Iowa AI Prior Authorization Law (HF 2635)

The Iowa AI Prior Authorization Law (HF 2635) permits utilization review organizations to use artificial intelligence for initial prior authorization reviews. At the same time, it prohibits AI from being the sole basis to deny, delay, or downgrade an authorization request. The law took effect July 1, 2026.

What the Iowa AI Prior Authorization Law Requires

Adverse decisions require human clinical judgment. In practice, that means an AI system can screen and approve requests at the front end, but a denial, delay, or downgrade cannot go out the door on the algorithm’s word alone. A clinician has to be part of any adverse determination.

Enforcement and Context

Existing insurance law penalties apply to violations, so insurers face the same consequences they would for other utilization review failures. The measure aligns Iowa with the wave of states requiring a human in the loop for AI-assisted coverage decisions.

Source: Iowa Legislature: HF 2635

Report a violation: If you believe a business is violating this law, you can file a complaint with the Iowa Attorney General Consumer Protection Division.