Statewide Iowa (RI) — Supporters say a bill working its way through the Iowa Senate could speed up the process insurance companies and government-run insurance programs require before approving a patient’s medical treatment.
Seth Brown, a lobbyist for the Iowa Medical Society, says the bill addresses a huge headache for doctors, clinics, and hospitals.
The bill would require a peer-to-peer review when a doctor contacts a patient’s insurance company to try to reverse denied care.
Iowa’s two major hospital systems, UnityPoint and MercyOne, support the bill. Insurance companies oppose it.
Matt McKinney, a lobbyist for the Federation of Iowa Insurers, uses the phrase “utilitzation management” rather than “prior authorization.”
Jay McLaren is a lobbyist for Iowa Total Care, one of the three companies that’s managing all Medicaid claims in Iowa. He raised concerns about the bill’s requirement that notification letters name the person who rejected a doctor’s care plan.
McLaren says his company quit identifying the people making prior authorization decisions in December of 2024 shortly after the CEO of UnitedHealthcare was shot to death in New York City.
The bill also would make it illegal for insurance companies to use Artificial Intelligence to authorize or deny medical treatment. Lobbyists for insurance companies told senators human beings are making prior authorization decisions, and they don’t object to that part of the bill.
KIWA Staff Photo
