This bill requires Iowa's Department of Health and Human Services to seek federal approval to expand Medicaid and CHIP coverage for mental health services provided in schools. It ensures all children enrolled in Iowa's Medicaid or CHIP programs - regardless of whether they have a special education plan - can access covered services without needing a formal mental health diagnosis. Covered services include individual, group, and family therapy, prevention services, evaluation, and case management. The bill also mandates collaboration with schools and federal technical assistance to implement these changes, particularly in rural and under-resourced districts.
This bill (SF 433) removes a prior authorization requirement for direct-acting antiviral medications treating hepatitis C that are already on Iowa's preferred drug list for Medicaid. It directly affects Medicaid patients seeking hepatitis C treatment by simplifying access to these specific medications. The bill also requires the Iowa Medical Assistance Drug Utilization Review Commission to review the drug Vosevi for potential inclusion on the preferred formulary by July 1, 2026, per federal guidelines.
This bill requires Medicaid and health insurers to treat nonopioid pain medications equally with opioids in coverage. It prohibits designating nonopioid drugs as "nonpreferred" when opioids are preferred and bans stricter prior authorization or step therapy requirements for nonopioid drugs compared to opioids. Health insurers must develop a "pain management access plan" covering at least two FDA-approved non-opioid prescription medications (not controlled substances) and three non-drug pain treatments, without more restrictive rules for nonopioid options. The bill applies immediately upon FDA approval of a nonopioid pain drug, regardless of prior committee review. It affects Medicaid managed care organizations and health carriers offering coverage in Iowa.
SF 467 establishes licensing requirements for anesthesiologist assistants in Iowa. The bill requires individuals to complete an accredited education program, pass a certification exam, and obtain a license from the Board of Medicine to practice or use the title "anesthesiologist assistant" (including abbreviations "A.A." or "C.A.A."). It defines key terms like "anesthesiologist assistant" and "supervising anesthesiologist," and creates a new section (148K) outlining the board's authority to grant, deny, and renew licenses. This directly affects anesthesiologist assistants seeking to legally practice in Iowa and ensures standardized training and oversight.
HF 708 establishes clear guidelines for making healthcare decisions when patients cannot communicate, specifically for those with terminal conditions or serious illnesses. It defines key terms like "attorney in fact" (a health care agent), "close adult friend" (a designated trusted person meeting specific criteria), and clarifies hospice/palliative care eligibility. The bill creates a priority order for decision-makers: first a designated health care agent, then family members (spouse, children, parents), and finally a close adult friend, all guided by the patient’s known wishes. This focuses on ensuring patient autonomy and providing a structured process for care decisions without adding new services or altering hospice program requirements.
HF 716 allows employees and elected officials of local governments (like counties, cities, school districts, and community colleges) who participate in Iowa’s public retirement system to enroll in the state’s health insurance plan. It requires their employers to apply for coverage, pay monthly premiums at the same rate as state employees (including any employee contributions), and cover administrative fees. Payments go to a new trust fund managed by the state, and employers can deduct employee contributions subject to collective bargaining agreements. The bill mandates annual reports tracking costs, enrollment, and financial impacts. It takes effect July 1, 2026.
HF 735 requires health insurers and pharmacy benefits managers in Iowa to include all payments made by a plan participant (or others on their behalf) when calculating their total out-of-pocket cost-sharing under health plans. It specifically protects Health Savings Account (HSA) eligibility by delaying HSA contribution calculations until after a participant meets the federal minimum deductible, except for preventive care services. The bill applies to most health benefit plans issued or renewed in Iowa on or after January 1, 2026, but excludes accident-only, Medicare supplement, dental, vision, and other specialized coverage. It directs Iowa’s insurance commissioner to create implementing rules under Chapter 17A.
HF 739 requires Iowa's Medicaid dental plan contractors to set payment rates for dental providers equal to those paid under the Healthy and Well Kids in Iowa (Hawki) program for children. This change directly affects dental providers who treat Medicaid-eligible adults in Iowa, aiming to increase their participation in the Medicaid dental wellness plan. The bill mandates that reimbursement rates for adult dental services align with Hawki rates to improve access to dental care for Medicaid members. The goal is to address current low provider participation by making the Medicaid dental program more financially attractive.
HF 814 allows pregnant minors in Iowa to consent to prenatal, intrapartum, and postnatal medical care from specific healthcare providers if their parent, guardian, or legal custodian is not reasonably available. The bill directly affects pregnant minors who lack immediate access to a parent or guardian for medical decisions. It establishes that minors gain legal capacity to consent to this care, but healthcare providers must still obtain informed consent directly from the minor. The bill does not change existing requirements for providers to ensure minors understand their care options.
HF 815 requires Iowa's Medicaid program to automatically increase reimbursement rates for healthcare providers by 2.5% each July 1, regardless of other inflation adjustments. This applies to all providers enrolled in Medicaid as of July 1 of the prior year, directly affecting hospitals, clinics, and other medical service providers who bill Medicaid. The bill overrides existing laws about inflation indexing, mandating this specific percentage increase annually without additional legislative action. It ensures providers receive predictable, annual payment adjustments tied solely to this fixed rate.
