Prior Authorization in Iowa
Iowa enacted SF 2188 (2020) establishing step therapy exception requirements. Insurers must grant exceptions when the required drug is contraindicated, caused adverse reactions, is expected to be ineffective, or the patient is stable on current therapy. Iowa requires PA decisions within reasonable timeframes.
Key Facts About PA in Iowa
- ✓ Step therapy exception law with four qualifying criteria
- ✓ Stability on current therapy is a valid exception criterion
- ✓ External review available through the Iowa Insurance Division
- ✓ Wellmark BCBS is the dominant commercial carrier
Quick Stats
- Typical Appeal Filing Window: 30 days
- External Review Available: Yes
- Major Payers: 4
Top Payers in Iowa
RxCheckUp generates payer-specific Letters of Medical Necessity for each of these Iowa carriers:
Wellmark BCBSUnitedHealthcareMedicaAetna