Senate Study Bill 1060 - Introduced SENATE FILE _____ BY (PROPOSED COMMITTEE ON COMMERCE BILL BY CHAIRPERSON BOUSSELOT) A BILL FOR An Act relating to cost-sharing requirements for supplemental 1 and diagnostic breast examinations. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 2235XC (2) 91 nls/ko
S.F. _____ 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 shall not be imposed for 10 coverage required under this section. 11 Sec. 3. Section 514C.4A, subsection 3, Code 2025, is amended 12 by adding the following new paragraph: 13 NEW PARAGRAPH . c. If a covered persons policy, contract, 14 or plan providing for third-party payment or prepayment of 15 health or medical expenses qualifies as a high-deductible 16 health plan under section 223 of the Internal Revenue Code, 17 subsection 2, paragraph c , shall apply only after the covered 18 person satisfies the covered persons minimum deductible, 19 except for items or services determined to be preventive care 20 under section 223(c)(2)(C) of the Internal Revenue Code. 21 Sec. 4. 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 EXPLANATION 26 The inclusion of this explanation does not constitute agreement with 27 the explanations substance by the members of the general assembly. 28 This bill relates to cost-sharing requirements for 29 supplemental and diagnostic breast examinations. 30 Under the bill, a policy, contract, or plan providing for 31 third-party payment or prepayment of health or medical expenses 32 shall not impose cost-sharing requirements for required 33 coverage of supplemental and diagnostic breast examinations. 34 Cost-sharing is defined in the bill. If a covered persons 35 -1- LSB 2235XC (2) 91 nls/ko 1/ 2
S.F. _____ policy, contract, or plan qualifies as a high-deductible 1 health plan (HDHP) under section 223 of the Internal Revenue 2 Code (IRC), the cost-sharing prohibition shall apply only to 3 the covered persons qualified HDHP after the covered person 4 satisfies the covered persons minimum deductible, except 5 for items or services determined to be preventive care under 6 section 223(c)(2)(C) of the IRC. 7 The bill applies to third-party payment provider contracts, 8 policies, or plans delivered, issued for delivery, continued, 9 or renewed in this state on or after January 1, 2026. 10 -2- LSB 2235XC (2) 91 nls/ko 2/ 2