Bill Text: IA SSB3177 | 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: Committee Bill
Status: (N/A - Dead) 2018-02-14 - Subcommittee recommends passage. [SSB3177 Detail]
Download: Iowa-2017-SSB3177-Introduced.html
Senate
Study
Bill
3177
-
Introduced
SENATE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
HUMAN
RESOURCES
BILL
BY
CHAIRPERSON
SEGEBART)
A
BILL
FOR
An
Act
relating
to
health
insurance
coverage
for
mammograms
and
1
including
effective
date
and
applicability
provisions.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
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Section
1.
Section
514C.4,
Code
2018,
is
amended
to
read
as
1
follows:
2
514C.4
Mandated
coverage
for
mammography.
3
1.
As
used
in
this
section:
4
a.
“Health
care
professional”
means
a
health
care
5
practitioner
licensed,
accredited,
registered,
or
certified
6
consistent
with
state
law
to
recommend
the
performance
of
a
7
mammogram.
8
b.
“Mammogram”
means
a
radiographic
image
obtained
using
a
9
procedure,
including
two-dimensional
mammography
or
three-
10
dimensional
mammography,
as
recommended
by
a
woman’s
health
11
care
professional.
12
1.
2.
a.
A
policy
or
contract
providing
for
third-party
13
payment
or
prepayment
of
health
or
medical
expenses
shall
14
provide
minimum
mammography
examination
coverage,
including,
15
but
not
limited
to,
the
following
classes
of
third-party
16
payment
provider
contracts
or
policies
delivered,
issued
for
17
delivery,
continued,
or
renewed
in
this
state.
18
(1)
Individual
or
group
accident
and
sickness
insurance
19
providing
coverage
on
an
expense-incurred
basis.
20
(2)
An
individual
or
group
hospital
or
medical
service
21
contract
issued
pursuant
to
chapter
509
,
514
,
or
514A
.
22
(3)
An
individual
or
group
health
maintenance
organization
23
contract
regulated
under
chapter
514B
.
24
(4)
An
individual
or
group
Medicare
supplemental
policy,
25
unless
coverage
pursuant
to
such
policy
is
preempted
by
federal
26
law.
27
b.
A
long-term
care
policy
or
contract
is
specifically
28
excluded
from
regulation
under
this
section
.
29
2.
3.
As
used
in
this
section
,
“minimum
mammography
30
examination
coverage”
means
benefits
which
are
better
than
or
31
equal
to
the
following
minimum
requirements:
32
a.
One
baseline
mammogram
for
any
woman
who
is
thirty-five
33
through
thirty-nine
years
of
age,
or
more
frequent
mammograms
34
if
recommended
by
the
woman’s
physician
health
care
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professional
.
1
b.
A
mammogram
every
two
years
for
any
woman
who
is
2
forty
through
forty-nine
years
of
age,
or
more
frequently
if
3
recommended
by
the
woman’s
physician.
4
c.
b.
A
mammogram
every
year
for
any
woman
who
is
fifty
5
forty
years
of
age
or
older,
or
more
frequently
if
recommended
6
by
the
woman’s
physician
health
care
professional
.
7
3.
4.
Mammogram
benefits
may
be
subject
to
any
policy
or
8
contract
provisions
which
apply
generally
to
other
services
9
covered
by
the
policy
or
contract.
10
4.
5.
The
commissioner
of
insurance
shall
adopt
rules
under
11
chapter
17A
necessary
to
implement
this
section
.
12
Sec.
2.
EFFECTIVE
DATE.
This
Act,
being
deemed
of
immediate
13
importance,
takes
effect
upon
enactment.
14
Sec.
3.
APPLICABILITY.
This
Act
applies
to
the
classes
of
15
third-party
payment
provider
contracts
or
policies
specified
16
in
section
514C.4,
as
amended
by
this
Act,
that
are
delivered,
17
issued
for
delivery,
continued,
or
renewed
in
this
state
on
or
18
after
July
1,
2018.
19
EXPLANATION
20
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
21
the
explanation’s
substance
by
the
members
of
the
general
assembly.
22
This
bill
relates
to
insurance
coverage
for
a
mammogram
as
23
recommended
by
a
woman’s
health
care
professional.
24
The
bill
defines
“mammogram”
as
a
radiographic
image
25
obtained
using
a
procedure,
including
two-dimensional
26
mammography
or
three-dimensional
mammography,
as
recommended
27
by
a
woman’s
health
care
professional.
Currently,
insurance
28
coverage
is
required
for
one
mammogram
every
two
years
for
29
women
age
40
through
49.
The
bill
changes
this
to
require
30
insurance
coverage
for
an
annual
mammogram
for
women
age
40
and
31
over.
The
bill
requires
that
the
insurance
coverage
apply
to
32
two-dimensional
mammograms
and
three-dimensional
mammograms.
33
The
bill
also
allows
a
woman’s
health
care
professional,
34
defined
to
include
licensed,
accredited,
registered,
or
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certified
health
care
practitioners,
to
recommend
a
mammogram.
1
Currently,
a
woman’s
physician
must
recommend
the
performance
2
of
a
mammogram.
3
The
bill
applies
to
the
classes
of
third-party
payment
4
provider
contracts
or
policies
specified
in
Code
section
514C.4
5
that
are
delivered,
issued
for
delivery,
continued,
or
renewed
6
in
this
state
on
or
after
July
1,
2018.
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