Iowa HF 2635 (no AI-only prior-auth denials)
Iowa House File 2635 (2026) — Health Insurance Trade Practices (AI Prior Authorization)
Iowa · Iowa H.F. 2635, 91st Gen. Assemb. (2026), Sec. 514F.8(2A), eff. Jan. 1, 2027
- Status
- Enacted (not yet in effect)
- Takes effect
- January 1, 2027
- Applies to
- Utilization review organizations and health carriers conducting prior-authorization review in Iowa.
- Enforced by
- Iowa Insurance Commissioner / Iowa Insurance Division
Iowa lets a utilization review organization use an AI-based algorithm or system to conduct an initial review of a prior-authorization request, but forbids relying on AI as the sole basis to deny, delay, or downgrade a medical-necessity prior-authorization request. A qualified human reviewer — a clinical peer or qualified reviewer — must make the binding determination.
Who is protected: Patients and providers subject to health-insurer prior-authorization decisions.
Legal detail
HF 2635 (signed May 13, 2026; AI/prior-authorization provisions effective Jan. 1, 2027), amending Iowa Code ch. 514F (Sec. 514F.8), permits a utilization review organization to use an AI algorithm/system for initial review but bars its use as the sole basis to deny, delay, or downgrade a medical-necessity prior-authorization request.
Key facts
| Jurisdiction | Iowa |
|---|---|
| Level | State |
| Strength | Moderate |
| Enacted | May 13, 2026 |
| Citation | Iowa H.F. 2635, 91st Gen. Assemb. (2026), Sec. 514F.8(2A), eff. Jan. 1, 2027 |
| Penalties | No new AI-specific penalty; existing prior-authorization and trade-practice remedies under Iowa Code chs. 505 and 507B apply. |
| Topics | healthcare AI · insurance AI · automated decision-making |
| Bill text | Iowa Legislature — House File 2635, 91st General Assembly |
More AI rules in Iowa
- Iowa Synthetic Intimate Content Law · In effect
- Iowa AI CSAM Law · In effect
- Iowa Consumer Data Protection Act · In effect
- Iowa SF 2417 (Conversational AI Safety Act) · Enacted (not yet in effect)
- Generative Artificial Intelligence (AI) Policy (ENTERPRISE PY-AI) · In effect
- Attorney General Brenna Bird Warns of Deepfake Dangers as Students… · In effect
Related healthcare AI rules elsewhere
- Missouri AI Therapy Chatbot Ban (SB 1019) · In effect
- PA v. Character.AI (Fake Psychiatrist Chatbot) · Blocked / in litigation
- RI Therapy Chatbot Ban (2026) · In effect
- RI AI Companion Self-Harm Safety (2026) · Enacted (not yet in effect)
- California AB 489 (AI healthcare chatbot misrepresentation ban) · In effect
- AZ HB 2175 (AI Insurance Denial — Physician Review) · In effect
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