House File 2080 - Introduced HOUSE FILE 2080 BY SCHULTE A BILL FOR An Act relating to the adjudication and payment of certain 1 claims by health insurers. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 5285YH (4) 83 av/nh

H.F. 2080 Section 1. NEW SECTION . 505.26 Claims adjudication and 1 payment of clean claims —— Medicare rules. 2 The commissioner of insurance, by rules adopted under 3 chapter 17A, shall develop a claims adjudication procedure 4 and a procedure for the payment of clean claims to be used 5 by carriers, as defined in section 514C.13, that are based 6 on the rules used by the federal Medicare program for those 7 procedures. 8 EXPLANATION 9 This bill requires the commissioner of insurance to adopt 10 rules that develop a claims adjudication procedure and a 11 procedure for the payment of clean claims based on the rules 12 used by the federal Medicare program for those procedures, to 13 be used by carriers that provide health benefit plans in this 14 state. 15 For the purposes of the bill, “carrier” means an entity 16 that provides health benefit plans in the state including 17 an insurance company, group hospital or medical service 18 corporation, health maintenance organization, multiple employer 19 welfare arrangement, and any other person providing health 20 benefit plans in this state subject to regulation by the 21 commissioner of insurance. 22 -1- LSB 5285YH (4) 83 av/nh 1/ 1