HF 913 provides for the continuation of health insurance for the surviving spouse and children of Iowa state employees. This applies when an employee's death is determined to be the direct result of a traumatic personal injury incurred during work duties, with specific exclusions like intentional misconduct or intoxication. The state must permit survivors to continue or re-enroll in existing coverage, though the state is not required to pay the insurance costs. If the state does not cover the costs, the surviving family members can elect to continue coverage by paying the premiums themselves. The bill applies retroactively to January 1, 2024.
This bill addresses various matters under the purview of the Department of Health and Human Services. It introduces new definitions related to mental health and disability services, such as "disability access point," and modifies who can serve as an advocate for involuntarily hospitalized patients, excluding certain affiliated employees. For child foster care, the bill updates terminology to explicitly include "individual licensees" and "approved kinship caregivers." These caregivers are granted decision-making authority under the "reasonable and prudent parent standard" for children in their care, and eligibility for extended foster care is updated to reflect these roles.
HF 58 requires Iowa health insurance plans to cover treatment for eating disorders, directly affecting patients with conditions like anorexia, bulimia, or binge eating disorder and their insurers. The bill mandates coverage for all services in a patient's treatment plan - including therapy, medications, hospitalization, and out-of-network care when local options are unavailable and medically necessary - without stricter copays or deductibles than for physical illnesses. It applies to most individual and group health plans starting January 1, 2026, excluding accident-only, dental, or Medicare supplement insurance. The Iowa Insurance Commissioner must create rules to enforce these requirements.
This bill requires insurers to negotiate medical malpractice settlement offers within policy limits in good faith. If an insurer refuses a claimant's settlement offer at or below the policy limit and a court later awards more than the limit, the insurer must pay the full judgment amount. Health care providers who face excessive judgments due to an insurer's refusal to negotiate can sue the insurer for damages, including legal fees. The bill directly affects medical providers (by protecting them from uncovered costs) and insurers (by imposing new liability for settlement refusal).
SF 87 requires most health insurance plans in Iowa to cover acupuncture services performed by licensed acupuncturists, starting January 1, 2026. The bill mandates that this coverage must be equally favorable as coverage for general physical illness, meaning out-of-pocket costs (like deductibles or copays) cannot be higher than for standard medical care. It applies to individual, group, and small group health insurance plans but excludes dental, vision, Medicare supplements, workers' compensation, and other specialized coverage. This law directly affects health insurance providers and policyholders by expanding covered services without increasing patient costs relative to conventional medical treatments.
This bill requires most health insurance plans in Iowa to cover infertility diagnosis, treatment, and fertility preservation services starting July 1, 2025. It mandates coverage for up to three egg retrieval cycles with unlimited embryo transfers (using single embryo transfer when medically appropriate), and ensures fertility medications are covered at the same level as other prescription drugs. Plans must apply the same deductibles, copays, and benefit limits for infertility care as for other medical services. Religious employers may opt out of this requirement with written notice to employees. The law applies to standard health insurance plans but excludes dental, vision, short-term, and certain other specialized coverage types.
HF 4 requires healthcare providers to submit claims for reimbursement to a patient's primary health insurance plan first, before submitting to any secondary plans. It also mandates that primary health plans must provide a copy of the "explanation of benefits" (EOB) to the patient, their representative, or a secondary plan within 30 days of a request. The bill directly affects patients, healthcare providers, and health insurance companies by standardizing claim submission order and improving access to EOB documentation. These provisions aim to streamline billing processes and reduce administrative delays for covered individuals. The bill is procedural, focusing on claim handling rules rather than altering health coverage benefits.
SF 71 creates an annual 30-day open enrollment period for Iowa Medicare supplement policies, starting January 1, 2026, beginning on the applicant's birthday. It directly affects Iowans aged 65+ seeking individual policies, or those under 65 who qualify for Medicare due to disability, end-stage renal disease, or environmental hazard exposure. During this period, insurers cannot deny coverage, charge more based on health status, or exclude preexisting conditions. Applicants may switch to policies with the same or fewer benefits than their current coverage. The bill requires insurers to provide clear notice of this enrollment period to applicants.
SF 188 requires most health insurance plans in Iowa to cover contraceptive drugs, devices, and services without cost-sharing (like copays or deductibles), provided the plan covers other prescription drugs or services. It prohibits insurers from denying coverage, reducing benefits, or penalizing providers for offering contraceptive care, and defines "medical need" to allow doctors to recommend specific contraceptives without extra costs. The law applies to individual and group health plans (including those for public employees) issued or renewed on or after January 1, 2026, but excludes dental, vision, and short-term insurance. Insurers must clearly disclose contraceptive coverage details on their websites and via mail upon request.
HF 217 prevents health insurance companies and utilization review organizations in Iowa from requiring prior approval for cancer treatments recommended by a patient's doctor using National Comprehensive Cancer Network (NCCN) protocols. This directly affects cancer patients and their healthcare providers by removing a common administrative barrier to timely care. The bill’s key provision mandates that insurers must cover these NCCN-recommended treatments without prior authorization. It changes the policy by requiring insurers to follow established clinical guidelines for cancer care, rather than imposing separate approval steps.
