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| 1 | 1 | House File 443 - Introduced HOUSE FILE 443 BY A. MEYER A BILL FOR An Act relating to health insurance coverage for assertive 1 community treatment services. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 1723YH (2) 91 nls/ko | |
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| 3 | 3 | H.F. 443 Section 1. NEW SECTION . 514C.37 Assertive community 1 treatment services coverage. 2 1. As used in this section, unless the context otherwise 3 requires: 4 a. Covered person means a policyholder, subscriber, 5 enrollee, or other individual participating in a health benefit 6 plan. 7 b. Dependent means a dependent of a covered person. 8 c. Health benefit plan means the same as defined in 9 section 510B.1. 10 2. Notwithstanding the uniformity of treatment requirements 11 of section 514C.6, a health benefit plan shall provide coverage 12 for assertive community treatment services for a dependent 13 who receives assertive community treatment services from an 14 assertive community treatment provider that is enrolled in, and 15 in good standing with, the medical assistance program under 16 chapter 249A. 17 3. a. This section applies to the following classes of 18 third-party payment provider contracts, policies, or plans 19 delivered, issued for delivery, continued, or renewed in this 20 state on or after January 1, 2026: 21 (1) Individual or group accident and sickness insurance 22 providing coverage on an expense-incurred basis. 23 (2) An individual or group hospital or medical service 24 contract issued pursuant to chapter 509, 514, or 514A. 25 (3) An individual or group health maintenance organization 26 contract regulated under chapter 514B. 27 (4) A plan established for public employees pursuant to 28 chapter 509A. 29 b. This section shall not apply to accident-only, specified 30 disease, short-term hospital or medical, hospital confinement 31 indemnity, credit, dental, vision, Medicare supplement, 32 long-term care, basic hospital and medical-surgical expense 33 coverage as defined by the commissioner of insurance, 34 disability income insurance coverage, coverage issued as a 35 -1- LSB 1723YH (2) 91 nls/ko 1/ 2 | |
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| 5 | 5 | H.F. 443 supplement to liability insurance, workers compensation or 1 similar insurance, or automobile medical payment insurance. 2 4. The commissioner of insurance may adopt rules pursuant to 3 chapter 17A to administer this section. 4 EXPLANATION 5 The inclusion of this explanation does not constitute agreement with 6 the explanations substance by the members of the general assembly. 7 This bill relates to insurance coverage for assertive 8 community treatment services. 9 The bill requires a health benefit plan to provide coverage 10 for assertive community treatment services for a dependent, as 11 defined in the bill, who receives services from an assertive 12 community treatment provider that is enrolled in, and in good 13 standing with, the medical assistance program under Code 14 chapter 249A. 15 The bill applies to third-party payment providers enumerated 16 in the bill. The bill specifies the types of specialized 17 health-related insurance which are not subject to the bill. 18 The commissioner of insurance may adopt rules to administer 19 the bill. 20 -2- LSB 1723YH (2) 91 nls/ko 2/ 2 |