IA HF 2635: A bill for an act relating to health carriers standards of conduct; utilization review organizations, artificial intelligence, audits, and prior auth…
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A bill for an act relating to health carriers standards of conduct; utilization review organizations, artificial intelligence, audits, and prior authorizations; certificate of need processes; and including applicability provisions. (Formerly HF 2438.) Effective date: 07/01/2026.
AI Summary
This bill regulates health carriers' conduct, focusing on AI in prior authorizations and certificate of need processes. Effective July 1, 2026.
If you operate a utilization review organization in Iowa, you must ensure AI is not the sole basis for denying prior authorizations by 2026 or face penalties.
State
Iowa
Bill Number
HF 2635
Status
Passed Both Chambers
Risk Level
Medium
Category
Comprehensive
Effective Date
Jan 1, 2027
Last Action
May 13, 2026
Last Verified
May 29, 2026
Data Updated
May 29, 2026
Version
v4
What do these statuses mean?▼
Introduced— Filed in the legislature; not yet heard in committee
In Committee— Assigned to and being reviewed by a legislative committee
Passed— Approved by one or both chambers; awaiting further action
Signed / Enacted— Signed into law by the governor; may or may not be in effect yet
Dead / Vetoed— Vetoed, failed to pass, or session expired without action
Unknown— Status data not yet available or awaiting classification
House File 2635 introduces new standards for health carriers and utilization review organizations in Iowa, particularly concerning the use of artificial intelligence in prior authorizations. The bill addresses certificate of need processes. This legislation will impact health care providers and insurers, with an effective date of July 1, 2026.
Key Provisions
Verification needed on AI reliance for medical necessity decisions.
Includes provisions on certificate of need processes.
Latest Legislative Action
Signed by Governor. H.J. 05/13.
Bill Sponsors
Name
Role
Health And Human Services
Sponsor
Roll Call Votes
H ·
Shall the bill pass? ·
Mar 5, 2026
87 Yea 0 Nay 13 OtherPassed ✓
S ·
Shall the bill pass? ·
Mar 4, 2026
44 Yea 0 Nay 6 OtherPassed ✓
H ·
Shall the bill pass? ·
Mar 3, 2026
94 Yea 1 Nay 5 OtherPassed ✓
Compliance Checklist
Ensure AI is not the sole basis for denying prior authorizations based on medical necessity. Who: Utilization review organizations Deadline: By July 1, 2026 Penalty: Potential suspension of authority to conduct utilization reviews.
Implement electronic submission processes for prior authorization requests. Who: Health care providers Deadline: By July 1, 2027 Penalty: Non-compliance may lead to delays in authorization.
Full Legal Analysis
House File 2635 establishes new standards of conduct for health carriers and utilization review organizations in Iowa, particularly focusing on the use of artificial intelligence in the prior authorization process. The bill's text needs to be verified to confirm if it explicitly prohibits sole reliance on AI for medical necessity decisions. It also addresses certificate of need processes, which are critical for health care facility expansions and services. The bill's description does not confirm a process for health care providers to appeal adverse determinations. The effective date for these provisions is July 1, 2026.
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