Initial 2022 Legislative Priorities
At their September 17 meeting, the IMS Board of Directors voted to approve recommendations from the Committee on Legislation for our initial 2022 Legislative Agenda. These priorities are as follows:
Medical Liability Reform
Combatting Vaccine Hesitancy
Expanding Physician Workforce
Protecting Safe Medical Care
Reducing Administrative Burden
Read the full Initial 2022 Legislative Priorities
These priorities represent the top focus areas for the organization as we prepare for the next legislative session, however, this is by no means an exhaustive list. Each session, IMS engages on hundreds of pieces of legislation to ensure the voice of Iowa physicians is a part of the policy discussions that impact medical practice in our state.
IMS Legislative Planning
Early each fall, the IMS Committee on Legislation meets to establish recommendation to the Board of Directors for the organization’s Legislative Agenda for the coming year. Ideas for these priorities come from a host of source. A member might submit a legislative request through the Policy Forum process, staff flag trends in issues that they hear from member contacts throughout the year, and partner organizations regularly contact IMS to request that we partner to work on a legislative idea.
Regardless of its source, an idea for legislative action follows the same path. Staff review the issues and work to identify potential legislative and non-legislative solutions, including legislation that has been proposed in other states to address the problem. This information is then shared with the IMS Committee on Legislation – a diverse group of physicians from various specialties, practice settings, and areas of the state, as well as representatives from both medical schools. This group finalizes the recommended priorities to the IMS Board of Directors for approval at their September meeting.
Once approved, these initial priorities are shared with the membership, the impacted IMS standing committees that meet throughout the fall, and other key IMS partners for feedback and additional insights. This input is brought back to the Committee on Legislation when it reconvenes in late fall to determine if any refinements or additions should be made to the IMS Legislative Agenda. If adjustments or additional priorities are recommended, these are approved by the IMS Board of Directors at its December meeting.
For more information on the IMS legislative priority development process, to share your thoughts on the initial 2022 Legislative Agenda, or to get more involved in this work, please contact Dennis Tibben with the IMS center for Physician Advocacy.
Through a contract with the Iowa Department of Public Health (IDPH), IMS has worked over the past year to lead a multi-disciplinary workforce project team that included the Iowa Hospital Association, the Iowa Pharmacy Association, and the Iowa Primary Care Association. This group has collaborated to establish a comprehensive statewide strategy to address the workforce barriers in Iowa. This initiative brought together healthcare leaders and stakeholders from the business, payer, and educational communities. It built upon the work initiated in 2018 with the formation of the IMS Physician Workforce Committee and the fall 2019 Physician Workforce Stakeholder Meeting that included many of these same stakeholder groups meeting for the first time across industries for a frank and comprehensive discussion about our state’s provider workforce needs at all levels.
Over the past year, the project team has conducted a series of townhall-style focus groups and surveys to identify needs, barriers, and opportunities, which helped to inform a stakeholder task force that jointly crafted the Iowa Rural Healthcare Workforce Strategic Action Plan – Iowa’s first-ever comprehensive, statewide provider workforce strategic plan. This report has been submitted to IDPH and IMS has been tapped to lead year two of this work, which now pivots to implementation of the recommendations included in the plan.
This week’s full FDA approval of the Pfizer-BioNTech COVID-19 vaccine marks another milestone in the fight to end the pandemic, but nearly half of all Iowans remain unvaccinated and many remain deeply skeptical of the vaccines. In the face of this persistent vaccine hesitancy and confusion over the evolving public health guidance regarding COVID-19, more and more patients are looking for a trusted, local authority for information. Iowa physicians are well-versed in breaking down complex medical conditions and helping their patients make the best care decisions for their individual circumstances, but how do we reach those who are deeply skeptical of the safety, efficacy, or even the need for a COVID-19 vaccine? How do you explain the relatively new Emergency Use Authorization (EUA) process or know which authoritative source to seek out when there is often conflicting guidance from state, federal, and international sources? IMS is here to help.
