Bills › 91st General Assembly
Relating to insurance coverage for health care services provided pursuant to a referral by an out-of-network primary care provider
Sponsored by the House Health and Human Services Committee
Topics:Health care
Same legislation: HSB 506
Where it is now
- Done: IntroducedJanuary 12, 2026
- Done: SubcommitteeJanuary 12, 2026
- Done: House committeeFebruary 10, 2026
- Done: Passes the HouseFebruary 25, 202692–0
- Done: Senate committeeMarch 19, 2026
- Done: Passes the SenateApril 6, 202647–0
- Done: To the GovernorApril 16, 2026
- Done: Signed into lawApril 16, 2026
Signed into law What’s a funnel?
What’s in it
This bill relates to insurance coverage for health care services provided pursuant to a referral by an out-of-network primary care provider. Under the bill, a health carrier (carrier) shall not deny coverage for a covered benefit provided to a covered person solely on the basis that the referral to receive the covered benefit was made by the covered person’s primary care provider (PCP) who does not participate in the carrier’s network. A carrier shall not impose a deductible, coinsurance, or copayment for a covered benefit for which a covered person was referred by the covered person’s PCP greater than what would be applicable to the same benefit had the covered person been referred by an in-network health care professional.
Read the full explanation
A carrier may require a PCP to provide evidence that the PCP executed a direct primary care agreement with the covered person, which evidence may include a written attestation or a copy of the executed agreement. “Covered benefit”, “direct primary care agreement”, and “primary care provider” are defined in the bill. The bill applies to covered benefits for which a covered person’s primary care provider referred the covered person on or after July 1, 2026. The commissioner of insurance may adopt rules to administer the bill.
From the explanation printed with the bill as introduced, written by the Legislative Services Agency. Changed since by amendments S-5117, H-8030; see Amendments. Full bill text · What changed before it passed
Senate subcommittee
Named March 3, 2026. On March 9, 2026 it recommended passage.
Three legislators hear a bill first and recommend what the committee should do; it’s the best time to weigh in. How to take part
Iowa Code it changes
Creates§514C.37
Read from the bill as introduced. Each links to every bill touching that chapter of the Iowa Code. How the Code works
Lobbying
9 for · 0 against · 16 undecided · Who →
Family tree
Where this legislation came from and where it went: earlier tries, the versions it moved through this Assembly, and later bills built on it.
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91st General Assembly
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