Bill Text: IA SSB3078 | 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.(See SF 2363.)
Spectrum: Committee Bill
Status: (Introduced - Dead) 2024-02-14 - Committee report approving bill, renumbered as SF 2363. [SSB3078 Detail]
Download: Iowa-2023-SSB3078-Introduced.html
Senate
Study
Bill
3078
-
Introduced
SENATE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
COMMERCE
BILL
BY
CHAIRPERSON
BROWN)
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
5499XC
(4)
90
nls/ko
S.F.
_____
Section
1.
NEW
SECTION
.
514C.36
Ovarian
cancer
prevention
1
——
coverage.
2
1.
As
used
in
this
section,
unless
the
context
otherwise
3
requires:
4
a.
“At
risk
for
ovarian
cancer”
means
any
of
the
following:
5
(1)
A
family
history
that
includes
any
of
the
following:
6
(a)
One
or
more
first
degree
relatives
that
have
had
ovarian
7
cancer.
8
(b)
Clusters
of
female
relatives
that
have
had
breast
9
cancer.
10
(c)
Nonpolyposis
colorectal
cancer.
11
(2)
Testing
positive
for
either
the
BRCA1
or
BRCA2
mutation.
12
b.
“Cost-sharing”
means
any
coverage
limit,
copayment,
13
coinsurance,
deductible,
or
other
out-of-pocket
expense
14
obligation
imposed
on
a
covered
person
by
a
policy,
contract,
15
or
plan
providing
for
third-party
payment
or
prepayment
of
16
health
or
medical
expenses.
17
c.
“Covered
person”
means
a
policyholder,
subscriber,
or
18
other
person
participating
in
a
policy,
contract,
or
plan
that
19
provides
for
third-party
payment
or
prepayment
of
health
or
20
medical
expenses.
21
d.
“Health
carrier”
means
the
same
as
defined
in
section
22
514J.102.
23
e.
“Surveillance
testing
for
ovarian
cancer”
means
24
annual
screening
using
CA
125
blood
testing,
a
transvaginal
25
ultrasound,
and
a
pelvic
examination.
26
2.
a.
Notwithstanding
the
uniformity
of
treatment
27
requirements
of
section
514C.6,
a
health
carrier
that
offers
28
individual,
group,
or
small
group
contracts,
policies,
or
29
plans
in
this
state
that
provide
for
third-party
payment
or
30
prepayment
of
health
or
medical
expenses
shall
offer
coverage
31
for
all
of
the
following:
32
(1)
An
annual
cervical
smear
test
or
pap
smear
test.
33
(2)
Surveillance
testing
for
ovarian
cancer
for
covered
34
persons
at
risk
for
ovarian
cancer.
35
-1-
LSB
5499XC
(4)
90
nls/ko
1/
3
S.F.
_____
b.
Coverage
required
under
this
section
shall
not
be
less
1
favorable
than
coverage
a
health
carrier
offers
for
general
2
physical
illness.
3
c.
Cost-sharing
requirements
imposed
for
coverage
4
required
under
this
section
shall
not
be
less
favorable
than
5
cost-sharing
requirements
imposed
by
a
health
carrier
for
6
general
physical
illness.
7
3.
a.
This
section
shall
apply
to
the
following
classes
8
of
third-party
payment
provider
contracts,
policies,
or
plans
9
delivered,
issued
for
delivery,
continued,
or
renewed
in
this
10
state
on
or
after
January
1,
2025:
11
(1)
Individual
or
group
accident
and
sickness
insurance
12
providing
coverage
on
an
expense-incurred
basis.
13
(2)
An
individual
or
group
hospital
or
medical
service
14
contract
issued
pursuant
to
chapter
509,
514,
or
514A.
15
(3)
An
individual
or
group
health
maintenance
organization
16
contract
regulated
under
chapter
514B.
17
(4)
An
individual
or
group
Medicare
supplement
policy,
18
unless
coverage
under
this
section
is
preempted
by
federal
law.
19
(5)
A
plan
established
for
public
employees
pursuant
to
20
chapter
509A.
21
b.
This
section
shall
not
apply
to
accident-only,
specified
22
disease,
short-term
hospital
or
medical,
hospital
confinement
23
indemnity,
credit,
dental,
vision,
long-term
care,
basic
24
hospital
and
medical-surgical
expense
coverage
as
defined
25
by
the
commissioner,
disability
income
insurance
coverage,
26
coverage
issued
as
a
supplement
to
liability
insurance,
27
workers’
compensation
or
similar
insurance,
or
automobile
28
medical
payment
insurance.
29
4.
The
commissioner
of
insurance
shall
adopt
rules
pursuant
30
to
chapter
17A
to
administer
this
section.
31
EXPLANATION
32
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
33
the
explanation’s
substance
by
the
members
of
the
general
assembly.
34
This
bill
relates
to
insurance
coverage
for
health
care
35
-2-
LSB
5499XC
(4)
90
nls/ko
2/
3
S.F.
_____
services
related
to
the
prevention
of
ovarian
cancer.
1
The
bill
requires
a
policy,
contract,
or
plan
providing
for
2
third-party
payment
or
prepayment
of
health
or
medical
expenses
3
to
provide
coverage
for
an
annual
cervical
smear
test
or
pap
4
smear
test,
and
for
surveillance
testing
for
ovarian
cancer
5
for
covered
persons
at
risk
for
ovarian
cancer.
“Surveillance
6
testing
for
ovarian
cancer”
is
defined
in
the
bill
as
7
annual
screening
using
CA
125
blood
testing,
a
transvaginal
8
ultrasound,
and
a
pelvic
examination.
“At
risk
for
ovarian
9
cancer”
is
defined
as
a
family
history
that
includes
one
or
10
more
first
degree
relatives
that
have
had
ovarian
cancer,
11
clusters
of
female
relatives
that
have
had
breast
cancer
or
12
nonpolyposis
colorectal
cancer;
or
testing
positive
for
either
13
the
BRCA1
or
BRCA2
mutation.
14
Coverage
required
under
the
bill
shall
not
be
less
favorable
15
than
coverage
a
health
carrier
offers
for
general
physical
16
illness.
Cost-sharing
requirements
imposed
for
coverage
17
required
under
the
bill
shall
not
be
less
favorable
than
18
cost-sharing
requirements
imposed
by
a
health
carrier
for
19
general
physical
illness.
20
The
bill
applies
to
third-party
payment
providers
enumerated
21
in
the
bill.
The
bill
specifies
the
types
of
specialized
22
health-related
insurance
which
are
not
subject
to
the
bill.
23
The
commissioner
of
insurance
is
required
to
adopt
rules
to
24
administer
the
bill.
25
The
bill
applies
to
third-party
payment
provider
contracts,
26
policies,
or
plans
delivered,
issued
for
delivery,
continued,
27
or
renewed
in
this
state
on
or
after
January
1,
2025.
28
-3-
LSB
5499XC
(4)
90
nls/ko
3/
3