IMS has launched a new vaccine confidence initiative aimed at better equipping Iowa physicians to be the trusted local messengers to help their communities navigate the questions and skepticism around the COVID-19 vaccines. This new project is being built in conjunction with state and federal public health experts to ensure that every Iowa physician has the tools necessary to best advise their patients on COVID-19 vaccinations. These resources will include:
In addition to these more traditional resources, IMS will be standing up one of the country’s first Vaccine ECHO Projects – a hub and spoke model of virtual grand rounds that will regularly connect physicians from across the state to share best practices and what’s working in their local communities. First established nearly twenty years ago by the University of New Mexico School of Medicine, Project ECHO utilizes technology to connect providers with subject matter experts and each other in a virtual “community of practice” to learn from each other and foster greater professional collaboration. Based upon New Mexico’s success in the treatment of hepatitis C, the ECHO model has been expanded and replicated for the treatment and management of a host of medical conditions. Now, IMS is leading the way in utilizing this innovative model to better equip Iowa physicians to build confidence in the COVID-19 vaccine.
IMS has hired a dedicated project manager with a background in public health and clinical care delivery to help lead this work. In the coming weeks and months, we will begin rolling out additional patient and provider resources, including live and on-demand trainings on skills such as motivational interviewing. The first of these resources – a quick guide on talking with patients about COVID-19, as well as a patient guide to understanding the COVID-19 vaccines and the EUA process – have been posted to the IMS Patient Resource Page. For more information on this project, please contact Kady Reese with IMS.
August 19, 2021
As the COVID-19 pandemic continues to impact our communities, the impending start of the 2021-2022 school year necessitates continued COVID-conscious planning by parents and students.
Over the summer, the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) issued updated guidance on face mask usage, including the recommendation for universal indoor masking by all students (age 2 and older), staff, teachers, and visitors to K-12 schools, regardless of vaccination status.
This guidance for universal indoor masking regardless of vaccination status was made in response to evolving understanding of the COVID-19 Delta variant. The Delta variant is significantly more infectious than previous strains of the virus, as contagious as the chicken pox. Delta may also carry with it greater risk for serious illness and potential hospitalization. The increased risk of infection, coupled with the current absence of an authorized COVID-19 vaccine for children under 12 years of age, warrants a return to more stringent COVID precautions.
As we await authorization for vaccination for individuals under age 12, masking by all individuals in all public indoor spaces, including school-based settings, is our best defense to protect our children against COVID-19 and emerging variants.
Vaccinated Individuals, Adults and Students Age 12+
While currently available COVID-19 vaccines have demonstrated strong effectiveness in preventing severe illness and hospitalization, we are learning more about the strength of defense against mild and non-symptomatic infection and transmission. Based on the information available and to best protect those who are currently unable to receive vaccination, vaccinated individuals should resume masking in all indoor public spaces, including school and child care settings.
Unvaccinated Individuals, Adults and Students under Age 12
Currently, there are no COVID-19 vaccines approved to protect children under the age of 12. While many infections among children may have been asymptomatic or have resulted in less severe illness with previous COVID variants, the Delta variant may potentially carry a higher risk of symptomatic infection and potential severe illness.
Until there is a vaccine available for all age groups, continued masking is critical to protect children under age 12 and vulnerable individuals who are otherwise unable to receive vaccination. Any unvaccinated person over the age of 2 should wear a mask in all indoor settings outside of your own home, including school and child care settings.
Persons with Previous COVID Infection
While prior COVID-19 infection does provide a level of natural immunity against COVID, current studies indicate this immunity is shorter-lived than immunity from vaccination. Vaccination among those who have also previously had COVID-19 strengthens and prolongs any existing immunity. Vaccination is appropriate and encouraged for persons who have had COVID-19. As with vaccinated individuals, wearing of face masks is the best practice to both protect yourself and those around you.
As we continue to navigate this pandemic and prepare for approval of COVID-19 vaccinations for children under the age of 12, it is understandable that parents and families have questions. Iowa’s physician community stands ready to help you make sense of it all. If you or a family member have not yet received your vaccination, speak with your family’s care provider about your individual health circumstances, the COVID-19 vaccines, and how best to keep your family safe.
