Senate File 374 - Introduced
SENATE FILE 374
BY QUIRMBACH
A BILL FOR
1 An Act relating to dialysis services provided under an Iowa
2 comprehensive health insurance association policy.
3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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 S.F. 374
1 Section 1. Section 514E.1, Code 2023, is amended by adding
2 the following new subsection:
3 NEW SUBSECTION. 5A. “Cost-sharing” means any coverage
4 limit, copayment, coinsurance, deductible, or other
5 out-of-pocket expense obligation.
6 Sec. 2. NEW SECTION. 514E.12 Health care services ——
7 payments.
8 On or after January 1, 2024, a provider of dialysis services
9 shall accept as payment in full from the association, for the
10 provision of health care services to an insured, an amount
11 equal to the amount that Medicare pays a provider of dialysis
12 services for provision of the same health care services. An
13 insured shall be responsible only for any cost-sharing imposed
14 on the insured by the insured’s association policy for the
15 health care services.
16 EXPLANATION
17 The inclusion of this explanation does not constitute agreement with
18 the explanation’s substance by the members of the general assembly.
19 This bill relates to health insurance provided under an
20 Iowa comprehensive health insurance association policy. The
21 bill requires a provider of dialysis services (provider)
22 to accept as payment in full from the association, for the
23 provision of health care services (services) to an insured, an
24 amount equal to the amount that Medicare pays a provider for
25 provision of the same services. An insured is only responsible
26 for any cost-sharing imposed on the insured by the insured’s
27 association policy. This applies to services provided by a
28 provider to an insured on or after January 1, 2024.
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Statutes affected:
Introduced: 514E.1