2021 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.

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 obligations 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 carries pay for the same services. This disparity is leading to may providers making the difficult decision to limit the number of Medicaid patients for which they care.

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. Over the past several years, non-physician healthcare provider have sought legislation expanding their scope of practice. IOMA believes that the providers seeking to expand their scope of practice bear the burden of proof in demonstrating that they are capable of providing high quality, cost-effective and safe care to Iowans. The Legislature should be skeptical of claims of expanded access to care until they are presented with validated data demonstrating the distribution of the practitioners in question.

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 to how contact them.

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

Wellness is at the core of the Osteopathic approach to health care. Key to individual wellness is the health of the community in which a person lives. A robust public health system can reduce illness, improve well-being, and make workers more productive. All of these benefits lead to a reduction in the cost of health care and make Iowa a more attractive place to work and live. We encourage the State to continue to set health goals such as those contained in the Healthy Iowans 2020. IOMA supports adequate funding of the state Department of Public Health and local boards of health.

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 they 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 non exist. IOMA also supports efforts to expand Iowa’s health workforce through workforce incentives and forgivable loans.

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 spectrum, updating the committal process and creating sufficient treatment facilities.

The difference is that the osteopathic physician receives additional training in what the osteopathic profession believes to be a most significant factor in comprehensive health care.

The D.O. recognizes that all the body’s systems are interdependent and a disturbance in one system causes altered function in other systems of the body. D.O.s use structural diagnosis and manipulative therapy of the musculoskeletal system, along with all of the other more traditional forms of diagnosis and treatment (drugs and surgery), to care effectively for patients and to relieve their distress.

“The mission of the Iowa Osteopathic Medical Association is helping members practice osteopathic medicine and preserve the profession.”


Iowa Osteopathic Medical Association
6919 Vista Drive
West Des Moines, IA 50266
515-282-9117 FAX