The Centers for Medicare & Medicaid Services (CMS) has published the proposed rule for the 2022 Medicare Physician Fee Schedule (PFS). The proposed rule seeks to implement or receive public input on a number of payment and policy changes of interest including:
More information on these and additional policy and payment changes under consideration is available on the CMS website. IMS staff are in the process of completing a comprehensive review of the 1,700-page rule. In consultation with the AMA and other stakeholders, we will be preparing written comments ahead of the September 13, 2021, submission deadline. Watch future IMS publications for additional information. Please contact Dennis Tibben in the IMS Center for Physician Advocacy if you have questions or would like to provide input on this proposed rule.
In recent weeks, the Centers for Disease Control and Prevention (CDC) and the Iowa Department of Public Health (IDPH) have issued updated guidance on face mask usage. In recent days, the Iowa Legislature has enacted a new statutory ban on local municipalities and school districts enacting their own mask usage mandates.
These rapidly changing guidelines, coupled with the fatigue of a global pandemic now entering its fifteenth month, have left many Iowans understandably confused and frustrated about how best to protect themselves and their families from COVID-19. Iowa’s physician community understands your confusion and frustration, and stands ready to help you make sense of it all.
It is important to remember that while the local mandates are no longer in place, this new law does not prohibit individual mask use and still allows for private businesses to make their own decisions. If you are not yet fully vaccinated, masking in public settings, including schools, is one of the most effective ways to protect yourself and your family until the majority of Iowans are vaccinated.
Fully Vaccinated Individuals
Protecting you and your family starts with getting vaccinated as soon as possible, if you are eligible and able. Vaccine supply is now plentiful, widely available across the state, and approved down to age 12. Once you are fully vaccinated, the CDC and IDPH advise that a mask is no longer necessary in most settings to help protect you from COVID-19. Of note, in healthcare settings, masks are still recommended.
Full protection from COVID-19 occurs approximately two weeks following the completion of your vaccination series. If you have received the Pfizer/BioNTech or Moderna vaccines, this means a two-dose series. Between these two doses, you are not yet fully protected. You should continue to wear a mask in public settings. Similarly for the two weeks after receiving these or the single-dose Johnson & Johnson/Janssen vaccine, you should continue to wear a mask in public settings.
On May 10th, the Pfizer vaccine was approved for use in 12-15 year-olds. Currently, there are no COVID-19 vaccines approved to protect children under the age of 12. While infections among most children are less severe, some have seen severe complications. Children with even a mild infection are still able to transmit the disease to more vulnerable populations. We are also still learning about the long-term side effects of even mild infection. Until vaccines are approved for them, children ages 2-11 should wear a mask in public indoor spaces to protect themselves and those around them. The CDC continues to recommend children wear masks in school unless fully protected by vaccination- two weeks after their second dose is received.
A return to a more normal daily routine is on the horizon. For many of us who are now fully vaccinated, this return has already begun to occur. Adapting to the final phases of the COVID-19 pandemic can be stressful and confusing. As we move together toward a more normal tomorrow, we must exercise grace and understanding for the individual, small business, or family who is navigating mask usage in the manner that makes sense for their unique circumstances. Continue to look to your local physician as a trusted source to help make sense of evolving public health guidance, and encourage your friends and neighbors to join you in becoming vaccinated.
Together, we will emerge stronger from this pandemic.
Iowa practices have reported receiving a check that appears to be an insurance payment from TRPN DirectPay. The check, typically for $15 or $20, includes a restricted endorsement. This means that cashing or depositing the check automatically enrolls the clinic in TRPN’s network. Being enrolled in the network subjects the clinics to TRPN’s terms and conditions, which can be highly restrictive and unfavorable to clinics. For example, once enrolled, a clinic has agreed to:
Once enrolled, the clinic is bound to the terms for three years and the agreement auto-renews. If you or your clinic receive a check from TRPN DirectPay, review the enclosed terms and conditions carefully. You should be aware that merely depositing the check subjects your organization to these terms. IMS has notified the Iowa Attorney General’s Office of the issue.
It has been a long year as our state and our nation has worked to respond to the COVID-19 pandemic. Our healthcare community has faced dangerous supply shortages, worked long hours, and continuously adapted to ensure that Iowans have access to safe, quality care. Nearly 300,000 Iowans have become sick and sadly, more than 5,000 Iowans have lost their lives to this disease.
