Iowa legislation · 91st General Assembly
Iowa HF2635: A BILL FOR An Act 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
Status: Signed into law, May 13, 2026
An Act 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.
What the bill says
From the enrolled text, April 1, 2026:
House File 2635 - Enrolled House File 2635 RELATING TO HEALTH CARRIERS STANDARDS OF CONDUCT; UTILIZATION REVIEW ORGANIZATIONS, ARTIFICIAL INTELLIGENCE, AUDITS, AND PRIOR AUTHORIZATIONS; CERTIFICATE OF NEED PROCESSES; AND INCLUDING APPLICABILITY PROVISIONS. BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: DIVISION I HEALTH INSURANCE TRADE PRACTICES Section 1. Section 514F.8, subsection 1, Code 2026, is amended by adding the following new paragraph: NEW PARAGRAPH. 0b. "Downgrade" means a decision by a utilization review organization to change an expedited or urgent request for prior authorization to a standard determination, or otherwise modify a health care service that is the subject of a request for prior authorization to a lower-level health care service. House File 2635, p. Sec. 2. Section 514F.8, Code 2026, is amended by adding the following new subsection: NEW SUBSECTION. 2A. A utilization review organization may use an artificial intelligence-based algorithm or system to provide an initial review of a request for prior authorization, except that, for a prior authorization request for a health care service based on medical necessity, a utilization review organization shall not use an artificial intelligence-based algorithm or system as the sole basis for the utilization review organization's decision to deny, delay, or downgrade the prior authorization request. Sec. 3. NEW SECTION. 514F.8C Utilization review organizations ---- audits. 1. As used …
Sponsors
- Health and Human Services · primary sponsor
Latest actions
- : Signed by Governor . H.J. 1168 .
- : Reported correctly enrolled, signed by Speaker and President, and sent to Governor. H.J. 1164 .
- : Fiscal note .
- : Message from House. S.J. 492 .
- : Immediate message. H.J. 601 .
- : Passed House , yeas 87, nays 0. H.J. 574 .
- : House concurred in Senate amendment H-8154 . H.J. 574 .
- : Senate amendment H-8154 filed. H.J. 571 .
- : Message from Senate. H.J. 570 .
- : Immediate message. S.J. 475 .
Votes
- Passed House , yeas 87, nays 0. H.J. 574 . (March 5, 2026): 87 yea, 0 nay, passed
- Passed House , yeas 87, nays 0. H.J. 03/05 . (March 5, 2026): 87 yea, 0 nay, passed
- Passed Senate , yeas 44, nays 0. S.J. 474 . (March 4, 2026): 44 yea, 0 nay, passed
- Passed House , yeas 94, nays 1. H.J. 489 . (March 3, 2026): 94 yea, 1 nay, passed
Subjects: health insurance, audits, public assistance, insurance, claims
Common questions
- What is HF2635?
- HF2635 is a bill in the Iowa Legislature (91st General Assembly): A BILL FOR An Act 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.
- What does HF2635 do?
- An Act 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.
- What is the status of HF2635?
- Signed into law as of May 13, 2026. Latest action: Signed by Governor . H.J. 1168 . (May 13, 2026).
- Who sponsored HF2635?
- Health and Human Services.
- Where is the official record for HF2635?
- On the Iowa Legislature website: https://www.legis.iowa.gov/legislation/BillBook?ba=HF+2635&ga=91
Source: official Iowa record. Tracked by Delilah, AI for legislation across all 50 states and Congress.