2009 Iowa Code
Title 13 - Commerce
Subtitle 1 - Insurance and Related Regulation
CHAPTER 514J - EXTERNAL REVIEW OF HEALTH CARE COVERAGE DECISIONS
514J.12 - STANDARD OF REVIEW.

        514J.12  STANDARD OF REVIEW.
         Review by the independent review entity is de novo.  The standard
      of review to be used by an independent review entity shall be whether
      the health care service or treatment denied by the carrier or
      organized delivery system was medically necessary as defined by the
      enrollee's evidence of coverage subject to Iowa law and consistent
      with clinical standards of medical practice.  The independent review
      entity shall take into consideration factors identified in the review
      record that impact the delivery of or describe the standard of care
      for the medical service or treatment under review.  The medical
      service or treatment recommended by the enrollee's treating health
      care provider shall be upheld upon review so long as it is found to
      be medically necessary and consistent with clinical standards of
      medical practice.  

         99 Acts, ch 41, §18, 22