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Senate
File
87
-
Introduced
SENATE
FILE
87
BY
DONAHUE
A
BILL
FOR
An
Act
relating
to
insurance
coverage
for
acupuncture.
1
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
2
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Section
1.
Section
148E.9,
Code
2025,
is
amended
to
read
as
1
follows:
2
148E.9
Accident
and
health
insurance
coverage.
3
This
chapter
shall
not
be
construed
to
require
accident
and
4
health
insurance
coverage
for
acupuncture
services
under
an
5
existing
or
future
contract
or
policy
for
insurance
issued
or
6
issued
for
delivery
in
this
state,
unless
otherwise
provided
by
7
the
contract
or
policy
,
or
as
required
by
section
514C.36
.
8
Sec.
2.
NEW
SECTION
.
514C.37
Acupuncture
——
coverage.
9
1.
As
used
in
this
section,
unless
the
context
otherwise
10
requires:
11
a.
“Acupuncture”
means
the
same
as
defined
in
section
12
148E.1.
13
b.
“Acupuncturist”
means
a
person
who
is
engaged
in
the
14
practice
of
acupuncture
and
who
is
licensed
pursuant
to
section
15
148E.2.
16
c.
“Cost-sharing”
means
any
coverage
limit,
copayment,
17
coinsurance,
deductible,
or
other
out-of-pocket
expense
18
obligation
imposed
on
a
covered
person
by
a
policy,
contract,
19
or
plan
providing
for
third-party
payment
or
prepayment
of
20
health
or
medical
expenses.
21
d.
“Covered
person”
means
a
policyholder,
subscriber,
or
22
other
person
participating
in
a
policy,
contract,
or
plan
that
23
provides
for
third-party
payment
or
prepayment
of
health
or
24
medical
expenses.
25
e.
“Health
carrier”
means
the
same
as
defined
in
section
26
514J.102.
27
f.
“Practice
of
acupuncture”
means
the
same
as
defined
in
28
section
148E.1.
29
2.
a.
Notwithstanding
the
uniformity
of
treatment
30
requirements
of
section
514C.6,
a
health
carrier
that
offers
31
individual,
group,
or
small
group
contracts,
policies,
or
32
plans
in
this
state
that
provide
for
third-party
payment
or
33
prepayment
of
health
or
medical
expenses
shall
offer
coverage
34
for
acupuncture
performed
by
an
acupuncturist.
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b.
Coverage
required
under
this
section
shall
not
be
less
1
favorable
than
coverage
a
health
carrier
offers
for
general
2
physical
illness.
3
c.
Cost-sharing
requirements
imposed
for
coverage
4
required
under
this
section
shall
not
be
less
favorable
than
5
cost-sharing
requirements
imposed
by
a
health
carrier
for
6
general
physical
illness.
7
3.
a.
This
section
shall
apply
to
the
following
classes
8
of
third-party
payment
provider
contracts,
policies,
or
plans
9
delivered,
issued
for
delivery,
continued,
or
renewed
in
this
10
state
on
or
after
January
1,
2026:
11
(1)
Individual
or
group
accident
and
sickness
insurance
12
providing
coverage
on
an
expense-incurred
basis.
13
(2)
An
individual
or
group
hospital
or
medical
service
14
contract
issued
pursuant
to
chapter
509,
514,
or
514A.
15
(3)
An
individual
or
group
health
maintenance
organization
16
contract
regulated
under
chapter
514B.
17
(4)
A
plan
established
for
public
employees
pursuant
to
18
chapter
509A.
19
b.
This
section
shall
not
apply
to
accident-only,
20
specified
disease,
short-term
hospital
or
medical,
hospital
21
confinement
indemnity,
credit,
dental,
vision,
Medicare
22
supplement,
long-term
care,
basic
hospital
and
medical-surgical
23
expense
coverage
as
defined
by
the
commissioner,
disability
24
income
insurance
coverage,
coverage
issued
as
a
supplement
25
to
liability
insurance,
workers’
compensation
or
similar
26
insurance,
or
automobile
medical
payment
insurance.
27
4.
The
commissioner
of
insurance
may
adopt
rules
pursuant
to
28
chapter
17A
to
administer
this
section.
29
EXPLANATION
30
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
31
the
explanation’s
substance
by
the
members
of
the
general
assembly.
32
This
bill
relates
to
insurance
coverage
for
acupuncture.
33
“Acupuncture”
is
defined
in
the
bill
as
a
form
of
health
34
care
developed
from
traditional
and
modern
oriental
medical
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concepts
that
employs
oriental
medical
diagnosis
and
treatment,
1
and
adjunctive
therapies
and
diagnostic
techniques,
for
the
2
promotion,
maintenance,
and
restoration
of
health
and
the
3
prevention
of
disease.
4
The
bill
requires
a
policy,
contract,
or
plan
providing
5
for
third-party
payment
or
prepayment
of
health
or
medical
6
expenses
to
offer
coverage
for
acupuncture
performed
by
an
7
acupuncturist.
“Acupuncturist”
is
defined
as
a
person
who
is
8
engaged
in
the
practice
of
acupuncture
and
who
is
licensed
9
pursuant
to
Code
section
148E.2.
“Practice
of
acupuncture”
is
10
also
defined
in
the
bill.
Coverage
required
under
the
bill
11
shall
not
be
less
favorable
than
coverage
a
health
carrier
12
offers
for
general
physical
illness.
Cost-sharing
requirements
13
imposed
for
coverage
required
under
the
bill
shall
not
be
14
less
favorable
than
cost-sharing
requirements
imposed
by
a
15
health
carrier
for
general
physical
illness.
“Cost-sharing”
16
is
defined
in
the
bill.
17
The
bill
applies
to
third-party
payment
providers
enumerated
18
in
the
bill.
The
bill
specifies
the
types
of
specialized
19
health-related
insurance
which
are
not
subject
to
the
bill.
20
The
commissioner
of
insurance
may
adopt
rules
to
administer
21
the
bill.
22
The
bill
applies
to
third-party
payment
provider
contracts,
23
policies,
or
plans
delivered,
issued
for
delivery,
continued,
24
or
renewed
in
this
state
on
or
after
January
1,
2026.
25
The
bill
makes
conforming
changes
to
Code
section
148E.9.
26
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