2009 Iowa Code
Title 13 - Commerce
Subtitle 1 - Insurance and Related Regulation
CHAPTER 514I - HEALTHY AND WELL KIDS IN IOWA PROGRAM
514I.6 - PARTICIPATING INSURERS.

        514I.6  PARTICIPATING INSURERS.
         Participating insurers shall meet the qualifying standards
      established by rule under this chapter and shall perform all of the
      following functions:
         1.  Provide plan cards and membership booklets to qualifying
      families.
         2.  Provide or reimburse accessible, quality medical or dental
      services.
         3.  Require that any plan provided by the participating insurer
      establishes and maintains a conflict management system that includes
      methods for both preventing and resolving disputes involving the
      health or dental care needs of eligible children, and a process for
      resolution of such disputes.
         4.  Provide the administrative contractor with all of the
      following information pertaining to the participating insurer's plan:

         a.  A list of providers of medical or dental services under
      the plan.
         b.  Information regarding plan rules relating to referrals to
      specialists.
         c.  Information regarding the plan's conflict management
      system.
         d.  Other information as directed by the board.
         5.  Submit a plan for a health improvement program to the
      department, for approval by the board.
         6.  Develop a plan for provider network development including
      criteria for access to pediatric subspecialty services.  

         98 Acts, ch 1196, §7, 16; 2003 Acts, ch 108, §131; 2003 Acts, ch
      124, §8; 2009 Acts, ch 118, §32, 33