Iowa SSB3118 regulates utilization review organizations' use of AI in prior authorizations, establishes peer review for appeals, and sets rules for.

Iowa SSB3118 introduces provisions for utilization review organizations (URO) in health care services. It allows UROs to use artificial intelligence for initial reviews of prior authorization requests, except for medical necessity decisions, which must involve a qualified reviewer or clinical peer. Appeals of denied or downgraded prior authorization requests must be conducted by a different reviewer or peer. The bill exempts cancer-related screenings and preventative services from prior authorization if recommended by a health care professional based on updated cancer guidelines.

Iowa SSB3118 regulates utilization review organizations' use of AI in prior authorizations, establishes peer review for appeals, and sets rules for.

Iowa SSB3118 introduces provisions for utilization review organizations (URO) in health care services. It allows UROs to use artificial intelligence for initial reviews of prior authorization requests, except for medical necessity decisions, which must involve a qualified reviewer or clinical peer. Appeals of denied or downgraded prior authorization requests must be conducted by a different reviewer or peer. The bill exempts cancer-related screenings and preventative services from prior authorization if recommended by a health care professional based on updated cancer guidelines.