Iowa  Iowa UM – 2.27.19 I.  Scope and Applicability A.  Who is subject to the state’s utilization management regulations? The provisions apply to third-party payors who provide health benefits to a covered individual residing in this state. Iowa Code § 514F.4(1); 191 IAC 70.3(1) HMOs? Yes. Insurers? Yes. Utilization Review Organizations? Yes, but indirectly. The regulation […]

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