2009 Iowa Code
Title 13 - Commerce
Subtitle 1 - Insurance and Related Regulation
CHAPTER 514F - UTILIZATION AND COST CONTROL
514F.5 - EXPERIMENTAL TREATMENT REVIEW.

        514F.5  EXPERIMENTAL TREATMENT REVIEW.
         1.  A carrier, as defined in section 513B.2, an organized delivery
      system authorized under 1993 Iowa Acts, ch. 158, or a plan
      established pursuant to chapter 509A for public employees, that
      limits coverage for experimental medical treatment, drugs, or
      devices, shall develop and implement a procedure to evaluate
      experimental medical treatments and shall submit a description of the
      procedure to the division of insurance.  The procedure shall be in
      writing and must describe the process used to determine whether the
      carrier, organized delivery system, or chapter 509A plan will provide
      coverage for new medical technologies and new uses of existing
      technologies.  The procedure, at a minimum, shall require a review of
      information from appropriate government regulatory agencies and
      published scientific literature concerning new medical technologies,
      new uses of existing technologies, and the use of external experts in
      making decisions.  A carrier, organized delivery system, or chapter
      509A plan shall include appropriately licensed or qualified
      professionals in the evaluation process.  The procedure shall provide
      a process for a person covered under a plan or contract to request a
      review of a denial of coverage because the proposed treatment is
      experimental.  A review of a particular treatment need not be
      reviewed more than once a year.
         2.  A carrier, organized delivery system, or chapter 509A plan
      that limits coverage for experimental treatment, drugs, or devices
      shall clearly disclose such limitations in a contract, policy, or
      certificate of coverage.  

         99 Acts, ch 41, §6