General Assembly: 74 (1992 Regular GA) - Chapter 1120 - Workers’ compensation disputes regarding health service charges


Published: 1992-04-22

Subscribe to a Global-Regulation Premium Membership Today!

Key Benefits:

Subscribe Now for only USD$20 per month, or Get a Day Pass for only USD$4.99.

CH. 1119 LA WS OF THE SEVENTY -FOURTH G.A., 1992 SESSION 162

a. With all due diligence adopt by rule requirements for the general provision of coverage for benefits for routine well-baby care.

b. Adopt by rule the time period, as determined by the commissioner to be appropriate, for which well-baby care shall be provided.

c. Apply the requirement for coverage to all appropriate entities providing group or employee health care benefits under the jurisdiction of the commissioner.

2. In determining the requirements under subsection 1 the commissioner shall consider all of the following:

a. The costs versus corresponding benefits of such coverage. b. Normally anticipated health problems and recommended routine preventive care. c. Continuity of coverage for any congenital defects and birth abnormalties,* injuries, or

illnesses arising within the well-baby coverage period.

Approved April 22, 1992

CHAPTER 1120 WORKERS' COMPENSATION DISPUTES REGARDING HEALTH SERVICE CHARGES

H.F.2165

AN ACT relating to disputes regarding health service charges in workers' compensation cases.

Be It Enacted by the General Assembly of the State of Iowa:

Section 1. Section 85.27, unnumbered paragraph 3, Code 1991, is amended to read as follows: ChaFges Notwithstanding section 85.26, subsection ~ charges believed to be excessive or

unnecessary may be referred by the employer, insurance carrier, or health service provider to the industrial commissioner for determination, and the commissioner may, ift eeBBeetieB theFewith, utilize the procedures provided in sections 86.38 and 86.39! or set by rule, and con- duct such inquiry as the commissioner shall deem deems necessary. Any health service provider charges not in dispute shall be paid directly to the health service provider prior to utilization of procedures provided in sections 86.38 and 86.39 or set by rule. Afty- iBstitHtieB 6!' pePS6ft ~ health service provider rendering treatment to an employee whose injury is compensable under this section agrees to be bound by such charges as allowed by the industrial commis- sioner and shall not recover in law or equity any amount in excess of that charges set by the commissioner. When ~ dispute under chapter 85 regarding reasonableness of ~ fee for medical services arises between ~ health service provider and an employer or insurance car- rier, the health service provider, employer, or insurance carrier shall not seek payment from the injured employee.

Approved April 22, 1992

• According to enrolled Act