Bill Text: IA HF803 | 2021-2022 | 89th General Assembly | Enrolled

---

Bill Title: A bill for an act relating to duties performed by physician assistants. (Formerly HSB 255.) Effective date: 07/01/2022.

Spectrum: Committee Bill

Status: (Passed) 2022-05-17 - Signed by Governor. H.J. 876. [HF803 Detail]

Download: Iowa-2021-HF803-Enrolled.html

---

House File 803 - Enrolled
House File 803
AN ACT
RELATING TO DUTIES PERFORMED BY PHYSICIAN ASSISTANTS.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
DIVISION I
DUTIES OF PHYSICIAN ASSISTANTS
Section 1. Section 90A.1, Code 2022, is amended by adding
the following new subsections:
NEW SUBSECTION . 5A. “Physician” means a person licensed as
a physician pursuant to chapter 148.
NEW SUBSECTION . 5B. “Physician assistant” means a person
licensed as a physician assistant pursuant to chapter 148C.
Sec. 2. Section 90A.8, subsection 2, Code 2022, is amended
to read as follows:
2. A contestant shall not take part in a boxing match
unless the contestant has presented a valid registration
identification card issued pursuant to section 90A.3 to the
commissioner prior to the weigh-in for the boxing match.
The contestant shall pass a rigorous physical examination
to determine the contestant’s fitness to engage in any such
match within twenty-four hours of the start of the match.
The examination shall be conducted by a licensed practicing
physician or physician assistant designated or authorized by
the commissioner.
Sec. 3. Section 96.5, subsection 1, paragraphs d and e, Code
2022, are amended to read as follows:

House File 803, p. 2
d. The individual left employment because of illness,
injury, or pregnancy upon the advice of a licensed and
practicing physician or physician assistant , and upon knowledge
of the necessity for absence immediately notified the employer,
or the employer consented to the absence, and after recovering
from the illness, injury, or pregnancy, when recovery was
certified by a licensed and practicing physician or physician
assistant , the individual returned to the employer and offered
to perform services and the individual’s regular work or
comparable suitable work was not available, if so found by the
department, provided the individual is otherwise eligible.
e. The individual left employment upon the advice of a
licensed and practicing physician or physician assistant ,
for the sole purpose of taking a member of the individual’s
family to a place having a different climate, during which
time the individual shall be deemed unavailable for work, and
notwithstanding during such absence the individual secures
temporary employment, and returned to the individual’s
regular employer and offered the individual’s services and the
individual’s regular work or comparable work was not available,
provided the individual is otherwise eligible.
Sec. 4. Section 135.109, subsection 3, paragraph b, Code
2022, is amended to read as follows:
b. A licensed physician , physician assistant, or nurse who
is knowledgeable concerning domestic abuse injuries and deaths,
including suicides.
Sec. 5. Section 135.146, subsection 2, Code 2022, is amended
to read as follows:
2. Participation in the vaccination program shall be
voluntary, except for first responders who are classified
as having occupational exposure to blood-borne pathogens as
defined by the occupational safety and health administration
standard contained in 29 C.F.R. §1910.1030 . First responders
who are so classified shall be required to receive the
vaccinations as described in subsection 1 . A first responder
shall be exempt from this requirement, however, when a
written statement from a licensed physician or physician
assistant is presented indicating that a vaccine is medically
contraindicated for that person or the first responder signs

House File 803, p. 3
a written statement that the administration of a vaccination
conflicts with religious tenets.
Sec. 6. Section 135J.1, Code 2022, is amended by adding the
following new subsection:
NEW SUBSECTION . 01. “Attending physician” means a physician
licensed pursuant to chapter 148 or a physician assistant
licensed pursuant to chapter 148C.
Sec. 7. Section 135J.1, subsection 6, paragraph e, Code
2022, is amended to read as follows:
e. As deemed appropriate by the hospice, physician
assistants, providers of special services including but
not limited to a spiritual counselor, a pharmacist, or
professionals in the fields of mental health may be included
on the interdisciplinary team.
Sec. 8. Section 135J.3, subsections 1 and 4, Code 2022, are
amended to read as follows:
1. A planned program of hospice care, the medical components
of which shall be under the direction of a licensed an
attending physician.
4. Palliative care provided to a hospice patient and family
under the direction of a licensed an attending physician.
Sec. 9. Section 141A.5, subsection 2, paragraph c, Code
2022, is amended to read as follows:
c. (1) Devise a procedure, as a part of the partner
notification program, to provide for the notification of an
identifiable third party who is a sexual partner of or who
shares drug injecting equipment with a person who has tested
positive for HIV, by the department or a physician or physician
assistant , when all of the following situations exist:
(a) A physician or physician assistant for the infected
person is of the good faith opinion that the nature of the
continuing contact poses an imminent danger of HIV transmission
to the third party.
(b) When the physician or physician assistant believes
in good faith that the infected person, despite strong
encouragement, has not and will not warn the third party and
will not participate in the voluntary partner notification
program.
(2) Notwithstanding subsection 3 , the department or a

