| 3 | | - | H.F. 318 Section 1. Section 514C.4A, subsection 1, Code 2025, is 1 amended by adding the following new paragraph: 2 NEW PARAGRAPH . 0c. Cost-sharing means any coverage limit, 3 copayment, coinsurance, deductible, or other out-of-pocket cost 4 obligation imposed by a policy, contract, or plan providing for 5 third-party payment or prepayment of health or medical expenses 6 on a covered person. 7 Sec. 2. Section 514C.4A, subsection 2, Code 2025, is amended 8 by adding the following new paragraph: 9 NEW PARAGRAPH . c. (1) Cost-sharing requirements imposed 10 for coverage required under this section shall not be less 11 favorable than cost-sharing requirements imposed by a health 12 carrier for screening mammograms. 13 (2) If a covered persons policy, contract, or plan 14 providing for third-party payment or prepayment of health or 15 medical expenses qualifies as a high-deductible health plan 16 under section 223 of the Internal Revenue Code, subparagraph 17 (1) shall apply only after the covered person satisfies 18 the covered persons minimum deductible, except for items 19 or services determined to be preventive care under section 20 223(2)(2)(C) of the Internal Revenue Code. 21 Sec. 3. APPLICABILITY. This Act applies to third-party 22 payment provider contracts, policies, or plans delivered, 23 issued for delivery, continued, or renewed in this state on or 24 after January 1, 2026. 25 -1- HF 318 (2) 91 nls/ko/md 1/ 1 |
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| 3 | + | H.F. 318 Section 1. Section 514C.4A, subsection 1, Code 2025, is 1 amended by adding the following new paragraph: 2 NEW PARAGRAPH . 0c. Cost-sharing means any coverage limit, 3 copayment, coinsurance, deductible, or other out-of-pocket cost 4 obligation imposed by a policy, contract, or plan providing for 5 third-party payment or prepayment of health or medical expenses 6 on a covered person. 7 Sec. 2. Section 514C.4A, subsection 2, Code 2025, is amended 8 by adding the following new paragraph: 9 NEW PARAGRAPH . c. Cost-sharing requirements imposed 10 for coverage required under this section shall not be less 11 favorable than cost-sharing requirements imposed by a health 12 carrier for screening mammograms. 13 Sec. 3. APPLICABILITY. This Act applies to third-party 14 payment provider contracts, policies, or plans delivered, 15 issued for delivery, continued, or renewed in this state on or 16 after January 1, 2026. 17 EXPLANATION 18 The inclusion of this explanation does not constitute agreement with 19 the explanations substance by the members of the general assembly. 20 This bill relates to cost-sharing requirements for 21 supplemental and diagnostic breast examinations. 22 Under the bill, a policy, contract, or plan providing for 23 third-party payment or prepayment of health or medical expenses 24 shall not impose cost-sharing requirements for required 25 coverage of supplemental and diagnostic breast examinations 26 that is less favorable than cost-sharing requirements imposed 27 for screening mammograms. 28 Cost-sharing is defined in the bill. The bill applies 29 to third-party payment provider contracts, policies, or plans 30 delivered, issued for delivery, continued, or renewed in this 31 state on or after January 1, 2026. 32 -1- LSB 2394HV (1) 91 nls/ko 1/ 1 |
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