Iowa case law summary by Attorney Richard Clem: Insurance.

Lyle H. Abbas, et al., v. Iowa Insurance Division. IA Insurance

The plaintiffs in this 2017 Iowa Supreme Court case construing Iowa Code section 514F.2 were Iowa-licensed chiropractors who argued that the payments made by Wellmark, Inc., were unlawfully discriminatory under the statute.

The Iowa Insurance Commissioner held that the insurer had not violated the statute, and the district court agreed.

On appeal, the Supreme Court affirmed, holding:

(1) the interpretation of section 514F.2 has not been clearly vested by a provision of law in the discretion of the commissioner, (2) section 514F.2 regulates payments to providers, (3) the health insurer’s payments for chiropractic care are not based solely on licensure, and (4) the Employee Retirement Security Program (ERISA) preempts the application of Iowa Code section 514F.2 to self-funded health plans.

No. 15-1248 (Iowa April 21, 2017).

Please see the original opinion for the court's exact language.

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Richard P. Clem is an attorney and continuing legal education (CLE) provider in Minnesota. He has been in private practice in the Twin Cities for 25 years. He has a J.D., cum laude, from Hamline University School of Law in St. Paul and a B.A. in History from the University of Minnesota. His reported cases include: Asociacion Nacional de Pescadores a Pequena Escala o Artesanales de Colombia v. Dow Quimica de Colombia, 988 F.2d 559, rehearing denied, 5 F.3d 530 (5th Cir. 1993), cert. denied, 510 U.S. 1041 (1994); LaMott v. Apple Valley Health Care Center, 465 N.W.2d 585 (Minn. Ct. App. 1991); Abo el Ela v. State, 468 N.W.2d 580 (Minn. Ct. App. 1991).

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