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

SF 2421: Relating to utilization review organizations’ use of artificial intelligence, prior authorization determinations and exemptions, and audits, and including applicability provisions

Died when the session ended · The General Assembly adjourned on October 2, 2026. Bills that didn’t pass both chambers died.

What it does

This bill relates to utilization review organizations’ use of artificial intelligence, prior authorization determinations and exemptions, and audits. DIVISION I —— PRIOR AUTHORIZATION —— USE OF ARTIFICIAL INTELLIGENCE AND PEER REVIEW. Under the bill, a utilization review organization (URO) may use an artificial intelligence-based algorithm to provide an initial review of a request for prior authorization (authorization), except that, for a request for a health care service (service) based on medical necessity, a URO shall not use an artificial intelligence-based algorithm as the sole basis for a decision to deny, delay, or downgrade the authorization request.

Sponsors

Health and Human Services committee

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.

Senate subcommittee · named February 25, 2026

  • Sen. Kara Warme (R) · kara.warme@legis.iowa.gov
  • Sen. Mike Bousselot (R) · mike.bousselot@legis.iowa.gov
  • Sen. Izaah Knox (D) · izaah.knox@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

  1. February 5, 2026Filed in the Senate and sent to the Health and Human Services committee · as SSB 3118
  2. February 5, 2026Senate subcommittee named: Warme, Trone Garriott and Webster · as SSB 3118
  3. February 10, 2026Subcommittee recommended passing it with changes · as SSB 3118
  4. February 19, 2026Approved by the Senate committee, and given a new number: SF 2421 · as SSB 3118
  5. February 23, 2026Filed in the Senate
  6. February 23, 2026Approved by the Senate committee
  7. February 24, 2026Sent to the Senate Commerce committee
  8. February 25, 2026Senate subcommittee named: Warme, Bousselot and Knox
  9. March 2, 2026Subcommittee recommended passing it
  10. March 3, 2026Approved by the Senate committee
  11. March 4, 2026Cost estimate (fiscal note) posted
  12. March 4, 2026Withdrawn

From public records at legis.iowa.gov, compiled by Funnel (iowafunnel.com), an independent, nonpartisan site. Current as of Monday, November 9, 2026. https://iowafunnel.com/bills/91/SF2421