Iowa Gov. Kim Reynolds has signed the Patients First Act, which lets doctors order cancer screenings without prior approval from insurance companies. The law comes as Iowa continues to report one of the highest cancer rates in the U.S.
The measure takes effect July 1, but its reach is limited. Medicaid, Medicare, and many employer-plan members will not receive the new protections.
The Iowa Insurance Division said the law applies to people enrolled in fully insured individual or small-group plans. It also covers self-insured public employees and members of the State of Iowa plan.
Julie Watts, an Iowa Insurance Division insurance examiner, said the change will affect about 829,000 Iowans. That equals a little over 25% of the state’s population.
For those covered by the law, doctors can order cancer screenings without waiting for insurer approval. Insurers also cannot deny payment for those screenings when the service is a plan benefit or medically necessary.
Watts said the law removes prior authorization for qualifying cancer screenings. She said patients also cannot be penalized for having the screening done.
Dr. Dustin Arnold, chief medical officer at UnityPoint St. Luke’s Hospital, said the law will help patients get answers faster. He said waiting two weeks for possible cancer results can be difficult for both patients and physicians.
Arnold said earlier screening decisions can help patients and doctors move faster toward treatment planning. The practical effect is less waiting around before the next medical step.
The Iowa Insurance Division said federal action would be needed for similar protections to reach Medicaid, Medicare, and most employer-plan members. Watts called the new law a small step, but a meaningful one for the Iowans it covers.
Insurance companies must follow the new rules or face penalties. Those penalties could include fines, suspension, or license revocation.
Iowans unsure whether their plan qualifies can contact the Iowa Insurance Division at 515-654-6600.