Fortunately, hope is on the horizon. While the rollout of the COVID-19 vaccine has not been as smooth or as quick as any of us would have liked, more than 300,000 Iowans have now received at least one dose of the vaccine and a third COVID-19 vaccine is now under consideration for federal authorization. At the same time, our state’s positivity rate has dropped substantially since its peak in November and the number of Iowans hospitalized with the disease is also on the decline.
These achievements should be celebrated, but it is also absolutely critical that Iowans not let their guard down now, even with the recent lifting of COVID-19-related public health state orders. It is likely going to be several months before COVID-19 vaccines are readily available and new, more highly infectious variants of the disease have begun to be detected in our state. The great achievements our state has made in the fight against the pandemic are a direct result of greater observance of the basic COVID-19 safety measures:
1. Wear a well-fitting facemask over your mouth and nose whenever you are in public, or in close contact with anyone outside your immediate household.
2. Avoid large gatherings and maintain at least six feet of social distance with those outside your immediate household.
3. Wash your hands with soap and water frequently and for at least twenty seconds especially when you are in public or have just blown your nose, coughed, or sneezed. If soap and water are not available, use hand sanitizer that contains at least 70% alcohol.
4. Monitor your daily health and be alert to COVID-19 symptoms including a fever, cough, or shortness of breath. If you experience symptoms, stay home and call your doctor immediately.
We must all continue to do the right thing and work together to keep ourselves and our communities safe. Failing to do so will result in another deadly spike in infections, which will further divert resources from rollout of the COVID-19 vaccines. Now is the time to double-down on the Iowan commitment to caring for our neighbors and working together to help end this pandemic.
While attempts to pass a hard cap during the 2020 Legislative Session were unsuccessful, IMS has not stopped working toward that goal. Over the past year, we have continued to educate legislators, successfully pushed to expand the pro-tort reform majority in the Iowa House, collected new data and additional examples of the implications of the current liability climate, and activated additional local physicians to contact targeted legislators. Behind the scenes, IMS has been brought on additional staff to support our efforts and developed detailed plans to maximize our chances for success in this uphill legislative battle. IMS has further grown the coalition of advocacy organizations who will be joining our efforts this session and developed extensive resources to equip physicians to advocate on this issue. IMS is all in on tort reform in 2021.
Hundreds of physicians have advocated for tort reform over the past year and reengaged in the lead up to the 2021 Legislative Session. We continue to hear questions about how an individual physician can help. There are so many ways to get involved, but where to start? This checklist is your one-stop resource to prepare to make your voice heard this legislative session and there are several steps you can take RIGHT NOW to do so.
Once you’ve prepared yourself for the tort reform fight, we need your help to recruit others. Iowa physicians have fought for more than 40 years to pass a hard cap on noneconomic damages. This session, we are closer than ever to finally achieving this goal, but the path is not easy and success is far from certain. We need your help to educate your peers about this problem and recruit more physicians, residents, and medical students to joint the fight that impacts us all.
This week, hundreds of providers across the state received their first doses of the new Pfizer-BioNTech COVID-19 vaccine. With thousands of additional doses now arriving weekly and the Moderna vaccine candidate likely receiving FDA approval within days, attention is now increasingly turning to those who have expressed reluctance to receiving the new vaccines. Recent national polling shows a steady increase in the number of individuals willing to receive a COVID-19 vaccine, but vaccine hesitancy both among general public and some provider groups remains at alarming levels. More must be done to ensure Iowans feel confident receiving a vaccine when it becomes available to them. This week, IMS is rolling out a new campaign intended to help build confidence in the new vaccines.
Physicians on the Frontlines
These efforts begin with you! IMS is compiling photos of Iowa physicians who are stepping up to receive their COVID-19 vaccines. These photos will be shared on social media and on the Physicians on the Frontlines website to spotlight local physicians who trust the safety and efficacy of the new vaccines. By showcasing physicians who patients know and trust, we can help to dispel myths about the vaccine and concerns that the development process was rushed. Please snap a quick photo as you receive your COVID-19 vaccination and submit it to IMS. We’ll make sure to share your photos statewide and showcase your leadership in helping to bring an end to the pandemic.
COVID-19 Vaccine Resources
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