Impact for Pharmacists 
The 2021 Legislative Session, and first year of the 889th General Assembly, ended on May 19. The 2021 session brought several major victories for pharmacy and pro-pharmacy policies, including significant expansion of the authority of pharmacists. 

Victories

Test and Treat/Collaborative Practice
IPA's bill (SF 296/HF 794) to create a statewide protocol for test and treat and establish broad collaborative practice authority passed both the Senate and the House and was signed by the Governor on May 19. The new law will allow pharmacists to not only test for strep, flu, and Covid, but also prescribe necessary treatment following a positive test. 

The bill also establishes broad collaborative practice authority, ensuring that a pharmacist can enter into a CPA with any prescriber to treat any patient population in the state of Iowa. The legislation becomes effective July 1, and IPA is currently working the Board of Pharmacy to ensure smooth implementation of this major step forward.
 

Pharmacist Delegation/Pilot Project Authority
IPA also supported the Board of Pharmacy's legislation that was enacted into law this session. The law will broaden the ability of a pharmacist to delegate duties to a pharmacy technician using their professional judgment, including the administration of vaccines. The bill also expands the ability of the Board to approve innovative pilot projects to help improve patient care in Iowa. 
 

Medicaid Reimbursement 
In the fall of 2020, Iowa Medicaid indicated they did not intend to implement the latest cost of dispensing survey, which was to increase the pharmacy dispensing fee at $10.38. While this has previously never been the case following completion of the cost of dispensing survey, IPA was successful in amending the final HHS budget bill to ensure the increase to $10.38 was implemented. The amended language also ensures that every future increase will be implemented by IME immediately.  

Where Work Remains… 

PBM Reform
While these pieces are all positive, much work remains to reign in PBM practices that threaten the viability of pharmacies to continue serving patients. IPA's PBM bill cleared the House Commerce Committee but failed to advance past the second funnel deadline. The bill remains eligible for consideration next year, and we intend to begin working immediately to see passage of that bill and relief for pharmacies next session.  
 

Tiered Reimbursement 
While the push to ensure implementation of the latest and future dispensing fee increases was successful, a last-minute addition to the HHS budget has potentially detrimental implications moving forward. This change will allow the MCOs to pay out of state chain pharmacies, with more than thirty locations in the state of Iowa, a dispensing fee determined contractually by mutual agreement between the managed care organization and a participating pharmacy. IPA and our partners are already working to make sure this change is not used to erode Iowa's current system for Medicaid reimbursement, which has been a transparent and data-driven methodology since 2012.  

What's Next? 

The road to a successful 2022 Legislative Session starts right now. Here's how to help: hosting a legislator at your practice site, sitting down for a meeting to discuss pharmacy, or donating to the Iowa Pharmacy Political Action Committee are essential components to passing meaningful legislation next year. Additionally, if you are interested in the political process and pharmacy advocacy, consider signing up for IPA's Champion Advocate program.

Please contact IPA's Director of Public Affairs Casey Ficek at cficek@iarx.org to learn more about how you can get involved in IPA's advocacy efforts this year.