Iowa SSB1016 mandates prior authorization exemptions for certain health care providers and establishes response timelines for prior authorization.

Iowa SSB1016 introduces a pilot program exempting a subset of health care providers, including primary care providers, from certain prior authorization requirements. Health carriers must detail these exemptions on their websites, including criteria for provider eligibility, services exempt from authorization, and contact information for inquiries. The bill also mandates response timelines for prior authorization requests, with urgent requests needing a response within 48 hours and nonurgent requests within 10 calendar days, or 15 days under complex circumstances.

Iowa SSB1016 mandates prior authorization exemptions for certain health care providers and establishes response timelines for prior authorization.

Iowa SSB1016 introduces a pilot program exempting a subset of health care providers, including primary care providers, from certain prior authorization requirements. Health carriers must detail these exemptions on their websites, including criteria for provider eligibility, services exempt from authorization, and contact information for inquiries. The bill also mandates response timelines for prior authorization requests, with urgent requests needing a response within 48 hours and nonurgent requests within 10 calendar days, or 15 days under complex circumstances.