Title XIII, COMMERCE (Ch. 505 - 554I)

1. A carrier, as defined in section 513B.2 , or a plan established pursuant to chapter 509A for public employees, that limits coverage for experimental medical treatment, drugs, or devices, shall develop and implement a procedure to evaluate experimental medical treatments and sh…

1. Retrospective payment. The commissioner shall adopt rules to provide for the retrospective payment of clean claims for covered services provided by a physician, advanced registered nurse practitioner, or physician assistant during the credentialing period, once the physician, …

1. Definitions. For the purposes of this section : a. “Authorized representative” means the same as defined in section 514J.102 . b. “Clinical practice guidelines” means a systematically developed statement to assist health care professionals and covered persons in making decisio…

1. For purposes of this section : a. “Covered person” means a policyholder, subscriber, enrollee, or other individual participating in a health benefit plan. b. “Facility” means the same as defined in section 514J.102 . c. “Health benefit plan” means the same as defined in sectio…

1. Definitions. For the purpose of this section : a. “Commissioner” means the commissioner of insurance. b. “Cost sharing” means any coverage limit, copayment, coinsurance, deductible, or other out-of-pocket expense requirement. c. “Covered person” means the same as defined in se…