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Read. Follow. Verify.Iowa sets prior authorization deadlines and annual reporting rules for health insurance review organizations
Last action · May 27, 2025: Signed by Governor . H.J. 1225 .
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What This Bill Does
Senate File 231 establishes strict timelines for health insurance s to approve or deny requests, requiring responses within 48 hours for urgent cases and 10 to 15 days for nonurgent cases. The law also mandates that reviewers conduct annual evaluations to eliminate unnecessary authorization requirements and submit detailed compliance reports to the state insurance commissioner.
Health care providers and patients face legally binding response deadlines for medical treatments, while insurance review organizations must compile and submit extensive annual metrics on approval rates, processing times, and eliminated authorization requirements.
Who It Affects
Groups the bill's text affects, as described in the record. Being affected is not a position for or against it.
utilization review organizations
Utilization review organizations must adhere to strict decision deadlines, conduct annual evaluations of prior authorization requirements, and submit comprehensive compliance and metric reports to the state insurance commissioner.
health care providers
Health care providers receive guaranteed notification receipts within 24 hours and mandatory response times for urgent and nonurgent prior authorization requests.
Key Facts
- Utilization review organizations must provide a prior authorization determination within 48 hours for urgent requests.
- Nonurgent prior authorization requests must be answered within 10 calendar days under standard conditions.
- Nonurgent requests with complex circumstances or high request volumes must be answered within 15 calendar days.
- Organizations must notify or provide health care providers with a receipt within 24 hours of receiving a prior authorization request.
Show all 9 facts
- Review organizations must conduct an annual review and submit findings on approval and denial totals to the commissioner.
- Organizations must eliminate prior authorization requirements for health care services that are routinely approved and fail to promote quality or reduce spending.
- Organizations must list prior authorizations that had at least 80 percent approval rates but were retained due to medical or scientific evidence.
- The insurance commissioner must submit an annual report summarizing the data and review findings to the general assembly.
- Complaints regarding an organization's compliance may be directed to the insurance division and are exempted from public records under chapter 22.
Frequently Asked Questions
How quickly must an insurance reviewer answer an urgent medical request?
What happens to prior authorization requirements that are almost always approved?
Who receives the annual reports on prior authorization metrics?
What else do you want to know?
News Coverage
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Votes, people, money & the original sourceWhere This Stands
Current status: Signed into law.
Procedural history
39 actions- May 27, 2025HouseEnrolledSigned by Governor . H.J. 1225 .
- May 19, 2025HouseReported correctly enrolled, signed by Speaker and President, and sent to Governor. H.J. 1224 .
- Apr 23, 2025HouseMessage from House. S.J. 862 .
- Apr 22, 2025HouseImmediate message. H.J. 1033 .
- Apr 22, 2025HouseFloorPassed House , yeas 92, nays 0. H.J. 1017 .
- Apr 22, 2025HouseFloorHouse concurred in Senate amendment H-1244 . H.J. 1017 .
Show 33 earlier actions
- Apr 17, 2025HouseSenate amendment H-1244 filed. H.J. 993 .
- Apr 17, 2025HouseMessage from Senate. H.J. 951 .
- Apr 16, 2025SenateImmediate message. S.J. 814 .
- Apr 16, 2025SenateFloorPassed Senate , yeas 47, nays 0. S.J. 813 .
- Apr 16, 2025SenateFloorAmendment S-3015 adopted. S.J. 813 .
- Apr 16, 2025SenateSubstituted for SF 231 . S.J. 812 .
- Apr 16, 2025SenateWithdrawn. S.J. 814 .
- Apr 16, 2025SenateHF 303 substituted. S.J. 812 .
- Apr 16, 2025SenateFloorAmendment S-3014 adopted. S.J. 812 .
- Apr 3, 2025SenatePlaced on calendar under unfinished business. S.J. 688 .
- Apr 3, 2025SenatePlaced on calendar under unfinished business. S.J. 688 .
- Mar 4, 2025SenateAmendment S-3015 filed. S.J. 412 .
- Mar 4, 2025SenateAmendment S-3014 filed. S.J. 412 .
- Feb 24, 2025SenateIntroducedRead first time, attached to SF 231 . S.J. 336 .
- Feb 24, 2025HouseMessage from House. S.J. 336 .
- Feb 24, 2025SenateAttached to HF 303 . S.J. 336 .
- Feb 20, 2025HouseImmediate message. H.J. 401 .
- Feb 20, 2025HouseFloorPassed House , yeas 92, nays 0. H.J. 389 .
- Feb 10, 2025HouseIntroducedIntroduced, placed on calendar. H.J. 277 .
- Feb 10, 2025Iowa LegislatureCommittee report approving bill, renumbered as HF 303 .
- Feb 10, 2025SenateCommittee report, approving bill. S.J. 218 .
- Feb 10, 2025SenateIntroducedIntroduced, placed on calendar. S.J. 214 .
- Feb 6, 2025Iowa LegislatureCommittee report approving bill, renumbered as SF 231 .
- Feb 6, 2025HouseCommittee vote: Yeas, 23. Nays, 0. H.J. 266 .
- Feb 6, 2025HouseCommittee report, recommending passage. H.J. 266 .
- Jan 23, 2025Iowa LegislatureSubcommittee recommends passage.
- Jan 23, 2025Iowa LegislatureSubcommittee recommends passage.
- Jan 22, 2025SenateSubcommittee Meeting: 01/23/2025 3:30PM Senate Lounge.
- Jan 21, 2025HouseSubcommittee Meeting: 01/23/2025 12:30PM House Lounge.
- Jan 16, 2025Iowa LegislatureSubcommittee: Klimesh, Costello, and Trone Garriott.
- Jan 16, 2025Iowa LegislatureIntroducedIntroduced, referred to Health and Human Services.
- Jan 15, 2025HouseSubcommittee: Nordman, Lawler and Srinivas. H.J. 83 .
- Jan 15, 2025HouseIntroducedIntroduced, referred to Commerce. H.J. 78 .
Version history
Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.
View official text →Lobbying Activity
No state lobbying filings in our records match this bill. Federal lobbying reports (LDA) cover Congress, so they are not listed on state bills.
Full breakdown
Who this bill affects and the strongest case for and against it, written only from the bill’s own text.
Discoveries
Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.
Mandatory Elimination of Redundant Authorizations
The bill requires review organizations to actively audit and strip away prior authorization barriers that show high approval frequencies and lack justification.
Connected Entities
Sources
www.legis.iowa.gov
Analysis Score
0–100- Significance65How much this matters to a regular citizen
- Controversy25Intensity of disagreement among stakeholders
- Entertainment5Compellingness for a non-policy-wonk reader
- Buzz30Current news / social attention level
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