the following: 8 (a) One or more first degree relatives that have had ovarian 9 cancer. 10 (b) Clusters of female relatives that have had breast 11 cancer. 12 (c) Nonpolyposis colorectal cancer. 13 (2) Testing positive for either the BRCA1 or BRCA2 mutation. 14 b. “Cost-sharing” means any coverage limit, copayment, 15 coinsurance, deductible, or other out-of-pocket expense 16 obligation imposed on a covered person by a policy, contract, 17 or plan providing for third-party payment or prepayment of 18 health or medical expenses. 19 c. “Covered person” means a policyholder, subscriber, or 20 other person participating in a policy, contract, or plan that 21 provides for third-party payment or prepayment of health or 22 medical expenses. 23 d. “Health carrier” means the same as defined in section 24 514J.102. 25 e. “Surveillance testing for ovarian cancer” means 26 annual screening using CA 125 blood testing, a transvaginal 27 ultrasound, and a pelvic examination. 28 2. a. Notwithstanding the uniformity of treatment 29 requirements of section 514C.6, a health carrier that offers 30 individual, group, or small group contracts, policies, or 31 plans in this state that provide for third-party payment or 32 prepayment of health or medical expenses shall offer coverage 33 for all of the following: 34 (1) An annual cervical smear test or pap smear test. 35 -1- LSB 2147XS (3) 90 ko/rn 1/ 3
S.F. 290 (2) Surveillance testing for ovarian cancer for covered 1 persons at risk for ovarian cancer. 2 b. Coverage required under this section shall not be less 3 favorable than coverage a health carrier offers for general 4 physical illness. 5 c. Cost-sharing requirements imposed for coverage 6 required under this section shall not be less favorable than 7 cost-sharing requirements imposed by a health carrier for 8 general physical illness. 9 3. a. This section shall apply to the following classes 10 of third-party payment provider contracts, policies, or plans 11 delivered, issued for delivery, continued, or renewed in this 12 state on or after January 1, 2024: 13 (1) Individual or group accident and sickness insurance 14 providing coverage on an expense-incurred basis. 15 (2) An individual or group hospital or medical service 16 contract issued pursuant to chapter 509, 514, or 514A. 17 (3) An individual or group health maintenance organization 18 contract regulated under chapter 514B. 19 (4) An individual or group Medicare supplement policy, 20 unless coverage under this section is preempted by federal law. 21 (5) A plan established for public employees pursuant to 22 chapter 509A. 23 b. This section shall not apply to accident-only, specified 24 disease, short-term hospital or medical, hospital confinement 25 indemnity, credit, dental, vision, long-term care, basic 26 hospital and medical-surgical expense coverage as defined 27 by the commissioner, disability income insurance coverage, 28 coverage issued as a supplement to liability insurance, 29 workers’ compensation or similar insurance, or automobile 30 medical payment insurance. 31 4. The commissioner of insurance shall adopt rules pursuant 32 to chapter 17A to administer this section. 33 EXPLANATION 34 The inclusion of this explanation does not constitute agreement with 35 -2- LSB 2147XS (3) 90 ko/rn 2/ 3
S.F. 290 the explanation’s substance by the members of the general assembly. 1 This bill relates to insurance coverage for health care 2 services related to the prevention of ovarian cancer, and shall 3 be known as “Barbara’s Bill”. 4 The bill requires a policy, contract, or plan providing for 5 third-party payment or prepayment of health or medical expenses 6 to provide coverage for an annual cervical smear test or pap 7 smear test, and for surveillance testing for ovarian cancer 8 for covered persons at risk for ovarian cancer. “Surveillance 9 testing for ovarian cancer” is defined in the bill as 10 annual screening using CA 125 blood testing, a transvaginal 11 ultrasound, and a pelvic examination. “At risk for ovarian 12 cancer” is defined as a family history that includes one or 13 more first degree relatives that have had ovarian cancer, 14 clusters of female relatives that have had breast cancer or 15 nonpolyposis colorectal cancer; or testing positive for either 16 the BRCA1 or BRCA2 mutation. 17 Coverage required under the bill shall not be less favorable 18 than coverage a health carrier offers for general physical 19 illness. Cost-sharing requirements imposed for coverage 20 required under the bill shall not be less favorable than 21 cost-sharing requirements imposed by a health carrier for 22 general physical illness. 23 The bill applies to third-party payment providers enumerated 24 in the bill. The bill specifies the types of specialized 25 health-related insurance which are not subject to the bill. 26 The commissioner of insurance is required to adopt rules to 27 administer the bill. 28 The bill applies to third-party payment provider contracts, 29 policies, or plans delivered, issued for delivery, continued, 30 or renewed in this state on or after January 1, 2024. 31 -3- LSB 2147XS (3) 90 ko/rn 3/ 3
feedback