IMS Advocate: 2021 Session - Week Ten

Saturday, March 20, 2021 7:30 AM | Sydney Maras (Administrator)

Both chambers spent considerable time in floor debate this week as they work to move policy bills through the legislative process. On Friday, the state’s Revenue Estimating Conference (REC) met to revise their estimates of the state’s tax receipts for the coming year. Legislators are required to follow the lower of the December or March REC estimates in the formation of the state budget each year. With this week’s revised estimates, budget discussions are expected to begin gaining steam in the next few weeks.

Tort Reform

Discussions continue on our top legislative priority this session – a hard cap on noneconomic damages. On Monday, the House placed HF 592, the bill to enact a $1 million hard cap on noneconomic damages, on its debate calendar. Under House rules, leadership is required to publish its debate calendar at least 24 hours in advance to give legislators notice of the bills coming up for consideration and time to hold closed-door party caucus meetings to prepare for debate. On Monday afternoon, House Republicans began their caucus on HF 592. Ahead of this meeting and throughout the discussion, IMS helped prepare our legislative champions and the bill’s floor manager to make the case for this reform and respond to opposition being raised by the handful of House Republicans who oppose the measure.

HF 592 remains eligible for consideration at any time, as long as it remains on the debate calendar. Leadership typically will not call a bill up for consideration until they have confirmed they have at least 51 members of their caucus in support of the measure. We continue to be a handful of votes short of this threshold. This week, IMS arranged for medical students and residents to travel to the capitol to have targeted discussions with our final holdout votes about how Iowa’s unfavorable liability climate is impacting our state’s ability to recruit and retain the next generation of physicians. It continues to be vitally important for House Republicans to hear from local physicians about the need for this reform. If you haven’t spoken to your House members lately on this issue, please contact them again directly or via the IMS Action Center.

Scope of Practice


On Tuesday, the Senate State Government took up consideration of HF 528, a bill to allow dentists to administer the flu and COVID-19 vaccines. The committee opted to not advance the amendment we told you about last week, which would prohibit dental administration of the COVID-19 vaccine, as well as limit administration of the flu vaccine to only adult patients who have an established relationship with that dentist.

Instead, the committee adopted a lesser amendment, which would prohibit the administration of either vaccine to patients under the age of 18, unless administered by a dentist as part of a state or county public health-organized vaccination clinic in accordance with CDC recommendations. The bill now moves to the full Senate where it is expected to pass. Upon passage, the bill must return to the House for consideration of the pediatric restriction amendment.


On Wednesday, the Senate took up and unanimously passed SF 296, which would expand the pharmacist statewide protocol statute to allow for administration of pediatric immunizations to patients over the age of three; allow for point-of-care testing and treatment for flu, strep, and COVID-19 to patients of any age; and allow for pharmacists to enter into a collaborative practice agreement with any authorized prescriber.

The bill now goes to the House where the Human Resources Committee has previously passed companion bill HF 794. In doing so, the committee amended that bill to remove the expanded pediatric immunization authority and prohibit treatment resulting from point-of-care testing for patients under the age of six. The House must now determine how to reconcile the two forms of the bill before sending the bill in some form back to the Senate for final passage.


Progress continues on one of our priority telehealth bills – HF 431, which would update statutory and administrative references to recognize audio-only telehealth as a permissible form of telehealth following the end of the public health emergency. This bill has previously passed the House unanimously. On Wednesday, a Senate subcommittee met to discuss the bill and unanimously passed the measure to the full Senate Human Resources Committee for consideration. While the telehealth payment parity bills have encountered significant pushback from the insurance industry and some members of the Senate, this coverage expansion enjoys wide support.

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