CEDAR RAPIDS, Iowa (KCRG) – Governor Kim Reynolds signed the Patients First Act earlier this month. It allows doctors to screen patients for cancer without approval from insurance companies. It comes as Iowa continues to have one of the highest cancer rates in the nation. But the law’s reach is limited. Only about one in four Iowans will benefit.
Iowans who use Medicaid, Medicare, or some kind of insurance through their employer will not see the benefits of the Patients First Bill.
The Iowa Insurance Division said the change will affect only people enrolled in fully insured individual or small-group plans, self-insured public employees, and those in the State of Iowa plan.
“Breaking that down, that’s only going to affect about 829,000 Iowans, or a little over 25% of Iowa’s population,” said Julie Watts, an Iowa Insurance Division insurance examiner.
For those patients that will be impacted, doctors can now order cancer screenings without needing insurance approval first. Insurers also cannot deny payment for those screenings.
“As long as it’s a benefit under their plan or it’s medically necessary, they have to. They’re just saying, you don’t need a prior authorization to have this done. And they can’t be penalized for having it done either,” Watts said.
The Chief Medical Officer at UnityPoint St. Luke’s Hospital said the bill will help patients learn if they have cancer faster.
“Once you know that you possibly have a cancer, you want your answers, and the sooner the better, to make those decisions on what the treatment is. So, could it wait two weeks? Yeah, probably. But that’s a torturous 14 days for that patient to wait, and even for the physician to wait,” said Dr. Dustin Arnold, UnityPoint St. Luke’s Chief Medical Officer.
The Iowa Insurance Division said for Medicaid, Medicare, and employer-plan holders to see similar benefits, federal action would be required.
“But this is a small step. This is great for those Iowans that this is going to affect,” Watts said.
As for the insurance companies, they will have to follow the new rules or they risk punishment like fines, suspension or revocation of their licenses.
For Iowans unsure if their plan qualifies for these benefits, the Iowa Insurance Division can be reached at 515-654-6600. The law takes effect on July 1.
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