514C.35 Behavioral health services provided in a school — coverage.
1. Notwithstanding the uniformity of treatment requirements of section 514C.6, a policy, contract, or plan providing for third-party payment or prepayment of health or medical expenses shall not deny coverage or payment for behavioral health services, including behavioral health services provided via telehealth, solely because the services are delivered in a school.
2. Nothing in this section shall be interpreted to do any of the following:
a. Require an insurer to pay for behavioral health services that are otherwise excluded from coverage under a policy, contract, or plan.
b. Require an insurer to pay for behavioral health services that are provided by an individual employed by or under contract with a school district or an educational service agency in a regular full-time or part-time position, or any other party that has not entered into a provider agreement with the insurer.
c. Prevent application of any other provision of a policy, contract, or plan.
3. This section applies to third-party payment provider policies, contracts, or plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2021, and to claims for reimbursement under such policies, contracts, or plans incurred on or after January 1, 2021.
4. For the purposes of this section:
a. “Behavioral health services” means services provided by a health care professional operating within the scope of the health care professional’s practice which address mental, emotional, medical, or behavioral conditions, illnesses, diseases, or problems.
b. “Educational service agency” means a governmental agency or government entity which is established and operated exclusively for the purpose of providing educational services to one or more educational institutions.
c. “Health care professional” means a physician or other health care practitioner licensed, accredited, registered, or certified to perform specified health care services consistent with state law.
d. “School” means all of the following:
(1) Any school, other than a public school, that is accredited pursuant to section 256.11 for any and all levels for grades one through twelve.
(2) Any school directly supported in whole or in part by taxation.
(3) An area education agency established pursuant to chapter 273.
e. “School district” means a school district described in chapter 274.
f. “Telehealth” means the same as defined in section 514C.34.
2020 Acts, ch 1105, §5; 2020 Acts, ch 1121, §66, 70
Structure Iowa Code
Chapter 514C - SPECIAL HEALTH AND ACCIDENT INSURANCE COVERAGES
Section 514C.1 - Supplemental coverage for adopted or newly born children.
Section 514C.2 - Skilled nursing care covered in hospitals.
Section 514C.3 - Dentist’s services under accident and sickness insurance policies.
Section 514C.3A - Disclosures relating to dental coverage reimbursement rates.
Section 514C.3B - Dental coverage — fee schedules.
Section 514C.4 - Mandated coverage for mammography.
Section 514C.5 - Prescription drug benefit restrictions.
Section 514C.6 - Uniformity of treatment — employee welfare benefit plans.
Section 514C.8 - Coordination of health care benefits with state medical assistance.
Section 514C.9 - Medical support — insurance requirements.
Section 514C.10 - Coverage for adopted child.
Section 514C.12 - Postdelivery benefits and care.
Section 514C.14 - Continuity of care — pregnancy.
Section 514C.15 - Treatment options.
Section 514C.16 - Emergency room services.
Section 514C.17 - Continuity of care — terminal illness.
Section 514C.18 - Diabetes coverage.
Section 514C.19 - Prescription contraceptive coverage.
Section 514C.20 - Mandated coverage for dental care — anesthesia and certain hospital charges.
Section 514C.21 - Coverage for immunizations — mercury.
Section 514C.22 - Biologically based mental illness coverage.
Section 514C.23 - Human papilloma virus vaccinations — coverage.
Section 514C.24 - Cancer treatment — coverage.
Section 514C.25 - Coverage for prosthetic devices.
Section 514C.26 - Approved cancer clinical trials coverage.
Section 514C.27 - Mental illness and substance abuse treatment coverage for veterans.
Section 514C.28 - Autism spectrum disorders coverage.
Section 514C.29 - Services provided by a doctor of chiropractic.
Section 514C.31 - Applied behavior analysis for treatment of autism spectrum disorder — coverage.
Section 514C.33 - Services provided by provisionally licensed psychologists.
Section 514C.34 - Health care services delivered by telehealth — coverage.
Section 514C.35 - Behavioral health services provided in a school — coverage.