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164 chapters · 3,415 sections in this title.
Iowa Code § 514J.101 Purpose — applicability.
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The purpose of this chapter is to provide uniform standards for the establishment and maintenance of external review procedures to assure that covered persons have the opportunity for an independent review of an adverse determination or final adverse determination made by a healt…
Iowa Code § 514J.102 Definitions.
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As used in this chapter , unless the context otherwise requires: 1. a. “Adverse determination” means a determination by a health carrier that an admission, availability of care, continued stay, or other health care service, other than a dental care service, that is a covered bene…
Iowa Code § 514J.103 Applicability and scope.
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1. Except as provided in subsection 2 , this chapter shall apply to all health carriers. 2. This chapter shall not apply to any of the following: a. A policy or certificate that provides coverage only for a specified disease, specified accident or accident-only, credit, disabilit…
Iowa Code § 514J.104 Notice of right to external review.
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1. A health carrier shall notify a covered person or the covered person’s authorized representative, if known, in writing of the covered person’s right to request an external review and include the appropriate statements and information set forth in this chapter at the time the h…