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STATE OF IOWA
KIM REYNOLDS
GOVERNOR
May 6, 2025
The Honorable Paul Pate
Secretary of State of Iowa
State Capitol
Des Moines, Iowa 50319
Dear Mr. Secretary,
I hereby transmit:
House File 875, an Act relating to health insurers' credentialing process.
The above House File is hereby approved on this date.
Sincerely,
( 4 , Kim Mynolds
Governor of Iowa
cc: Secretary of the Senate
Clerk of the House
STATE CAPITOL DES MOINES, IONX 7A 50319 515.281.5211 FAX 515.725.3527 WWW.GOVERNOR.IOWA.GOV
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House File 875
AN ACT
RELATING TO HEALTH INSURERS' CREDENTIALING PROCESS.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
Section 1. Section 514F.6, Code 2025, is amended to read as
follows:
514F.6 Credentialing rctr03pcctive paymcnt.
1. Retrospective payment. The commissioner shall adopt
rules to provide for the retrospective payment of clean
claims for covered services provided by a physician, advanced
registered nurse practitioner, or physician assistant during
the credentialing period, once the physician, advanced
registered nurse practitioner, or physician assistant is
credentialed.
2. Credentialing process.
a . A health insurer shall respond to a physician, advanced
registered nurse practitioner, or physician assistant's request
for credentialing within fifty-six calendar days from the date
of the request.
b. If a physician's, advanced registered nurse
practitioner's, or physician assistant's request for
credentialing is denied by the health insurer, the health
insurer shall provide a reason for the denial, in writing,
to the physician, advanced registered nurse practitioner, or
physician assistant.
3. Definitions. For purposes of this section:
a. Advanced registered nurse practitioner - means a person
House File 875, p. 2
currently licensed as a registered nurse under chapter 152 or
152E who is licensed by the board of nursing as an advanced
registered nurse practitioner.
b, - Clean claim"" means the same as defined in section
507B.4A, subsection 2, paragraph " b - .
C. - Credentialing - means a process through which a health
insurer makes a determination based on criteria established by
the health insurer concerning whether a physician, advanced
registered nurse practitioner, or physician assistant is
eligible to provide health care services to an insured and to
receive reimbursement for the health care services provided
under an agreement entered into between the physician, advanced
registered nurse practitioner, or physician assistant and the
health insurer.
d. - Credentialing period - means the time period between the
health insurer's receipt of a physician's, advanced registered
nurse practitioner's, or physician assistant's application for
credentialing and approval of that application by the health
insurer.
e, Physician - means a licensed doctor of medicine and
surgery or a licensed doctor of osteopathic medicine and
surgery.
f, " Physician assistant" means the same as defined in
section 148C.1.
PAT GRASSLEY
Speaker of t7e House President of the Senate
I hereby certify that this bill originated in the House and
is known as House File 875, Ninety-first General Assembly.
Approved Wk e , 2025
MEGAN NELSON
Chi f lerk
KIM R YNOLDS
Governor