House File 803, p. 4
physician or physician assistant may reveal the identity of a
person who has tested positive for HIV infection pursuant to
this subsection only to the extent necessary to protect a third
party from the direct threat of transmission. This subsection
shall not be interpreted to create a duty to warn third parties
of the danger of exposure to HIV through contact with a person
who tests positive for HIV infection.
(3) The department shall adopt rules pursuant to chapter
17A to implement this paragraph “c” . The rules shall provide a
detailed procedure by which the department or a physician or
physician assistant may directly notify an endangered third
party.
Sec. 10. Section 141A.6, subsections 3 and 4, Code 2022, are
amended to read as follows:
3. Within seven days of diagnosing a person as having AIDS
or an AIDS-related condition, the diagnosing physician or
physician assistant shall make a report to the department on a
form provided by the department.
4. Within seven days of the death of a person with HIV
infection, the attending physician or attending physician
assistant shall make a report to the department on a form
provided by the department.
Sec. 11. Section 141A.7, subsection 3, Code 2022, is amended
to read as follows:
3. A person may apply for voluntary treatment,
contraceptive services, or screening or treatment for HIV
infection and other sexually transmitted diseases directly to a
licensed physician and surgeon, an osteopathic physician and
surgeon, a physician assistant, or a family planning clinic.
Notwithstanding any other provision of law, however, a minor
shall be informed prior to testing that, upon confirmation
according to prevailing medical technology of a positive
HIV-related test result, the minor’s legal guardian is required
to be informed by the testing facility. Testing facilities
where minors are tested shall have available a program to
assist minors and legal guardians with the notification process
which emphasizes the need for family support and assists in
making available the resources necessary to accomplish that
goal. However, a testing facility which is precluded by

House File 803, p. 5
federal statute, regulation, or centers for disease control
and prevention guidelines from informing the legal guardian
is exempt from the notification requirement. The minor shall
give written consent to these procedures and to receive the
services, screening, or treatment. Such consent is not subject
to later disaffirmance by reason of minority.
Sec. 12. Section 144A.2, Code 2022, is amended by adding the
following new subsections:
NEW SUBSECTION . 2A. “Attending physician assistant” means
the physician assistant selected by, or assigned to, the
patient who has primary responsibility for the treatment and
care of the patient.
NEW SUBSECTION . 10A. “Physician assistant” means a person
licensed to practice as a physician assistant in this state.
Sec. 13. Section 144A.4, Code 2022, is amended to read as
follows:
144A.4 Revocation of declaration.
1. A declaration may be revoked at any time and in any
manner by which the declarant is able to communicate the
declarant’s intent to revoke, without regard to mental or
physical condition. A revocation is only effective as to
the attending physician or attending physician assistant
upon communication to such physician or physician assistant
by the declarant or by another to whom the revocation was
communicated.
2. The attending physician or attending physician assistant
shall make the revocation a part of the declarant’s medical
record.
Sec. 14. Section 144A.7A, subsection 1, Code 2022, is
amended to read as follows:
1. If an attending physician or attending physician
assistant issues an out-of-hospital do-not-resuscitate order
for an adult patient under this section , the physician shall
use the form prescribed pursuant to subsection 2 , include a
copy of the order in the patient’s medical record, and provide
a copy to the patient or an individual authorized to act on the
patient’s behalf.
Sec. 15. Section 144A.7A, subsection 3, paragraph e, Code
2022, is amended to read as follows:

