Gov. Reynolds outlines 2023 legislative priorities in address
Tuesday night, Gov. Kim Reynolds presented her annual condition of the state address in the Iowa House chamber. The governor expressed her support for a strong health care environment in Iowa, especially in rural areas.

“To support our families, we need a strong health care system in every part of the state,” said Gov. Reynolds. “While our health care system is in the top 10 nationally, we still face challenges, especially in rural Iowa.”

She highlighted several of IHA’s key priorities to achieve her goals including:

• Enacting common-sense tort reform to place hard caps on noneconomic damages in medical malpractice cases.
• Expanding funding for two more Centers of Excellence and four OB fellowships to connect maternal health services to rural patients.
• Increasing funding for the health care apprenticeship program from $3 million to $15 million and adding nursing apprenticeships for emergency medical services, mental and behavioral health, and direct support professionals.

Additionally, Gov. Reynolds addressed opioid overdoses and laid out plans for public awareness campaigns and making naloxone readily available to first responders.

IHA appreciates the governor’s recognition of the importance of health care in Iowa and looks forward to working together on these initiatives. These issues will be further discussed in IHA’s Legislative Bulletin. For more information and to receive IHA’s Legislative Bulletin, email Erin Cubit at IHA.

District Court remands case to HHS to determine 340B underpayment remedy
The U.S. District Court for the District of Columbia has decided to allow the Department of Health and Human Services to propose an appropriate remedy for its past underpayments to hospitals participating in the 340B Drug Pricing Program.

After a unanimous decision last summer, the D.C. court ordered HHS to halt its unlawful 340B cuts for the remainder of 2022. In the outpatient prospective payment system final rule for calendar year 2023, the agency said it would defer any proposal of a remedy for calendar years 2018-2022 until sometime before its calendar year 2024 payment rule. IHA is continuing to monitor this and will provide updates.

Omnibus appropriations bill expands telehealth flexibilities
The $1.7 trillion omnibus appropriations bill recently signed by President Joe Biden includes several provisions extending and expanding telehealth flexibilities through Dec. 31, 2024. Prior to this bill, many flexibilities would expire at the end of the COVID-19 public health emergency.

The new provisions include:

• Extending the ability for federally qualified health centers and rural health clinics to furnish telehealth services.
• Expanding originating site to include any site at which the patient is located, including the patient’s home.
• Delaying the six-month in-person requirement for mental health services furnished through telehealth, including the in-person requirements for federally qualified health centers and rural health clinics.
• Expanding eligible practitioners to furnish telehealth services to include occupational therapists, physical therapists, speech-language pathologists and audiologists.
• Extending coverage and payment for audio-only telehealth services.
• Extending the ability to use telehealth services to meet the face-to-face recertification requirement for hospice care.
• Extending safe harbor exceptions for telehealth services in high-deductible health plans.

Additionally, the Department of Health and Human Services secretary is required to submit an interim report in October 2024 and a final report on April 2026 about the utilization services.

IHA 2022 Highlights available now
The IHA 2022 Highlights Report is now available online and have been mailed to member hospitals. The annual booklet celebrates IHA’s successes in 2022 and provides a snapshot of results from the 2022 IHA membership satisfaction survey.

Census Bureau releases 2020 urban-area files
The U.S. Census Bureau release the official list of urban areas and is releasing relationship files and shapefiles for geographic analysis and mapping later this month. Organizations including the Office of Management and Budget and the Economic and Research Service use the files to define rural areas for multiple programs. Release of the files allows organizations to start calculating updated rural definitions.

The Census Bureau updated the criteria for identifying densely developed territory. It no longer separates urbanized areas and urban clusters by population size. All places with urban-land uses meeting the Census Bureau’s criteria are now delineated as urban areas, all other places are rural when using the Census Bureau’s definition.