SSB 1016: Relating to prior authorizations and exemptions by health benefit plans and utilization review organizations

What it does

This bill relates to prior authorizations and exemptions by health benefit plans and utilization review organizations. The bill requires a utilization review organization (organization) to respond to a request for prior authorization (authorization) from a health care provider (provider) within hours after receipt for urgent requests or within calendar days for nonurgent requests, unless there are complex or unique circumstances, or the organization is experiencing an unusually high volume of authorization requests, then an organization must respond within calendar days.

Senate subcommittee · named January 16, 2025

• Sen. Mike Klimesh (R) · mike.klimesh@legis.iowa.gov
• Sen. Mark Costello (R) · mark.costello@legis.iowa.gov
• Sen. Sarah Trone Garriott (D) · sarah.trone.garriott@legis.iowa.gov

Lobbying · 25 for, 2 against

For: American Diabetes Association; American Physical Therapy Association of Iowa; Autism Speaks; Broadlawns Medical Center; Central Iowa Physicians; Classroom Clinic; Easterseals Iowa; Exceptional Persons, Inc.; Imagine the Possibilities; Integrated Telehealth Partners; Iowa Affiliate of the American College of Nurse-Midwives; Iowa Association of Rural Health Clinics; and 13 more

Against: AHIP; CVS Health

In plain words

1. January 16, 2025Filed in the Senate and sent to the Health and Human Services committee
2. January 16, 2025Senate subcommittee named: Klimesh, Costello and Trone Garriott
3. January 23, 2025Subcommittee recommended passing it
4. February 6, 2025Approved by the Senate committee, and given a new number: SF 231