Read the full stored bill text
Senate
File
417
-
Introduced
SENATE
FILE
417
BY
DONAHUE
,
STAED
,
TOWNSEND
,
CELSI
,
PETERSEN
,
WAHLS
,
DOTZLER
,
WEINER
,
BISIGNANO
,
TRONE
GARRIOTT
,
and
WINCKLER
A
BILL
FOR
An
Act
relating
to
insurance
coverage
and
Medicaid
coverage
for
1
annual
lung
cancer
screenings
for
at-risk
individuals.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
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417
Section
1.
NEW
SECTION
.
249A.34
Annual
lung
cancer
1
screenings.
2
1.
As
used
in
this
section,
unless
the
context
requires
3
otherwise:
4
a.
“At-risk
individual”
means
a
recipient
fifty
years
of
age
5
or
older
to
which
any
of
the
following
circumstances
apply:
6
(1)
The
individual
has
smoked
cigarettes
regularly
or
7
experienced
secondhand
smoke
regularly.
8
(2)
The
individual
has
an
immediate
family
member
diagnosed
9
with
lung
cancer.
10
(3)
The
individual
has
been
regularly
exposed
to
asbestos,
11
radon,
arsenic,
nickel,
chromium,
tar,
or
soot
in
the
12
individual’s
home
or
workplace.
13
b.
“Lung
cancer
screening”
means
a
scan
of
the
lungs
using
14
low-dose
computed
tomography.
15
2.
The
department
shall
seek
any
federal
waiver
necessary
16
for
the
medical
assistance
program
to
provide
coverage
for
17
an
annual
lung
cancer
screening
for
at-risk
individuals.
18
Contingent
on
receiving
approval
of
a
federal
waiver,
and
19
effective
immediately
upon
receiving
approval
of
a
federal
20
waiver,
the
medical
assistance
program
shall
provide
coverage
21
for
annual
lung
cancer
screenings
for
at-risk
individuals.
22
Sec.
2.
NEW
SECTION
.
514C.37
Annual
lung
cancer
screening
23
——
coverage.
24
1.
As
used
in
this
section,
unless
the
context
otherwise
25
requires:
26
a.
“At-risk
individual”
means
a
covered
person
fifty
years
27
of
age
or
older
to
which
any
of
the
following
circumstances
28
apply:
29
(1)
The
individual
has
smoked
cigarettes
regularly
or
30
experienced
secondhand
smoke
regularly.
31
(2)
The
individual
has
an
immediate
family
member
diagnosed
32
with
lung
cancer.
33
(3)
The
individual
has
been
regularly
exposed
to
asbestos,
34
radon,
arsenic,
nickel,
chromium,
tar,
or
soot
in
the
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417
individual’s
home
or
workplace.
1
b.
“Cost-sharing”
means
any
coverage
limit,
copayment,
2
coinsurance,
deductible,
or
other
out-of-pocket
expense
3
obligation
imposed
on
a
covered
person
by
a
policy,
contract,
4
or
plan
providing
for
third-party
payment
or
prepayment
of
5
health
or
medical
expenses.
6
c.
“Covered
person”
means
a
policyholder,
subscriber,
or
7
other
person
participating
in
a
policy,
contract,
or
plan
that
8
provides
for
third-party
payment
or
prepayment
of
health
or
9
medical
expenses.
10
d.
“Lung
cancer
screening”
means
a
scan
of
the
lungs
using
11
low-dose
computed
tomography.
12
2.
Notwithstanding
the
uniformity
of
treatment
requirements
13
of
section
514C.6,
a
policy,
contract,
or
plan
providing
for
14
third-party
payment
or
prepayment
of
health
or
medical
expenses
15
shall
provide
coverage
for
an
annual
lung
cancer
screening
for
16
an
at-risk
individual.
17
3.
Cost-sharing
shall
not
be
imposed
by
a
health
carrier
for
18
coverage
required
under
this
section.
19
4.
a.
This
section
applies
to
the
following
classes
of
20
third-party
payment
provider
contracts,
policies,
or
plans
21
delivered,
issued
for
delivery,
continued,
or
renewed
in
this
22
state
on
or
after
January
1,
2026:
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
b.
This
section
shall
not
apply
to
accident-only,
specified
32
disease,
short-term
hospital
or
medical,
hospital
confinement
33
indemnity,
credit,
dental,
vision,
Medicare
supplement,
34
long-term
care,
basic
hospital
and
medical-surgical
expense
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417
coverage
as
defined
by
the
commissioner
of
insurance,
1
disability
income
insurance
coverage,
coverage
issued
as
a
2
supplement
to
liability
insurance,
workers’
compensation
or
3
similar
insurance,
or
automobile
medical
payment
insurance.
4
5.
The
commissioner
of
insurance
may
adopt
rules
pursuant
to
5
chapter
17A
to
administer
this
section.
6
EXPLANATION
7
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
8
the
explanation’s
substance
by
the
members
of
the
general
assembly.
9
This
bill
relates
to
insurance
coverage
and
medical
10
assistance
program
(Medicaid)
coverage
for
annual
lung
cancer
11
screenings
for
at-risk
individuals.
12
The
bill
defines
“at-risk
individual”
as
a
recipient
or
13
covered
person
50
years
of
age
or
older
that
either
has
smoked
14
cigarettes
regularly
or
experienced
secondhand
smoke
regularly,
15
has
an
immediate
family
member
diagnosed
with
lung
cancer,
or
16
has
been
regularly
exposed
to
asbestos,
radon,
arsenic,
nickel,
17
chromium,
tar,
or
soot
in
the
individual’s
home
or
workplace.
18
The
bill
defines
“lung
cancer
screening”
as
a
scan
of
the
lungs
19
using
low-dose
computed
tomography.
20
Under
the
bill,
the
department
of
health
and
human
services
21
shall
seek
any
federal
waiver
necessary
for
Medicaid
to
22
provide
coverage
for
an
annual
lung
cancer
screening
for
23
at-risk
individuals.
Contingent
on
receiving
approval
of,
and
24
effective
immediately
upon
receiving
approval
of,
a
federal
25
waiver,
Medicaid
shall
provide
coverage
for
annual
lung
cancer
26
screenings
for
at-risk
individuals.
27
The
bill
requires
a
policy,
contract,
or
plan
providing
for
28
third-party
payment
or
prepayment
of
health
or
medical
expenses
29
to
provide
coverage
for
an
annual
lung
cancer
screening
for
an
30
at-risk
individual.
Cost-sharing
shall
not
be
imposed
by
a
31
health
carrier
for
coverage
required
under
the
bill.
32
Coverage
required
under
the
bill
shall
not
be
less
favorable
33
than
coverage
a
health
carrier
offers
for
screening
mammograms.
34
The
bill
applies
to
third-party
payment
providers
enumerated
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417
in
the
bill,
and
the
commissioner
of
insurance
may
adopt
rules
1
to
administer
the
requirements
of
the
bill
applying
to
such
2
third-party
payment
providers.
3
The
bill
specifies
the
types
of
specialized
health-related
4
insurance
which
are
not
subject
to
the
coverage
requirements
5
of
the
bill.
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