IOWA OSTEOPATHIC MEDICAL ASSOCIATION
2019 Legislative Agenda

The Iowa Osteopathic Medical Association (IOMA) represents osteopathic physicians dedicated to serving their patients.  IOMA supports legislation that will ensure that Iowans have access to high quality affordable health care.

IOWA MEDICAID

While IOMA understands the financial pressures placed on the Legislature by the Medicaid system, payments to physicians fall far below the cost of providing care to Medicaid recipients.

IOMA requests that the state of Iowa uphold its obligation to reimburse Iowa’s physicians at a fair and equitable rate for providing quality care for the state’s Medicaid recipients.

IOMA also believes that Medicaid savings should not be found through cuts to providers with so-called “cost containment strategies.”  These measures only serve to reduce already inadequate payment rates.  The Medicaid system is now paying providers less than half of what commercial carriers pay for the same service.  This disparity is leading to many providers making the difficult decision to limit the number of Medicaid patients for which they care.

MENTAL/BEHAVIORAL HEALTH

IOMA offers it thanks and appreciation to the Iowa General Assembly for their hard work during the 2018 Legislative Session to improve the mental/behavioral health system in Iowa.  Many of the items in HF 2456 will provide for a broader and more accessible statewide array of crisis and intensive mental health services.   However, as we are working through the regulatory process we still find that there are areas which need legislative attention.  Children’s mental health must be a priority this year.  Plus, the IOMA feels changes need to be made in the committal process.

IOMA is eager to continue our work with the Legislature to design programs and systems to accomplish taking down the barriers in patient access to mental/behavioral healthcare, coordinating services across the mental/behavioral healthcare spectrum, updating the committal process and creating sufficient treatment facilities.

PRIOR AUTHORIZATION

The use of prior authorization in recent years has greatly expanded to include requirements for prior authorization of diagnostic testing, medical procedures, and pharmaceutical agents, including even some generic medications. This expansion of prior authorization now greatly interferes with, prohibits, and/or delays patient access to medically indicated and necessary diagnostic and therapeutic services and agents.

Many claims payers and pharmacy benefit managers refuse to disclose the criteria they use to make decisions on prior authorization request, make decisions contrary to their published policies, render decisions which are arbitrary and capricious, and/or fail to disclose information on how to contact them.

IOMA will seek legislation to remedy these areas so it is not detrimental to their patient’s health or well being.

SCOPE OF PRACTICE

IOMA values the role allied health practitioners play in the health care delivery system.  IOMA believes each professional should practice within the scope of their accredited training.

HEALTH CARE WORKFORCE/ACCESS TO HIGH QUALITY CARE

It is no secret that Iowa’s healthcare workforce is aging.  Recent studies suggest that in addition to replacing retiring physicians Iowa will need 300 more primary care physicians by the year 2020.  It is also true that as Iowa’s population shifts from rural to urban population centers; rural areas face the greatest challenges in attracting and retaining physicians.

IOMA will work with the Legislature to create and fund novel programs to attract and retain physicians in Iowa.

Des Moines University

Des Moines University has been a reliable source of high quality physicians for Iowa for over 100 years.  IOMA supports the use of State funds, either directly or through scholarships, for DMU as a mechanism to increase the number of DMU graduates practicing in Iowa.

Graduate Medical Education

One of the most effective ways to attract new physicians to Iowa is to train physicians in Iowa.

IOMA supports the investigation and debate of GME payment policies that reflect the contributions of parties other than the federal government.  While IOMA believes that GME is an inherent “public good” and that the federal government should continue to subsidize the training of physicians, IOMA recognizes that other parties benefit as well.  To this end, IOMA continues to encourage debate focused on the potential establishment of alternate GME financing mechanisms that rely upon all parties involved with a majority of funding continuing to be provided by the federal government.

IOMA supports state funding in the form of grants and low interest loans to hospitals and other entities willing to start new residency training programs where none exist.  IOMA also supports efforts to expand Iowa’s health workforce through workforce incentives and forgivable loans.