Complete Bill History



House File 311       

                            AN ACT
REQUIRING HEALTH CARE BENEFIT COVERAGE FOR CERTAIN MEDICALLY
   NECESSARY PROSTHETIC DEVICES AND PROVIDING AN APPLICABILITY
   DATE.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

   Section 1.  NEW SECTION.  514C.24  COVERAGE FOR PROSTHETIC
DEVICES.
   1.  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 benefits for medically
necessary prosthetic devices when prescribed by a physician
licensed under chapter 148.  Such coverage benefits for
medically necessary prosthetic devices shall provide coverage
for medically necessary prosthetic devices, that at a minimum,
equals the coverage and payment for medically necessary
prosthetic devices provided under the most recent federal laws
for health insurance for the aged and disabled pursuant to 42
U.S.C. } 1395k, 13951, and 1395m, and 42 C.F.R. } 410.100,
414.202, 414.210, and 414.228, as applicable.  For the
purposes of this section, "prosthetic device" means an
artificial limb device to replace, in whole or in part, an arm
or leg.
   2.  a.  This section applies to the following classes of
third=party payment provider policies, contracts, or plans
delivered, issued for delivery, continued, or renewed in this
state on or after July 1, 2009:
   (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 pursuant to chapter 509A for public
employees.
   (5)  An organized delivery system licensed by the director
of public health.
   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,
disability income insurance coverage, coverage issued as a
supplement to liability insurance, workers' compensation or
similar insurance, or automobile medical payment insurance.
   3.  Notwithstanding subsection 1, a policy, contract, or
plan providing for third=party payment or prepayment of health
or medical expenses that is issued for use in connection with
a health savings account as authorized under Title XII of the
Medicare Prescription Drug, Improvement, and Modernization Act
of 2003, Pub. L. No. 108=173, may impose the same deductibles
and out=of=pocket limits on the prosthetics coverage benefits
required in this section that apply to substantially all
health, medical, and surgical coverage benefits under the
policy, contract, or plan.


                                                            
                              PATRICK J. MURPHY
                              Speaker of the House


                                                            
                              JOHN P. KIBBIE
                              President of the Senate

   I hereby certify that this bill originated in the House and
is known as House File 311, Eighty=third General Assembly.


                                                            
                              MARK BRANDSGARD
                              Chief Clerk of the House
Approved                , 2009


                           
CHESTER J. CULVER
Governor

                            -1-