Iowa’s Republican Gov. Kim Reynolds has signed a bill into law eliminating the need for health insurance companies to authorize cancer screenings after they are requested by doctors, making it easier for patients to get treatment.
The issue is particularly pressing in the Midwestern state because it has the second-highest rate of cancer diagnoses of all the states in the union.
Some 87 of its 99 counties are listed as having cases significantly above the national norm, according to a University of Iowa study in February. The precise reason for that is not known but researchers are expected to turn in a report on their findings in July.
In the meantime, the new “Patients First Act” signed by Gov. Reynolds at Monroe County Hospital in Albia will remove a key bureaucratic obstacle for doctors seeking to establish whether their patients have the condition or not.
The legislation passed the Iowa House and Senate unanimously, 87-0 and 44-0 respectively, before reaching the governor’s desk and will now come into effect on July 1.
“We know those prior authorizations can take several weeks at some times to be able to get approved or denied, and this would now prohibit them,” said Iowa GOP State Rep. Austin Harris, who co-authored the bill.
“They’re going to be able to get those screenings much faster.”
In addition to streamlining the approval process and requiring insurance companies to give a clinical reason for denying care, it will also set deadlines for them to communicate with hospitals about particular patients’ claims in order to improve transparency and streamline the process.
“By establishing firm timelines for notifications, decisions, and appeals, insurance companies will now be required to provide clear clinical explanations when care is denied,” Gov. Reynolds said at the signing.
“And this helps providers spend less time navigating red tape and more time with the people they serve.”
The bill further moves to block insurers from using artificial intelligence as part of the process of approving or denying claims.
“One of the things that we have seen over time is that there has been some effort to only use AI in denials,” said Shelly Russell, board chair for Iowa Hospital Association.
“We didn’t want that. That’s a piece of that bill so that they couldn’t just deny it based only on AI. There has to be a human element in that.”