House File 803, p. 6
e. The physician’s or physician assistant’s signature.
Sec. 16. Section 144B.1, subsection 3, Code 2022, is amended
to read as follows:
3. “Durable power of attorney for health care” means a
document authorizing an attorney in fact to make health care
decisions for the principal if the principal is unable, in the
judgment of the attending physician or attending physician
assistant , to make health care decisions.
Sec. 17. Section 144B.5, subsection 1, Code 2022, is amended
to read as follows:
1. A durable power of attorney for health care executed
pursuant to this chapter may, but need not, be in the following
form:
I hereby designate ........ as my attorney in fact (my
agent) and give to my agent the power to make health care
decisions for me. This power exists only when I am unable, in
the judgment of my attending physician or attending physician
assistant , to make those health care decisions. The attorney
in fact must act consistently with my desires as stated in this
document or otherwise made known.
Except as otherwise specified in this document, this document
gives my agent the power, where otherwise consistent with the
law of this state, to consent to my physician or physician
assistant not giving health care or stopping health care which
is necessary to keep me alive.
This document gives my agent power to make health care
decisions on my behalf, including to consent, to refuse to
consent, or to withdraw consent to the provision of any care,
treatment, service, or procedure to maintain, diagnose, or
treat a physical or mental condition. This power is subject
to any statement of my desires and any limitations included in
this document.
My agent has the right to examine my medical records and to
consent to disclosure of such records.
Sec. 18. Section 144B.6, subsection 1, Code 2022, is amended
to read as follows:
1. Unless the district court sitting in equity specifically
finds that the attorney in fact is acting in a manner contrary
to the wishes of the principal or the durable power of attorney

House File 803, p. 7
for health care provides otherwise, an attorney in fact who
is known to the health care provider to be available and
willing to make health care decisions has priority over any
other person, including a guardian appointed pursuant to
chapter 633 , to act for the principal in all matters of health
care decisions. The attorney in fact has authority to make
a particular health care decision only if the principal is
unable, in the judgment of the attending physician or attending
physician assistant , to make the health care decision. If the
principal objects to a decision to withhold or withdraw health
care, the principal shall be presumed to be able to make a
decision.
Sec. 19. Section 144D.4, subsection 3, Code 2022, is amended
to read as follows:
3. If the individual’s physician or physician assistant has
issued an out-of-hospital do-not-resuscitate order pursuant
to section 144A.7A , the POST form shall not supersede the
out-of-hospital do-not-resuscitate order.
Sec. 20. Section 144F.2, subsection 1, paragraph b, Code
2022, is amended to read as follows:
b. A legal representative who is an agent under a durable
power of attorney for health care pursuant to chapter 144B
shall be given the opportunity to designate a lay caregiver
in lieu of the patient’s designation of a lay caregiver only
if, consistent with chapter 144B , in the judgment of the
attending physician or attending physician assistant , the
patient is unable to make the health care decision. A legal
representative who is a guardian shall be given the opportunity
to designate a lay caregiver in lieu of the patient’s
designation of a lay caregiver to the extent consistent with
the powers and duties granted the guardian pursuant to sections
232D.401 and 232D.402 or section 633.635 .
Sec. 21. Section 189A.6, Code 2022, is amended to read as
follows:
189A.6 Health examination of employees.
The operator of any establishment shall require all
employees of such establishment to have a health examination
by a physician or physician assistant and a certified health
certificate for each employee shall be kept on file by the

House File 803, p. 8
operator. The secretary may at any time require an employee
of an establishment to submit to a health examination by a
physician or physician assistant . No person suffering from
any communicable disease, including any communicable skin
disease, and no person with infected wounds, and no person who
is a “carrier” of a communicable disease shall be employed in
any capacity in an establishment. No person shall work or
be employed in or about any establishment during the time in
which a communicable disease exists in the home in which such
person resides unless such person has obtained a certificate
from a physician or physician assistant to the effect that
no danger of public contagion or infection will result from
the employment of such person in such establishment. Every
person employed by an establishment and engaged in direct
physical contact with meat or poultry products during its
preparation, processing, or storage, shall be clean in person,
wear clean washable outer garments and a suitable cap or other
head covering used exclusively in such work. Only persons
specifically designated by the operator of an establishment
shall be permitted to touch meat or poultry products with their
hands, and the persons so designated shall keep their hands
scrupulously clean.
Sec. 22. Section 225.9, Code 2022, is amended to read as
follows:
225.9 Voluntary private patients.
Voluntary private patients may be admitted in accordance
with the regulations to be established by the state board of
regents, and their care, nursing, observation, treatment,
medicine, and maintenance shall be without expense to
the state. However, the charge for such care, nursing,
observation, treatment, medicine, and maintenance shall not
exceed the cost of the same to the state. The physicians or
physician assistants who meet the qualifications set forth
in the definition of a mental health professional in section
228.1 on the hospital staff may charge such patients for
their medical services under such rules, regulations and plan
therefor as approved by the state board of regents.
Sec. 23. Section 225.10, unnumbered paragraph 1, Code 2022,
is amended to read as follows:

