Iowa § 514J.116 Disclosure requirements

Iowa Statutes

§ 514J.116 — Disclosure requirements

Iowa § 514J.116

Title XIIICOMMERCE

Ch. 514JEXTERNAL REVIEW OF HEALTH CARE COVERAGE DECISIONS

This text of Iowa § 514J.116 (Disclosure requirements) is published on Counsel Stack Legal Research, covering Iowa primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Iowa Code § 514J.116 (2026).

Text

1.Each health carrier shall include a description of the external review procedures contained in this chapter in or attached to any policy, certificate, membership booklet, outline of coverage, or other evidence of coverage that is provided to a covered person. The description shall be in a format prescribed by the commissioner by rule.

2.The description required by subsection 1 shall include a statement that informs the covered person of the right of the covered person to file a request for an external review of an adverse determination or final adverse determination of the health carrier with the commissioner. The statement shall explain that external review is available when the adverse determination or final adverse determination involves an issue of medical necessity, appropriatenes

Free access — add to your briefcase to read the full text and ask questions with AI

1. Each health carrier shall include a description of the external review procedures
contained in this chapter in or attached to any policy, certificate, membership booklet,
outline of coverage, or other evidence of coverage that is provided to a covered person. The
description shall be in a format prescribed by the commissioner by rule.
2. The description required by subsection 1 shall include a statement that informs the
covered person of the right of the covered person to file a request for an external review
of an adverse determination or final adverse determination of the health carrier with the
commissioner. The statement shall explain that external review is available when the
adverse determination or final adverse determination involves an issue of medical necessity,
appropriateness, health care setting, level of care, or effectiveness. The statement shall
include the telephone number and address of the commissioner. The statement shall also
inform the covered person that when filing a request for external review, the covered person
will be required to authorize the release of any medical records of the covered person that
may be required to be reviewed for the purpose of reaching a decision on the request for
external review.