(Radio Iowa) – Supporters say a bill working its way through the Iowa Senate could speed up the process insurance companies and government-run insurance programs require before approving a patient’s medical treatment. Seth Brown, a lobbyist for the Iowa Medical Society, says the bill addresses a huge headache for doctors, clinics and hospitals.

“Administrative burdens associated with prior authorizations are definitely the top pain point for our members and something that they voice a lot of frustration about,” Brown said. “For every 45 minutes of paperwork, it’s about 30 minutes of patient care, so that is a little bit of a lopsided equation.” The bill would require a peer-to-peer review when a doctor contacts a patient’s insurance company to try to reverse denied care.

“For example, if you have a gynecologist reviewing a neurosurgery, it just doesn’t make sense,” Brown said, “and so some constraints around that are definitely welcome on our end.” Iowa’s two major hospital systems — UnityPoint and MercyOne — support the bill. Insurance companies oppose it. Matt McKinney — a lobbyist for the Federation of Iowa Insurers — uses the phrase “utilization management” rather than “prior authorization.”

“Whether we like it or not, there are millions upon millions of dollars that are wasted in this country on health care,” McKinney said. “There are millions that have been saved this year, in Iowa, because of utilization management.” Jay McLaren is a lobbyist for Iowa Total Care, one of the three companies that’s managing all Medicaid claims in Iowa. He raised concerns about the bill’s requirement that notification letters include the name of the person who decided a doctor’s care plan is not approved.

“The people who put those letters out there do face threats of retaliations,” McLaren said, “and that’s something that we have a concern for based on the safety of our employees and contractors.” McLaren says his company quit identifying the people making prior authorization decisions in December of 2024 shortly after the C-E-O of UnitedHealthcare was shot to death in New York City.

The bill also would make it illegal for insurance companies to use Artificial Intelligence to authorize or deny medical treatment. Lobbyists for insurance companies told senators human beings are making prior authorization decisions and they don’t object to that part of the bill.