Overview
In the provider market, Iowa has limited oversight of certain non-profit corporations by requiring court approval for public benefit or religious corporations prior to a merger with a for-profit corporation. In 2020, Iowa’s certificate of need law, which requires healthcare providers to obtain state approval before opening a new facility, survived a legal challenge in the 8th Circuit after being attacked as anticompetitive and unconstitutional.
To control healthcare costs, Iowa protects consumers from some surprise medical bills by requiring insurers to cover all charges provided to an enrollee for emergency services, including those provided by out-of-network professionals and facilities. Additionally, Iowa’s telehealth law provides coverage parity, requiring insurers to provide the same level of coverage for telemedicine as in-person visits.
In 2023, Iowa enacted legislation stating that insurers, health plans, third-party administrators, and pharmacy benefit managers cannot discriminate against covered entities and contract pharmacies participating in the 340B drug program. In 2023-2024, the state legislature has entertained a number of bills addressing pharma-related issues, including PBMs and pharmaceutical affordability, as well as legislation to address non-compete clauses.
State Action
Latest Legislative Session: 1/9/2023 - 5/17/2023 (2023-2024 term). *Current session bill updates are ongoing. Check back weekly for updates.
HB 2408 (see companion bill SB 2238) – Iowa
Introduced: 2024 Status: In Process
A bill for an act relating to prescription drug affordability, including the creation of a prescription drug affordability board.
HB 93 (formerly known as HSB 8) – Iowa
Introduced: 2023 Status: In Process
An Act prohibiting specified provisions (limitations on competition) in agreements between employers and certain mental health professionals and including effective date provisions.
HF 13 (replaced by HF 144) – Iowa
Introduced: 2023 Status: Inactive / Dead
A bill for an act relating to rural emergency hospitals, including licensing requirements and fees, making penalties applicable, providing emergency rulemaking authority, and including applicability and effective date provisions.(See HF 144.)
HF 135 – Iowa
Introduced: 2019 Status: Inactive / Dead
A bill for an act relating to long-term services and supports and certain capitation rates under the Medicaid program, and including effective date provisions.
HF 144 (replaced HF 13) – Iowa
Introduced: 2023 Status: In Process
A bill for an act relating to rural emergency hospitals, including licensing requirements and fees, making penalties applicable, providing emergency rulemaking authority, and including applicability and effective date provisions.(Formerly HF 13.)
Iowa Code § 135C.1. Definitions: Health Care Facilities — General Provisions – Iowa
Introduced: Status: Enacted
Definitions for statutes under the chapter Health Care Facilities.
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Iowa Code § 135C.14. Rules: Health Care Facilities – Iowa
Introduced: Status: Enacted
The department shall, in accordance with chapter 17A and with the approval of the state board of health, adopt and enforce rules setting minimum standards for health care facilities.
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Iowa Code § 135N.1. Direct primary care agreements: Direct Primary Care Agreements – Iowa
Introduced: Status: Enacted
Statute governs direct primary care agreements.
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Iowa Code § 147A.12. Registered nurse exception: Emergency Medical Care – Iowa
Introduced: Status: Enacted
This subchapter does not restrict a registered nurse, licensed pursuant to chapter 152, from staffing an authorized service program provided the registered nurse can document equivalency through education and additional skills training essential in the …
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Iowa Code § 147A.13. Physician assistant exception: Emergency Medical Care – Iowa
Introduced: Status: Enacted
This subchapter does not restrict a physician assistant, licensed pursuant to chapter 148C, from staffing an authorized service program if the physician assistant can document equivalency through education and additional skills training essential in the …
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Pharm. Care Mgmt. Ass’n v. Gerhart – Iowa
District Court: Southern District of Iowa Status: Decided
Trade association representing pharmacy benefits managers (PBM) brought action against State of Iowa, seeking declaration that statute that regulated how PBMs established generic drug pricing …
United States et al. v. Anthem, Inc., and Cigna Corp. – California, Colorado, Connecticut, District of Columbia, Federal, Georgia, Iowa, Maine, Maryland, New Hampshire, New York, Tennessee, Virginia
District Court: District of Columbia Status: Decided
On April 28, 2017, the D.C. Circuit Court of Appeals affirmed the District Court’s decision to block the proposed $54 billion merger between Anthem and …
Federal Trade Commission and State of Idaho v. St. Luke’s Health System, Ltd and Saltzer Medical Group, P.A. – California, Connecticut, Delaware, Idaho, Illinois, Iowa, Kentucky, Maine, Maryland, Mississippi, Montana, Nevada, New Mexico, Oregon, Pennsylvania, Tennessee, Washington
District Court: District of Idaho Status: Decided
In March 2013, the FTC and the Idaho Attorney General filed a joint complaint challenging the merger betweenSt. Luke’s Health System, Idaho’s largest health system, …
In re: Suboxone Antitrust Litigation (State of Wisconsin, et al. v. Indivior Inc, et al.) – Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Utah, Virginia, Washington, West Virginia, Wisconsin
District Court: E.D. Pennsylvania Status: Pending
In September 2016, 35 state attorneys general and the District of Columbia brought a multi-district case against pharmaceutical manufacturer Indivior, MonoSol RX et al., alleging …
In Re: Generic Pharmaceuticals Pricing Antitrust Litigation – Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin
District Court: Eastern District of Pennsylvania Status: Pending
Plaintiffs are attorney generals from 48 states, Puerto Rico, and the District of Columbia, as well as classes of private plaintiffs that filed an antitrust …
Additional Resources
STATE BUDGET
The state operates on an annual budget cycle. Agency requests are submitted to the governor by October 1, and the Governor submits the proposed budget to the Legislature by February 1. The legislature adopts a budget in April or May, and the fiscal year begins in July.
STATE LEGISLATURE
The state’s 50 Senators are elected to four-year terms. The 100 members of the House of Representatives serve two-year terms. Sessions begin on the second Monday in January, and last 100 days in even-numbered years, and 110 days in odd numbered years. Bills carry over from odd to even numbered years.
