Bill Text: IA SF2301 | 2019-2020 | 88th General Assembly | Introduced
Bill Title: A bill for an act relating to health care benefits coverage for specified pediatric autoimmune neuropsychiatric disorders. (Formerly SF 2084.)
Spectrum: Committee Bill
Status: (Engrossed - Dead) 2020-06-09 - Amendment H-8243 filed. H.J. 671. [SF2301 Detail]
Download: Iowa-2019-SF2301-Introduced.html
Senate
File
2301
-
Introduced
SENATE
FILE
2301
BY
COMMITTEE
ON
HUMAN
RESOURCES
(SUCCESSOR
TO
SF
2084)
A
BILL
FOR
An
Act
relating
to
health
care
benefits
coverage
for
specified
1
pediatric
autoimmune
neuropsychiatric
disorders.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
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Section
1.
NEW
SECTION
.
514C.35
Pediatric
autoimmune
1
neuropsychiatric
disorders
associated
with
streptococcal
2
infections
and
pediatric
acute-onset
neuropsychiatric
syndrome
3
——
coverage.
4
1.
As
used
in
this
section,
unless
the
context
otherwise
5
requires:
6
a.
“Covered
person”
means
the
same
as
defined
in
section
7
514J.102.
8
b.
“Health
care
professional”
means
the
same
as
defined
in
9
section
514J.102.
10
c.
“Health
carrier”
means
the
same
as
defined
in
section
11
514J.102.
12
d.
“Pediatric
acute-onset
neuropsychiatric
syndrome”
or
13
“PANS”
means
a
class
of
acute-onset
obsessive
compulsive
or
tic
14
disorders
or
other
behavioral
changes
presenting
in
a
child
15
that
are
not
otherwise
explained
by
another
known
neurologic
or
16
medical
disorder.
17
e.
“Pediatric
autoimmune
neuropsychiatric
disorders
18
associated
with
streptococcal
infections”
or
“PANDAS”
means
19
a
condition
in
which
a
streptococcal
infection
in
a
child
20
causes
the
abrupt
onset
of
clinically
significant
obsessions,
21
compulsions,
tics,
or
other
neuropsychiatric
symptoms
or
22
behavioral
changes,
or
a
relapsing
and
remitting
course
of
23
symptom
severity.
24
2.
Notwithstanding
the
uniformity
of
treatment
requirements
25
of
section
514C.6,
a
health
carrier
that
offers
individual,
26
group,
or
small
group
contracts,
policies,
or
plans
in
this
27
state
that
provide
for
third-party
payment
or
prepayment
28
of
health
or
medical
expenses
shall
offer
coverage
for
the
29
diagnosis
and
treatment
of
PANS
and
PANDAS
as
recommended
by
30
a
health
care
professional
for
a
covered
person
who
is
age
31
eighteen
or
younger.
32
3.
a.
This
section
shall
apply
to
the
following
classes
33
of
third-party
payment
provider
contracts,
policies,
or
plans
34
delivered,
issued
for
delivery,
continued,
or
renewed
in
this
35
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state
on
or
after
January
1,
2021:
1
(1)
Individual
or
group
accident
and
sickness
insurance
2
providing
coverage
on
an
expense-incurred
basis.
3
(2)
An
individual
or
group
hospital
or
medical
service
4
contract
issued
pursuant
to
chapter
509,
514,
or
514A.
5
(3)
An
individual
or
group
health
maintenance
organization
6
contract
regulated
under
chapter
514B.
7
(4)
A
plan
established
for
public
employees
pursuant
to
8
chapter
509A.
9
b.
This
section
shall
not
apply
to
accident-only,
10
specified
disease,
short-term
hospital
or
medical,
hospital
11
confinement
indemnity,
credit,
dental,
vision,
Medicare
12
supplement,
long-term
care,
basic
hospital
and
medical-surgical
13
expense
coverage
as
defined
by
the
commissioner,
disability
14
income
insurance
coverage,
coverage
issued
as
a
supplement
15
to
liability
insurance,
workers’
compensation
or
similar
16
insurance,
or
automobile
medical
payment
insurance.
17
4.
The
commissioner
of
insurance
shall
adopt
rules
pursuant
18
to
chapter
17A
as
necessary
to
administer
this
section.
19
EXPLANATION
20
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
21
the
explanation’s
substance
by
the
members
of
the
general
assembly.
22
This
bill
relates
to
health
care
coverage
benefits
for
23
pediatric
acute-onset
neuropsychiatric
syndrome
(PANS)
and
24
pediatric
autoimmune
neuropsychiatric
disorders
associated
with
25
streptococcal
infections
(PANDAS).
26
The
bill
defines
“PANS”
as
a
class
of
acute-onset
obsessive
27
compulsive
or
tic
disorders
or
other
behavioral
changes
28
presenting
in
a
child
that
are
not
otherwise
explained
by
29
another
known
neurologic
or
medical
disorder.
“PANDAS”
is
30
defined
as
a
condition
in
which
a
streptococcal
infection
in
31
a
child
causes
the
abrupt
onset
of
clinically
significant
32
obsessions,
compulsions,
tics,
or
other
neuropsychiatric
33
symptoms
or
behavioral
changes,
or
a
relapsing
and
remitting
34
course
of
symptom
severity.
35
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The
bill
requires
a
health
carrier
that
offers
individual,
1
group,
or
small
group
contracts,
policies,
or
plans
in
this
2
state
that
provide
for
third-party
payment
or
prepayment
of
3
health
or
medical
expenses
to
offer
coverage
for
the
diagnosis
4
and
treatment
of
PANS
and
PANDAS
as
recommended
by
a
health
5
care
professional
for
a
covered
person
who
is
age
18
or
6
younger.
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,
2021,
by
the
10
third-party
payment
providers
enumerated
in
the
bill.
11
The
bill
specifies
the
types
of
specialized
health-related
12
insurance
which
are
not
subject
to
the
bill’s
coverage
13
requirements.
14
The
commissioner
of
insurance
is
required
to
adopt
rules
to
15
administer
the
provisions
of
the
bill.
16
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