DES MOINES, IOWA (May 13, 2026) — The Iowa Medical Society today applauded the signature of Governor Kim Reynolds on House File 2635 during a bill signing ceremony at Monroe County Hospital and Clinics, advancing significant reforms to prior authorization and strengthening protections for patients and physicians across the state.
“This law addresses a high priority for physicians across Iowa — fewer barriers to care and decisions grounded in clinical expertise,” said IMS President Lillian Erdahl MD.
“By addressing prior authorization challenges and strengthening accountability for insurers, we help ensure patients receive timely, appropriate care.”
House File 2635, a top legislative priority for IMS, makes substantial changes to how health-insurance carriers and utilization review organizations operate in Iowa. The law requires that only clinical peers or qualified reviewers may deny or downgrade prior-authorization requests, helping ensure medical decisions are made by individuals with appropriate expertise.
The legislation also exempts cancer-related screenings recommended under current National Comprehensive Cancer Network guidelines, as well as emergency medical conditions requiring immediate inpatient treatment, from prior authorization requirements across private insurance plans, Medicaid-managed care, and the Hawki program.
Additional provisions prohibit insurance carriers from penalizing physicians for referring patients to or affiliating with out-of-network providers, bar unreasonable or unconscionable contract terms, and ensure physicians have the opportunity to negotiate agreements and amendments with insurers.
The law also establishes new audit standards and timelines for insurer determinations and appeals, while including updates to Iowa’s certificate-of-need laws intended to support a more responsive, patient-centered health-care system.
IMS advocated for the bill throughout the 2026 legislative session, working with other leading health-care organizations, lawmakers, and physician members across the state to advance policies that improve access to care, reduce administrative burden, and strengthen the physician-patient relationship.
“This legislation represents meaningful progress for Iowa physicians and the patients they serve,” said IMS Director of Government Relations Seth Brown JD.
“We appreciate the bill’s sponsors, Senatpr Kara Warme, Representative Austin Harris, and Rep David Young for their leadership on the proposal and focus on removing administrative obstacles for Iowa physicians so they can focus on patient care.”
For more information about IMS advocacy efforts, visit iowamedical.org.
About Iowa Medical Society
The Iowa Medical Society, established in 1850, is the largest and oldest statewide professional association for Iowa physicians, representing more than 6,000 members. Its mission is to advance the practice of medicine through advocacy, education, and engagement with physicians throughout Iowa to ensure the highest quality of care for the patients they serve. Learn more at iowamedical.org.
