91st General Assembly · Funnel one-pager · Monday, November 9, 2026

HF 2438: Relating to health carriers and payment of claims, audits, and standards of conduct; prior authorizations and utilization review organizations; and providing civil penalties and including applicability provisions

Became HF 2635 · Its progress continues under the new number.

What it does

This bill relates to health carriers and payment of claims, audits, and standards of conduct, prior authorizations, and utilization review organizations. DIVISION I —— HEALTH INSURANCE TRADE PRACTICES. Under current law, an insurer shall either accept and pay or deny a clean claim. Under the bill, an insurer shall either accept and pay or deny a clean claim no later than days after receiving an electronic claim submission, or days after receiving a claim submitted on paper. After paying a clean claim, the insurer shall not retroactively deny, reduce, or recoup payment of the claim, except if the claim submission included a misrepresentation, was fraudulent, or was a duplicate submission, and the insurer first provides written notice including evidence to the health care provider (provider) that submitted the claim of the misrepresentation, fraud, or duplicate submission.

Cost

See the fiscal note

Division I of the Bill may increase costs to the State of Iowa and the BOR universities’ health plans incurred in responding to audits of clean claims; any potential fiscal impact is unknown but may be significant.

House subcommittee · named February 12, 2026

Rep. Austin Harris (R) · austin.harris@legis.iowa.gov
Rep. Ann Meyer (R) · ann.meyer@legis.iowa.gov
Rep. Beth Wessel-Kroeschell (D) · beth.wessel-kroeschell@legis.iowa.gov

Lobbying · 25 for, 6 against

For: American College of Obstetricians & Gynecologists; Americans For Prosperity; Bellin Gundersen Health System, Inc.; Brain Injury Association of Iowa; Broadlawns Medical Center; Central Iowa Physicians; Easterseals Iowa; Episcopal Diocese of Iowa; Iowa Academy of Family Physicians; Iowa Association of Ambulatory Surgery Centers; Iowa Chapter-American Academy of Pediatrics; Iowa Chiropractic Society; and 13 more

Against: Cigna Corporate Services, LLC; Elevance Health, and its Affiliates dba Anthem, Inc.; Federation of Iowa Insurers; Iowa Total Care, A Subsidiary of Centene Corporation; Molina Healthcare, Inc.; United Healthcare Services, Inc.

In plain words

February 12, 2026Filed in the House and sent to the Health and Human Services committee
February 12, 2026House subcommittee named: Harris, Meyer, A. and Wessel-Kroeschell
February 16, 2026Subcommittee recommended passing it
February 17, 2026Approved by the House committee
February 17, 2026Committee vote: 21–0
February 19, 2026Approved by the House committee, and given a new number: HF 2635
March 9, 2026Withdrawn