Week 3 Legislative Update

It was another busy week at the capitol as legislators spent significant time in subcommittee meetings working to move legislation forward ahead of the first legislative funnel on Friday, February 16. Legislators have three weeks to pass policy bills out of a committee in their chamber of origin in order for the bills to remain viable for consideration yet this session. This week saw action on the following issues of interest to the medical community:

FY18 Deappropriation Bill

On Thursday, the Senate released its proposed deappropriations bill for the current 2018 Fiscal Year. Theses cuts are necessary to balance the state budget after the Revenue Estimating Conference, at its December meeting, reduced its projections for FY18 state tax income by approximately $45 million. The Senate proposal, which passed out of committee on a party-line vote, includes $1.4 million in cuts to the Department of Public Health and $6.6 million in cuts to the Department of Human Services as part of their overall $54 million FY18 spending reduction. The departments would be tasked with determining how specifically to achieve these reductions within 15 days of enactment. The Senate’s bill has not been agreed to by leadership from the House, who are in the process of developing their own deappropriation proposal.

Telehealth Parity

This week also saw the introduction of HSB 572 – legislation to establish commercial coverage parity for telehealth services. Telehealth coverage and payment parity is a 2018 IMS Legislative Priority as a result of PRS 17-2-04, which was adopted at last fall’s meeting of the IMS Policy Forum. On Thursday, the House held a subcommittee hearing on HSB 572. IMS was joined by a number of patient and provider groups speaking in support of the legislation. While the subcommittee did not vote to move the bill forward at the meeting, the members indicated that they intended to do so once a handful of questions raised at the meeting were answered. IMS continues to have conversations with legislators in both chambers about the importance of this telehealth parity.

Nonmedical Switching

Burdensome insurance requirements continue to be identified as one of the most pressing issues facing physicians of every medical specialty and practice arrangement. Insurer-imposed barriers to care are also frequently cited as a contributing factor to physician burnout. As part of our ongoing efforts to reduce the administrative burden on medical practices and combat physician burnout, this session IMS has joined with a host of patient and provider organizations to form the Iowa Continuity of Care Coalition focused on passage of legislation to prevent insurer-imposed nonmedical switching of patient medications.

This week, the House held a lengthy subcommittee to consider HSB 516, the House bill on this issue. The insurance industry and representatives of several Pharmacy Benefits Managers (PBMs) offered testimony arguing that the legislation was unnecessary and would limit their ability to make necessary mid-year adjustments to the pharmacy benefits for their insured lives. IMS joined numerous members of the coalition in offering testimony in support of the legislation, emphasizing the importance of ensuring physicians have the ability to select the medications most appropriate to meet the unique needs of their individual patients and to maintain access to those medications when a patient is medically stable. The subcommittee opted to not move the legislation forward, to allow more time to refine the bill and to answer the many questions that arose during the subcommittee meeting.

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