Iowa House Bill HF637

Iowa 2025-2026 Regular Session

• Introduced: 2/28/25
• Refer: 4/3/25

Caption

A bill for an act relating to the recovery of overpayment of a claim by a dental carrier.(Formerly HSB 190.)

Impact

The bill is designed to enhance the protective measures for dental providers against unwarranted overpayment recoveries. By formalizing procedures that dental carriers must follow, the legislation seeks to reduce the potential for fraudulent recoveries or unwarranted financial burdens placed on dental practices. The requirement for timely notification and the establishment of clear appeal processes aim to foster a more equitable relationship between dental providers and insurance companies, thereby impacting the operational landscape of dental practices across the state.

Summary

House File 637 establishes guidelines for the recovery of overpayments made by dental carriers to dental providers. This legislation aims to ensure that dental care providers are notified of overpayment recoveries and that they retain the right to appeal such decisions. It mandates that carriers must provide detailed written notification within 365 days of any overpayment, clearly indicating the errors that necessitated the recovery. Additionally, it empowers dental providers to access relevant claim information pertaining to any dispute over these payments, allowing for greater transparency in the claims process.

Contention

While many stakeholders support HF637 for its consumer-friendly provisions, there may be contention regarding the administrative burdens it places on dental carriers. Critics may argue that the requirements for detailed notices and the appeal process could complicate the recovery of overpayments, possibly leading to increased operational costs for insurance providers. Additionally, the bill includes a clause that mandates the inability to waive these requirements by contract, which may raise concerns among dental carriers about the limitations placed on their contractual agreements with providers.