Pregnant Minor Consent (HF 2564)

Under new Iowa Code § 135.196, a pregnant minor can now consent to her own prenatal, labor and delivery, and postnatal care — but only when a parent, guardian, or legal custodian isn’t reasonably available. The law covers physicians, nurse practitioners, PAs, nurses, and emergency medical care providers.

Key points: you still need informed consent from the minor herself, and if a parent can be reached, you should still involve them. The operative phrase is “reasonably available” — make sure your staff understands what that means and how to document it.

HPV & Hepatitis B Vaccine Parental Consent (SF 304)

Senate File 304 amends Iowa Code § 139A.35, which has long allowed minors to consent on their own to medical care related to sexually transmitted diseases. The amendment narrows that rule: minors can still get STD testing and treatment without a parent’s permission, but they can no longer consent to STD-related vaccinations on their own. As a practical matter, this means the HPV vaccine and hepatitis B vaccine now require parental or guardian consent for anyone under 18.

This is a straightforward workflow change — but it’s easy to miss. Pediatric offices, pharmacies that give vaccines, and school-based health centers all need to make sure their staff are checking for parental authorization before giving these shots to minors.

Parental Override for Minor Behavioral Health Treatment (HF 2523)

House File 2523 amends Iowa Code § 601.1 to give parents and guardians explicit authority to consent to mental health and substance abuse treatment for their minor child — even over the child’s objection. That covers everything from counseling and therapy to medication management and inpatient admission.

The law also revises voluntary admission under § 229.2: if a minor objects, the case goes to juvenile court (strict scrutiny standard) rather than being blocked outright. Importantly, providers are not required to treat just because a parent consents — clinical judgment still controls.

Bottom line: you now have clear authority to proceed on parental consent alone, but you need solid documentation of the authorization, any objection, and your clinical rationale.

Medical Ethics Defense Act (HF 571 / Iowa Code ch. 135S)

House File 571 — the “Medical Ethics Defense Act” — added Iowa Code ch. 135S, giving doctors, hospitals, and insurers broad legal cover to decline services that conflict with their ethical, moral, or religious beliefs. Here’s what it does:

• Conscience-based refusals. Providers and institutions can refuse to participate in services based on their conscience. For an organization, “conscience” is defined by its governing documents — think mission statements, bylaws, or internal policies.
• Protection from retaliation. Employers can’t fire, discipline, or retaliate against a provider for exercising these rights.
• Whistleblower protections. If a provider reports a violation of law, a breach of care standards, or a threat to patient safety, they’re protected from blowback.
• Free speech. The law shields speech and expressive activity related to medical ethics.
• Emergency care still required. The law doesn’t change existing emergency care obligations or HIPAA requirements. Those stay in place.

The law creates a private cause of action for practitioners who face retaliation — meaning a hospital that disciplines a conscience-exercising employee could end up in court. Review your policies now.

Abortion Medication & Informed Consent (HF 2788)

House File 2788 (which started life as HF 2563) amends Iowa Code §§ 146A.1, 146B.1, and 146F, and creates new § 146A.2, making several changes to how abortion services are regulated in Iowa:

• In-person visits required. A physician must now examine a patient in person before performing an abortion, including screening for coercion or abuse. Telehealth prescriptions and mail-order delivery of medications like mifepristone and misoprostol are no longer permitted.
• New informed consent steps. Before dispensing abortion-inducing drugs, physicians must get the patient’s signed consent on an FDA form, confirm she’s been told about specific risks, and advise her on how to access emergency surgical care if needed.
• Miscarriage care is not affected. The law clarifies that “abortion” does not include treatment for miscarriages, incomplete pregnancy losses, or ectopic pregnancies. Providers treating those conditions are not subject to these new requirements.
• Private lawsuits allowed. Anyone who dispenses abortion-inducing drugs in violation of the new rules can be sued for damages. The law does not, however, impose any liability on the patient herself.
• More detailed reporting. Providers must now report whether mifepristone or misoprostol were used in induced terminations.

This law creates real liability exposure for OB/GYN practices and any facility that dispenses these medications. If you haven’t already updated your informed consent forms, prescribing protocols, and compliance procedures, treat this as urgent.

Care Facility Placement (HF 2562 / Iowa Code ch. 144H)

House File 2562 addresses a longstanding gap: what happens when a patient needs facility placement, can’t consent, and has no available family or guardian? The law establishes a priority hierarchy of authorized decision-makers, lets a physician certify incapacity in the record, and creates a court-petition path when no one else is available.

Good news: the law provides civil and criminal immunity, plus protection from professional discipline, for anyone acting in good faith under these procedures.

Medicaid Rates & HHS Budget (HF 2782)

The state’s FY 2027 health and human services budget includes a mix of rate increases and cost-cutting moves that took effect July 1:

• Rate increases went to elderly waiver services ($3 million), ambulatory surgical centers ($1.2 million), and special population nursing facilities ($333,000).
• Cost containment measures include reduced rates for telehealth-delivered services and site-of-service differentials, a new 30-day same-diagnosis readmission policy, and a rule that Medicaid pays the lowest available price.
• Children’s coverage got a boost — Hawk-i (Iowa’s CHIP program) received an additional $7.2 million.
• Graduate medical education picked up $9.9 million transferred from healthcare workforce funds that were eliminated earlier.

Bottom line: if your organization bills Medicaid, check the updated fee schedules. The telehealth rate reductions and readmission policy changes in particular could affect your bottom line more than you’d expect.

MAHA Act: CE, Ivermectin & Psychology Compact (HF 2676)

One of the Governor’s top priorities this session, House File 2676 — officially the “Iowa Make America Healthy Again Act” — amends Iowa Code §§ 148.3 and 148C.3 (physician CE requirements), creates new § 148.15 (medical school nutrition coursework), and enacts the Psychology Interjurisdictional Compact (new Iowa Code ch. 147M). Here’s what matters most for providers and health systems:

• Physician continuing education. Doctors in a long list of specialties (family medicine, internal medicine, pediatrics, OB/GYN, cardiology, oncology, and more) now need at least one hour of CE on nutrition and metabolic health every four years to renew their license.
• Medical school curriculum. Starting July 1, 2028, Iowa medical schools must require at least 40 hours of nutrition and metabolic health coursework for graduation.
• Ivermectin goes over-the-counter. Pharmacists can now distribute ivermectin for human use without a prescription, and they’re shielded from professional discipline for doing so.
• Psychology Interjurisdictional Compact. Iowa joined the compact, which lets licensed psychologists provide telepsychology and temporary in-person services across participating state lines. This is a big deal for behavioral health access.
• Epinephrine delivery options expanded. The law now allows nasal spray epinephrine delivery systems (not just auto-injectors), with updated liability protections for schools and public facilities.

Some provisions don’t kick in until July 1, 2027. The medical licensing boards still need to adopt implementing rules for the CE requirement, so watch for those. Health systems with pharmacy and behavioral health operations should assess what this means for their day-to-day.

Organ Donor Insurance Protections (HF 2633)

This one is simple but important. House File 2633 (2026 Iowa Acts, ch. 1110) makes it illegal for insurance companies to deny coverage, cancel a policy, or jack up premiums on someone’s life insurance, disability insurance, or long-term care insurance just because they donated a living organ. It’s a protection that removes a real financial barrier that has discouraged some people from becoming donors.

If you run a transplant program or counsel patients considering organ donation, make sure your team knows about this — it’s the kind of change that can make a difference in a conversation with a potential donor.