Iowa Legislation

This bill requires health insurance plans and policies to provide coverage for mental health and disability regional core services. Such coverage should be provided with equitable quantitative and nonquantitative treatment limitations.

This bill requires that the state Medicaid fee-for-service and managed care programs offer at least one form of MAT without prior authorization.

• It set a $36,000 annual maximum for applied behavior analysis for the treatment of autism
• It does not allow health plans to have any limits on the number of treatment visits
• Health plans are not allowed to have dollar limits, deductibles, copayments, or coinsurance provisions for autism treatment that are less favorable than the dollar limits, deductibles, copayments, or coinsurance for physical illnesses This bill is the same as HF 2112/SF 2072 from the same legislative session.

• It set a $36,000 annual maximum for applied behavior analysis for the treatment of autism
• It does not allow health plans to have any limits on the number of treatment visits
• Health plans are not allowed to have dollar limits, deductibles, copayments, or coinsurance provisions for autism treatment that are less favorable than the dollar limits, deductibles, copayments, or coinsurance for physical illnesses This bill is the same as SF 2254 from the same legislative session.

This bill added a section to the state insurance law that required health plans provide treatment for eating disorders. The bill requires that the treatment be subject to deductibles, copayments, or coinsurance or other limitations to the same extent as other health services.

This bill intended to require that all individual and group health plans and Medicaid eliminate a prerequisite for a face-to-face contact between a mental health professional and a patient before paying for telehealth treatment.

This bill tried to change the section of the state insurance law about autism coverage so that a certified assistant behavior analyst under the supervision of a certified behavior analyst would qualify as an “autism service provider.”

• It set a $36,000 annual maximum for applied behavior analysis for the treatment of autism
• It does not allow health plans to have any limits on the number of treatment visits
• Health plans are not allowed to have dollar limits, deductibles, copayments, or coinsurance provisions for autism treatment that are less favorable than the deductibles, copayments, or coinsurance for physical illnesses

• Requires coverage for substance use disorder services
• Applies to small employer fully-insured plans, individual plans, and public employee plans (currently small employer fully-insured plans only have to provide optional coverage)
• Eliminates inpatient day limit and outpatient visit limit and clarifies that visit limits must be the same as those used for other medical services
• Requires all financial requirements to be on the same terms and conditions as other medical services and requires plans to use only one deductible for all behavioral health and medical services
• Requires the Commissioner of the Insurance Division to issue regulation about this section of the law

This bill also tried to create a “mental health insurance advisory committee” that would include many different stakeholder groups.

This bill tried to change the state insurance law so that individual plans, small employer fully-insured plans, and large employer fully-insured plans would have to cover behavioral health services performed by marital and family therapists and mental health counselors.

• Requires coverage for large employer fully-insured plans and small employer fully-insured plans
• Lists and defines a behavior specialist and qualifications for a behavior specialist

• Requires coverage for substance use disorder services
• Applies to small employer fully-insured plans, individual plans, and public employee plans (currently small employer fully-insured plans only have to provide optional coverage)
• Eliminates inpatient day limits and outpatient visit limits and clarifies that visit limits must be the same as those used for other medical services
• Requires all financial requirements to be on the same terms and conditions as other medical services and requires plans to use only one deductible for all behavioral health and medical services
• Requires the Commissioner of the Insurance Division to issue regulation about this section of the law

This bill also tried to create a “mental health insurance advisory committee” that would include many different stakeholder groups.

• Requires coverage for substance use disorder services
• Applies to small employer fully-insured plans, individual plans, and public employee plans (currently small employer fully-insured plans only have to provide optional coverage)
• Eliminates inpatient day limits and outpatient visit limits
• Requires all financial requirements to be on the same terms and conditions as other medical services and requires plans to use only one deductible for all behavioral health and medical services
• Requires the Commissioner of the Insurance Division to issue regulation about this section of the law

This bill also tried to create a “mental health insurance advisory committee” that would include many different stakeholder groups.

• Requires coverage for substance use disorder services
• Applies to small employer fully-insured plans, individual plans, and public employee plans (currently small employer fully-insured plans only have to provide optional coverage)
• Eliminates inpatient day limits and outpatient visit limits
• Requires all financial requirements to be on the same terms and conditions as other medical services and requires plans to use only one deductible for all behavioral health and medical services

• Requires coverage for substance use disorder services
• Applies to small employer fully-insured plans, individual plans, and public employee plans (currently small employer fully-insured plans only have to provide optional coverage)
• Eliminates inpatient day limits and outpatient visit limits
• Requires all financial requirements to be on the same terms and conditions as other medical services and requires plans to use only one deductible for all behavioral health and medical services

• Requires coverage for large employer fully-insured plans and small employer fully-insured plans
• Lists and defines a behavior specialist and qualifications for a behavior specialist

This bill tried to add a section to the insurance law about autism coverage. This is nearly identical to what is currently in the law except this bill lists and defines a behavior specialist and qualifications for a behavior specialist.

• Applies to individual plans, small employer fully-insured plans and large employer fully-insured plans
• Includes Rett’s disorder and childhood disintegrative disorder as specifically-covered conditions
• Requires a $72,000 annual maximum for applied behavior analysis

The validity of a diagnosis of autism spectrum disorder cannot be reviewed once a year