Iowa 2025-2026 Regular Session

Iowa House Bill HSB190

Introduced
2/17/25  

Caption

A bill for an act relating to the recovery of overpayment of a claim by a dental carrier.(See HF 637.)

Impact

If enacted, HSB190 affects the relationship between dental carriers and providers by introducing stricter guidelines on how overpayments can be handled. It requires that a dental provider must receive written notice of an overpayment within 365 days of the payment date, ensuring that carriers cannot retroactively reclaim funds without due process. This legislation is intended to foster fairness and transparency in the recovery process, ultimately benefiting dental care providers who may previously have faced arbitrary reclaim requests from insurance carriers.

Summary

House Study Bill 190 (HSB190) addresses the issue of overpayment recovery by dental carriers. The bill mandates dental carriers to establish written policies and procedures that allow dental care providers to appeal any overpayment recovery requests. Crucially, the bill defines an 'overpayment' as any erroneous payment made to a dental provider for dental services. The bill sets forth a structured framework for both carriers and providers, ensuring that providers are informed of the policies within a specified timeframe and have the opportunity to contest recoveries effectively.

Contention

The bill has the potential to stir some contention among industry stakeholders. While proponents argue that it provides essential protections for dental care providers against unjust overpayment recoveries, critics may raise concerns about the ability of insurance carriers to manage their financial risk if they are limited in their ability to reclaim funds. Additionally, there may be apprehension regarding the enforcement of the bill and how it aligns with existing contracts between dental providers and carriers, as any conflicting contractual provisions would be rendered null and void under this law.

Companion Bills

IA HF637

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

Previously Filed As

IA HF637

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

IA SSB1146

A bill for an act relating to prior authorization for dental care services, notice to dental care providers that a dental care service plan is state-regulated, and the recovery of overpayments by a dental carrier.(See SF 470.)

IA HF874

A bill for an act relating to prior authorization for dental care services, notice to dental care providers that a dental care service plan is state-regulated, and the recovery of overpayments by a dental carrier.(Formerly HSB 182.)

IA SF470

A bill for an act relating to prior authorization for dental care services, notice to dental care providers that a dental care service plan is state-regulated, and the recovery of overpayments by a dental carrier. (Formerly SSB 1146.) Effective date: 07/01/2025.

IA SB2458

Relating to the review of claims and recovery of overpayments by Medicaid recovery audit contractors.

IA HB3984

Relating to the review of claims and recovery of overpayments by Medicaid recovery audit contractors.

IA HSB183

A bill for an act relating to prior authorization for dental care services.(See HF 636.)

IA HB142

Relating to the Health and Human Services Commission's office of inspector general, the review of certain Medicaid claims, and the recovery of certain overpayments under Medicaid.

IA HSB182

A bill for an act relating to notice to dental care providers that a dental care service plan is state-regulated.(See HF 874.)

IA HF636

A bill for an act relating to prior authorization for dental care services.(Formerly HSB 183.)

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