Bill Text: IA HF333 | 2021-2022 | 89th General Assembly | Introduced
Bill Title: A bill for an act relating to health care coverage benefits for the diagnosis and treatment of infertility, and for fertility preservation services, and including applicability provisions.
Spectrum: Partisan Bill (Democrat 13-0)
Status: (Introduced - Dead) 2021-02-02 - Introduced, referred to Commerce. H.J. 275. [HF333 Detail]
Download: Iowa-2021-HF333-Introduced.html
House
File
333
-
Introduced
HOUSE
FILE
333
BY
STECKMAN
,
ANDERSON
,
McCONKEY
,
SUNDE
,
WINCKLER
,
EHLERT
,
B.
MEYER
,
DONAHUE
,
WESSEL-KROESCHELL
,
ABDUL-SAMAD
,
HUNTER
,
BROWN-POWERS
,
and
KONFRST
A
BILL
FOR
An
Act
relating
to
health
care
coverage
benefits
for
the
1
diagnosis
and
treatment
of
infertility,
and
for
fertility
2
preservation
services,
and
including
applicability
3
provisions.
4
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
5
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Section
1.
NEW
SECTION
.
514C.36
Infertility.
1
1.
As
used
in
this
section,
unless
the
context
otherwise
2
requires:
3
a.
“Cost-sharing”
means
any
coverage
limit,
copayment,
4
coinsurance,
deductible,
or
other
out-of-pocket
expense
5
obligation
imposed
on
a
covered
person
by
a
policy,
contract,
6
or
plan
providing
for
third-party
payment
or
prepayment
of
7
health
or
medical
expenses.
8
b.
“Covered
person”
means
a
policyholder,
subscriber,
or
9
other
person
participating
in
a
policy,
contract,
or
plan
that
10
provides
for
third-party
payment
or
prepayment
of
health
or
11
medical
expenses.
12
c.
“Diagnosis
and
treatment
for
infertility”
means
health
13
care
services
or
prescription
drugs
recommended
by
an
14
individual’s
health
care
professional
and
that
are
consistent
15
with
the
established
medical
practices
or
published
guidelines
16
of
the
American
college
of
obstetricians
and
gynecologists,
17
or
of
the
American
society
for
reproductive
medicine,
for
the
18
diagnosis
and
treatment
of
infertility.
19
d.
“Fertility
preservation
services”
means
health
20
care
services
recommended
by
an
individual’s
health
care
21
professional
and
that
are
consistent
with
the
established
22
medical
practices
or
published
guidelines
of
the
American
23
society
for
reproductive
medicine,
or
of
the
American
society
24
of
clinical
oncology,
for
the
treatment
of
an
individual
who
25
has
a
medical
condition
or
is
expected
to
undergo
medication
26
therapy,
surgery,
radiation,
chemotherapy,
or
other
medical
27
treatment
that
creates
a
risk
of
impairment
of
the
individual’s
28
fertility.
29
e.
“Health
care
professional”
means
the
same
as
defined
in
30
section
514J.102.
31
f.
“Health
care
services”
means
services
for
the
diagnosis,
32
prevention,
treatment,
cure,
or
relief
of
a
health
condition,
33
illness,
injury,
or
disease.
34
g.
“Infertility”
means
a
health
condition,
illness,
injury,
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or
disease
characterized
by
any
of
the
following:
1
(1)
The
failure
to
establish
a
pregnancy
or
to
carry
a
2
pregnancy
to
live
birth
after
regular,
unprotected
sexual
3
intercourse.
4
(2)
The
inability
of
an
individual
to
reproduce
without
5
medical
intervention
either
as
a
single
individual
or
with
a
6
partner.
7
(3)
A
health
care
professional’s
diagnosis
based
on
an
8
individual’s
sex,
age,
medical
history,
sexual
history,
or
9
reproductive
history;
or
a
physical
examination
or
diagnostic
10
testing.
11
2.
Notwithstanding
the
uniformity
of
treatment
requirements
12
of
section
514C.6,
a
policy,
contract,
or
plan
providing
for
13
third-party
payment
or
prepayment
of
health
or
medical
expenses
14
shall
provide
coverage
for
the
diagnosis
and
treatment
of
15
infertility,
and
for
fertility
preservation
services.
16
3.
Coverage
shall
not
be
subject
to
cost-sharing,
17
waiting
periods,
or
exclusions
that
are
different
than
the
18
cost-sharing,
waiting
periods,
or
exclusions
that
a
policy,
19
contract,
or
plan
imposes
for
other
health
or
medical
expenses
20
covered
under
the
policy,
contract,
or
plan.
21
4.
a.
This
section
shall
apply
to
the
following
classes
of
22
third-party
payment
provider
contracts,
policies,
or
plans:
23
(1)
Individual
or
group
accident
and
sickness
insurance
24
providing
coverage
on
an
expense-incurred
basis.
