Senate File 87 - Introduced SENATE FILE 87 BY DONAHUE A BILL FOR An Act relating to insurance coverage for acupuncture. 1 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 2 TLSB 2198SS (2) 91 nls/ko
S.F. 87 Section 1. Section 148E.9, Code 2025, is amended to read as 1 follows: 2 148E.9 Accident and health insurance coverage. 3 This chapter shall not be construed to require accident and 4 health insurance coverage for acupuncture services under an 5 existing or future contract or policy for insurance issued or 6 issued for delivery in this state, unless otherwise provided by 7 the contract or policy , or as required by section 514C.36 . 8 Sec. 2. NEW SECTION . 514C.37 Acupuncture coverage. 9 1. As used in this section, unless the context otherwise 10 requires: 11 a. Acupuncture means the same as defined in section 12 148E.1. 13 b. Acupuncturist means a person who is engaged in the 14 practice of acupuncture and who is licensed pursuant to section 15 148E.2. 16 c. Cost-sharing means any coverage limit, copayment, 17 coinsurance, deductible, or other out-of-pocket expense 18 obligation imposed on a covered person by a policy, contract, 19 or plan providing for third-party payment or prepayment of 20 health or medical expenses. 21 d. Covered person means a policyholder, subscriber, or 22 other person participating in a policy, contract, or plan that 23 provides for third-party payment or prepayment of health or 24 medical expenses. 25 e. Health carrier means the same as defined in section 26 514J.102. 27 f. Practice of acupuncture means the same as defined in 28 section 148E.1. 29 2. a. Notwithstanding the uniformity of treatment 30 requirements of section 514C.6, a health carrier that offers 31 individual, group, or small group contracts, policies, or 32 plans in this state that provide for third-party payment or 33 prepayment of health or medical expenses shall offer coverage 34 for acupuncture performed by an acupuncturist. 35 -1- LSB 2198SS (2) 91 nls/ko 1/ 3
S.F. 87 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, 2026: 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) A plan established for public employees pursuant to 18 chapter 509A. 19 b. This section shall not apply to accident-only, 20 specified disease, short-term hospital or medical, hospital 21 confinement indemnity, credit, dental, vision, Medicare 22 supplement, long-term care, basic hospital and medical-surgical 23 expense coverage as defined by the commissioner, disability 24 income insurance coverage, coverage issued as a supplement 25 to liability insurance, workers compensation or similar 26 insurance, or automobile medical payment insurance. 27 4. The commissioner of insurance may adopt rules pursuant to 28 chapter 17A to administer this section. 29 EXPLANATION 30 The inclusion of this explanation does not constitute agreement with 31 the explanations substance by the members of the general assembly. 32 This bill relates to insurance coverage for acupuncture. 33 Acupuncture is defined in the bill as a form of health 34 care developed from traditional and modern oriental medical 35 -2- LSB 2198SS (2) 91 nls/ko 2/ 3
S.F. 87 concepts that employs oriental medical diagnosis and treatment, 1 and adjunctive therapies and diagnostic techniques, for the 2 promotion, maintenance, and restoration of health and the 3 prevention of disease. 4 The bill requires a policy, contract, or plan providing 5 for third-party payment or prepayment of health or medical 6 expenses to offer coverage for acupuncture performed by an 7 acupuncturist. Acupuncturist is defined as a person who is 8 engaged in the practice of acupuncture and who is licensed 9 pursuant to Code section 148E.2. Practice of acupuncture is 10 also defined in the bill. Coverage required under the bill 11 shall not be less favorable than coverage a health carrier 12 offers for general physical illness. Cost-sharing requirements 13 imposed for coverage required under the bill shall not be 14 less favorable than cost-sharing requirements imposed by a 15 health carrier for general physical illness. Cost-sharing 16 is defined in the bill. 17 The bill applies to third-party payment providers enumerated 18 in the bill. The bill specifies the types of specialized 19 health-related insurance which are not subject to the bill. 20 The commissioner of insurance may adopt rules to administer 21 the bill. 22 The bill applies to third-party payment provider contracts, 23 policies, or plans delivered, issued for delivery, continued, 24 or renewed in this state on or after January 1, 2026. 25 The bill makes conforming changes to Code section 148E.9. 26 -3- LSB 2198SS (2) 91 nls/ko 3/ 3