All Roll Calls
Yes: 142 • No: 0
IowaSF 47091st General Assembly (2025–2026)SenateWALLET
A bill for an act relating to prior authorization for dental care services, notice to dental care providers that a dental care service plan is state-regulated, and the recovery of overpayments by a dental carrier. (Formerly SSB 1146.) Effective date: 07/01/2025.
Sponsored By: COMMITTEE ON COMMERCE
Signed by Governor
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 1 benefits, 0 costs, 2 mixed.
Dental prior authorizations must be honored
Starting July 1, 2025, a dental plan must pay for services it approved by prior authorization. It must pay the provider the contracted rate. Plans can still deny or reduce payment in narrow cases, like when a benefit limit was later reached, the records do not match what was approved, the patient was ineligible, fraud occurred, another payer is responsible, or the provider left the network. Contracts cannot waive these protections. The insurance commissioner can issue rules to carry this out.
Fair process for dental overpayment recovery
Starting July 1, 2025, carriers must give written notice of any overpayment within 365 days of the provider receiving it. They must give providers at least 90 days to appeal and share the claim details used. If a carrier withholds money from another claim to recover, it must send written notice within 28 days that shows the original claim and the amount taken. Contracts cannot waive these protections. If the carrier reasonably believes fraud, abuse, or other intentional misconduct, the timing limits do not apply.
Clear notice when dental plans are state-regulated
Starting July 1, 2025, dental plans must tell providers when a patient’s plan is under Iowa insurance rules. ID cards issued on or after July 1, 2025 must include the words "state-regulated." Contracts cannot waive these disclosure rules. The insurance commissioner can set detailed rules.
Sponsors & Cosponsors
Sponsor
COMMITTEE ON COMMERCE
Affiliation unavailable
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
House vote • 3/19/2025
Passed House
Yes: 96 • No: 0
Senate vote • 3/17/2025
Passed Senate
Yes: 46 • No: 0
Actions Timeline
Signed by Governor.
5/1/2025GovernorReported correctly enrolled, signed by President and Speaker, and sent to Governor.
5/1/2025SenateMessage from House.
3/20/2025HouseImmediate message.
3/19/2025legislaturePassed House, yeas 96, nays 0.
3/19/2025HouseSubstituted for HF 874.
3/19/2025legislaturePlaced on calendar under unfinished business.
3/18/2025legislatureRead first time, passed on file.
3/18/2025legislatureMessage from Senate.
3/17/2025SenateImmediate message.
3/17/2025legislaturePassed Senate, yeas 46, nays 0.
3/17/2025SenateCommittee report, approving bill.
2/27/2025legislatureIntroduced, placed on calendar.
2/27/2025legislature
Bill Text
As Introduced
Enrolled
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