Relating to the administration of injections by licensed optometrists

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