25
(2)
An
individual
or
group
hospital
or
medical
service
26
contract
issued
pursuant
to
chapter
509,
514,
or
514A.
27
(3)
An
individual
or
group
health
maintenance
organization
28
contract
regulated
under
chapter
514B.
29
(4)
A
plan
established
for
public
employees
pursuant
to
30
chapter
509A.
31
(5)
The
medical
assistance
program
established
pursuant
32
to
chapter
249A,
including
a
managed
care
organization
acting
33
pursuant
to
a
contract
with
the
department
of
human
services
to
34
provide
coverage
to
medical
assistance
program
members.
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b.
This
section
shall
not
apply
to
accident-only,
specified
1
disease,
short-term
hospital
or
medical,
hospital
confinement
2
indemnity,
credit,
dental,
vision,
Medicare
supplement,
3
long-term
care,
basic
hospital
and
medical-surgical
expense
4
coverage
as
defined
by
the
commissioner
of
insurance,
5
disability
income
insurance
coverage,
coverage
issued
as
a
6
supplement
to
liability
insurance,
workers’
compensation
or
7
similar
insurance,
or
automobile
medical
payment
insurance.
8
5.
The
commissioner
of
insurance
shall
adopt
rules
pursuant
9
to
chapter
17A
to
administer
this
section.
10
Sec.
2.
APPLICABILITY.
This
Act
applies
to
third-party
11
payment
provider
contracts,
policies,
or
plans
delivered,
12
issued
for
delivery,
continued,
or
renewed
in
this
state
on
or
13
after
January
1,
2022.
14
EXPLANATION
15
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
16
the
explanation’s
substance
by
the
members
of
the
general
assembly.
17
This
bill
relates
to
health
care
coverage
benefits
for
the
18
diagnosis
and
treatment
of
infertility,
and
for
fertility
19
preservation
services.
20
The
bill
defines
“infertility”
as
a
health
condition,
21
illness,
injury,
or
disease
characterized
by
the
failure
to
22
establish
a
pregnancy
or
to
carry
a
pregnancy
to
live
birth
23
after
regular,
unprotected
sexual
intercourse;
or
the
inability
24
of
an
individual
to
reproduce
without
medical
intervention
25
either
as
a
single
individual
or
with
a
partner;
or
a
health
26
care
professional’s
diagnosis
based
on
a
covered
person’s
sex,
27
age,
medical
history,
sexual
history,
or
reproductive
history;
28
or
a
physical
examination
or
diagnostic
testing.
29
The
bill
defines
“diagnosis
and
treatment
for
infertility”
30
as
health
care
services
or
prescription
drugs
recommended
by
an
31
individual’s
health
care
professional
and
that
are
consistent
32
with
the
established
medical
practices
or
published
guidelines
33
of
the
American
college
of
obstetricians
and
gynecologists,
34
or
of
the
American
society
for
reproductive
medicine,
for
35
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333
the
diagnosis
and
treatment
of
infertility.
“Health
care
1
professional”
is
defined
in
the
bill.
2
“Fertility
preservation
services”
is
defined
in
the
bill
3
as
health
care
services
recommended
by
a
individual’s
health
4
care
professional
and
that
are
consistent
with
the
established
5
medical
practices
or
published
guidelines
of
the
American
6
society
for
reproductive
medicine,
or
of
the
American
society
7
of
clinical
oncology,
for
the
treatment
of
an
individual
who
8
has
a
medical
condition
or
is
expected
to
undergo
medication
9
therapy,
surgery,
radiation,
chemotherapy,
or
other
medical
10
treatment
that
creates
a
risk
of
impairment
of
the
individual’s
11
fertility.
12
The
bill
requires
a
health
carrier
that
offers
individual,
13
group,
or
small
group
contracts,
policies,
or
plans
in
this
14
state
that
provide
for
third-party
payment
or
prepayment
15
of
health
or
medical
expenses
to
provide
coverage
for
the
16
diagnosis
and
treatment
of
infertility,
and
for
fertility
17
preservation
services.
The
coverage
cannot
be
subject
to
18
cost-sharing,
waiting
periods,
or
exclusions
that
are
different
19
than
the
cost-sharing,
waiting
periods,
or
exclusions
that
the
20
policy,
contract,
or
plan
imposes
for
other
covered
health
or
21
medical
expenses.
22
The
bill
applies
to
the
third-party
payment
providers
23
enumerated
in
the
bill.
The
bill
specifies
the
types
of
24
specialized
health-related
insurance
which
are
not
subject
to
25
the
coverage
requirements
of
the
bill.
26
The
commissioner
of
insurance
must
adopt
rules
to
administer
27
the
requirements
of
the
bill.
28
The
bill
applies
to
third-party
payment
provider
contracts,
29
policies,
or
plans
delivered,
issued
for
delivery,
continued,
30
or
renewed
in
this
state
on
or
after
January
1,
2022.
31
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