514C.8 Coordination of health care benefits with state medical assistance.
1. An insurer, health maintenance organization, or hospital and medical service plan providing health care coverage to individuals in this state shall not consider the availability of or eligibility for medical assistance under Tit. XIX of the federal Social Security Act and chapter 249A, when determining eligibility of the individual for coverage or calculating payments to the individual under the health care coverage plan.
2. The state acquires the rights of an individual to payment from an insurer, health maintenance organization, or hospital or medical service plan to the extent payment for covered expenses is made pursuant to chapter 249A for health care items or services provided to the individual. Upon presentation of proof that payment was made pursuant to chapter 249A for covered expenses, the insurer, health maintenance organization, or hospital or medical service plan shall make payment to the state medical assistance program to the extent of the coverage provided in the policy or contract.
3. An insurer shall not impose requirements on the state with respect to the assignment of rights pursuant to this section that are different from the requirements applicable to an agent or assignee of a covered individual.
4. For purposes of this section, “insurer” means an entity which offers a health benefit plan, including a group health plan under the federal Employee Retirement Income Security Act of 1974.
95 Acts, ch 185, §13; 2010 Acts, ch 1061, §180
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.