HF 2053: Relating to the standardization of claim submission and reimbursement processes of managed care organizations

What it does

This bill relates to claim submission and reimbursement processes followed by managed care organizations (MCOs) administering the medical assistance program (program). The bill defines “managed care contract” and “managed care organization”. Under current law, the department of health and human services (HHS) is directed to adopt rules determining the method and level of reimbursement for all medical and health services provided under the program. The bill directs the director of HHS to also adopt rules establishing a standardized submission and reimbursement process (process) for claims for all benefits received by or services rendered to a recipient by a provider on or after July 1, 2027.

Lobbying · 11 for, 2 against

For: Air Methods; Classroom Clinic; Integrated Telehealth Partners; Iowa Association of Rural Health Clinics; Iowa Integrated Health Planning and Advisory Council; Iowa Medical Society; Iowa Mental Health Counselors Association; Iowa Pharmacy Association; Iowa Psychiatric Physicians Society; Iowa Speech Language Hearing Association; REM Iowa

Against: Elevance Health, and its Affiliates dba Anthem, Inc.; Iowa Total Care, A Subsidiary of Centene Corporation

In plain words

1. January 14, 2026Filed in the House and sent to the Health and Human Services committee