Iowa HF303 mandates prior authorization exemption programs for health carriers and sets response times for utilization review organizations.

Iowa HF303 establishes a pilot program for health carriers to exempt certain providers from prior authorization requirements. Health carriers must implement this program by January 15, 2026, for plans requiring prior authorizations. Utilization review organizations must respond to prior authorization requests within 48 hours for urgent cases, 10 days for nonurgent cases, and 15 days if there are complex circumstances or high volumes. The bill also requires carriers to detail their exemption programs online, including criteria for provider eligibility and the number of exempt providers.

Iowa HF303 mandates prior authorization exemption programs for health carriers and sets response times for utilization review organizations.

Iowa HF303 establishes a pilot program for health carriers to exempt certain providers from prior authorization requirements. Health carriers must implement this program by January 15, 2026, for plans requiring prior authorizations. Utilization review organizations must respond to prior authorization requests within 48 hours for urgent cases, 10 days for nonurgent cases, and 15 days if there are complex circumstances or high volumes. The bill also requires carriers to detail their exemption programs online, including criteria for provider eligibility and the number of exempt providers.