View full title
A bill for an act relating to utilization review organizations' use of artificial intelligence, prior authorization determinations and exemptions, and audits, and including applicability provisions.(Formerly SSB 3118.)
In one paragraph
Iowa's SF 2421 (formerly SSB 3118) would have let utilization review organizations use an AI-based algorithm for initial review of prior authorization requests but not as the sole basis to deny, delay or downgrade a medical-necessity request, and would have required review by a qualified reviewer or clinical peer, written reasons, and deadlines for claim audits. HF 2635 was substituted and SF 2421 was withdrawn March 4, 2026.
Plain-English summary, written with AI assistance. The official text controls.
What it means for business
None: the bill was withdrawn and never became law. HF 2635 was substituted for it on March 4, 2026.
Key provisions
- Division I: an AI-based algorithm may be used for initial review but not as the sole basis for denying, delaying or downgrading a medical-necessity request; denials and downgrades must be made by a qualified reviewer or clinical peer.
- The organization must give written reasons signed by the reviewer, an appeals explanation and reviewer credential attestation, and hold a consultation with the provider within seven business days after notifying the provider of a denial.
- Division II: carriers could not require prior authorization for cancer-related screenings recommended under NCCN guidelines; Division III: no prior authorization for life-threatening conditions developing during inpatient care.
- Division IV: audit notice within 15 calendar days after selecting a claim, a determination within 45 calendar days after receiving documentation, and a final appeal determination within 14 days; on a violation the claim is automatically approved and promptly paid.
- Division I would have applied to requests on or after January 1, 2027, Divisions II and III to plans delivered or renewed on or after that date, and Division IV to audits initiated on or after that date.
- Status: attached to HF 2635 and HF 2635 substituted March 4, 2026; SF 2421 withdrawn the same day.
Latest legislative action
Mar 4, 2026. Withdrawn. S.J. 475.
Sponsors
| Name | Role |
|---|---|
| Health And Human Services | Sponsor |
Roll call votes
S Senate Commerce Report Mar 3, 2026
16 yea0 nay3 otherPassed
S Senate Health And Human Services Report Feb 23, 2026
17 yea0 nay1 otherPassed
Topics and industries
Related topics
Affected industries
This page is general information, not legal advice. Summaries are AI-assisted and may contain errors; read the statute for the controlling text and talk to a lawyer about your situation. Full disclaimer · Report an error