HSB 506: Relating to insurance coverage for health care services provided pursuant to a referral by an out-of-network primary care provider

What it does

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. _____ 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.

House subcommittee · named January 12, 2026

• Rep. Austin Harris (R) · austin.harris@legis.iowa.gov
• Rep. Austin Baeth (D) · austin.baeth@legis.iowa.gov
• Rep. Ryan Weldon (R) · ryan.weldon@legis.iowa.gov

Lobbying · 9 for, 0 against

For: Integrated Telehealth Partners; Iowa Academy of Family Physicians; Iowa Chapter-American Academy of Pediatrics; Iowa Independent Physician Group; Iowa Integrated Health Planning and Advisory Council; Iowa Medical Society; Iowa Mental Health Counselors Association; Iowa Psychiatric Physicians Society; Rheumatology Association of Iowa

In plain words

1. January 12, 2026Filed in the House and sent to the Health and Human Services committee
2. January 12, 2026House subcommittee named: Harris, Baeth and Weldon
3. February 5, 2026Subcommittee recommended passing it
4. February 10, 2026Approved by the House committee
5. February 10, 2026Committee vote: 21–0
6. February 12, 2026Approved by the House committee, and given a new number: HF 2434