Fiscal Note
Fiscal Services Division
HF 347 – Licensed Optometrists, Injections (LSB1887HV.1)
Staff Contact: Christopher Ubben (515.725.0134) chris.ubben@legis.iowa.gov
Fiscal Note Version – Final Action
Description
House File 347 expands optometrists’ scope of practice as defined in Iowa Code section 154.1
to include the administration of injectable anesthetics prior to the administration of other
injections authorized in Iowa Code section 154.1(3)(b)(1).
Background
There are approximately 1,400 licensed optometrists in the State of Iowa. 2020 Iowa Acts,
chapter 1109, expanded the scope of practice of optometrists to include the administration of
injections for the following purposes:
• Subconjunctival injections for the medical treatment of the eye.
• Intralesional injections for the treatment of chalazia.
• Botulinum toxin to the muscles of facial expression innervated by the facial nerve.
• Injections to counteract an anaphylactic reaction.
The fiscal year (FY) 2023 General Fund appropriation for medical assistance was $1,510.1
million. According to the December 2022 Medicaid Forecast, the Medicaid surplus going into
FY 2023 is projected to be approximately $373.6 million.
Assumptions
• The Department of Health and Human Services estimates a 50.0% increase in provider
reimbursement costs for this procedure due to increased utilization.
• Increased costs could be absorbed within current Medicaid program funding.
Fiscal Impact
The 50.0% increase in utilization for the administration of injectable anesthetics would increase
costs by $357,000 for both FY 2024 and FY 2025. The State share of these costs paid from
Medicaid would be $129,000 for FY 2024 and $128,000 for FY 2025.
Sources
Department of Health and Human Services
Iowa Board of Optometry
Legislative Services Agency
/s/ Jennifer Acton
May 10, 2023
Doc ID 1373761
The fiscal note for this Bill was prepared pursuant to Joint Rule 17 and the Iowa Code. Data used in developing this
fiscal note is available from the Fiscal Services Division of the Legislative Services Agency upon request.
www.legis.iowa.gov
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Statutes affected:
Introduced: 154.1
Enrolled: 154.1