A bill for an act relating to health carriers and payment of claims, audits, and standards of conduct; prior authorizations and utilization review organizations; and providing civil penalties and including applicability provisions.

HF 2438 sets new rules for health insurance companies (health carriers) regarding claim payments, audits, and conduct. It requires health carriers to pay clean claims within 30 days (electronic) or 45 days (paper), prohibits retroactive denials without evidence, and mandates reimbursement of providers' costs for responding to audits. The bill also establishes strict timelines for audits (15-day notice, 45-day completion) and appeals (30-day window), with automatic approval and interest for missed deadlines. These provisions directly affect health insurance companies, Medicaid programs (like Iowa's Medical Assistance and Hawki), and healthcare providers (doctors, hospitals) who submit claims.