House File 803, p. 9
Persons suffering from mental diseases may be admitted to
the state psychiatric hospital as voluntary public patients
if a physician authorized to practice medicine or osteopathic
medicine in the state of Iowa or a physician assistant who
meets the qualifications set forth in the definition of a
mental health professional in section 228.1 files information
with the regional administrator for the person’s county of
residence, stating all of the following:
Sec. 24. Section 225.10, subsections 1 and 2, Code 2022, are
amended to read as follows:
1. That the physician or physician assistant who meets
the qualifications set forth in the definition of a mental
health professional in section 228.1 has examined the person
and finds that the person is suffering from some abnormal
mental condition that can probably be remedied by observation,
treatment, and hospital care.
2. That the physician or physician assistant who meets the
qualifications set forth in the definition of a mental health
professional in section 228.1 believes it would be appropriate
for the person to enter the state psychiatric hospital for that
purpose and that the person is willing to do so.
Sec. 25. Section 225.12, Code 2022, is amended to read as
follows:
225.12 Voluntary public patient —— physician’s report.
A physician or a physician assistant who meets the
qualifications set forth in the definition of a mental health
professional in section 228.1 filing information under
section 225.10 shall include a written report to the regional
administrator for the county of residence of the person named
in the information, giving a history of the case as will be
likely to aid in the observation, treatment, and hospital care
of the person and describing the history in detail.
Sec. 26. Section 225.15, subsection 1, Code 2022, is amended
to read as follows:
1. When a respondent arrives at the state psychiatric
hospital, the admitting physician , or a physician assistant
who meets the qualifications set forth in the definition of a
mental health professional in section 228.1, shall examine the
respondent and determine whether or not, in the physician’s

House File 803, p. 10
or physician assistant’s judgment, the respondent is a fit
subject for observation, treatment, and hospital care. If,
upon examination, the physician or physician assistant who
meets the qualifications set forth in the definition of a
mental health professional in section 228.1 decides that the
respondent should be admitted to the hospital, the respondent
shall be provided a proper bed in the hospital. The physician
or physician assistant who meets the qualifications set forth
in the definition of a mental health professional in section
228.1 who has charge of the respondent shall proceed with
observation, medical treatment, and hospital care as in the
physician’s or physician assistant’s judgment are proper and
necessary, in compliance with sections 229.13 , 229.14 , this
section , and section 229.16 . After the respondent’s admission,
the observation, medical treatment, and hospital care of the
respondent may be provided by a mental health professional,
as defined in section 228.1 , who is licensed as a physician,
advanced registered nurse practitioner, or physician assistant.
Sec. 27. Section 225.16, subsection 1, Code 2022, is amended
to read as follows:
1. If the regional administrator for a person’s county
of residence finds from the physician’s information or
from the information of a physician assistant who meets the
qualifications set forth in the definition of a mental health
professional in section 228.1 which was filed under the
provisions of section 225.10 that it would be appropriate for
the person to be admitted to the state psychiatric hospital,
and the report of the regional administrator made pursuant to
section 225.13 shows that the person and those who are legally
responsible for the person are not able to pay the expenses
incurred at the hospital, or are able to pay only a part of
the expenses, the person shall be considered to be a voluntary
public patient and the regional administrator shall direct that
the person shall be sent to the state psychiatric hospital at
the state university of Iowa for observation, treatment, and
hospital care.
Sec. 28. Section 225C.14, subsection 2, Code 2022, is
amended to read as follows:
2. As used in this section and sections 225C.15 , 225C.16 ,

House File 803, p. 11
and 225C.17 , the term “medical emergency” means a situation
in which a prospective patient is received at a state mental
health institute in a condition which, in the opinion of the
chief medical officer, or that officer’s physician or physician
assistant designee, provided that a physician assistant
designee meets the qualifications set forth in the definition
of a mental health professional in section 228.1, requires the
immediate admission of the person notwithstanding the policy
stated in subsection 1 .
Sec. 29. Section 225C.16, subsection 1, Code 2022, is
amended to read as follows:
1. The chief medical officer of a state mental health
institute, or that officer’s physician or physician assistant
designee, provided that a physician assistant designee meets
the qualifications set forth in the definition of a mental
health professional in section 228.1, shall advise a person
residing in that county who applies for voluntary admission, or
a person applying for the voluntary admission of another person
who resides in that county, in accordance with section 229.41 ,
that the regional administrator for the county has implemented
the policy stated in section 225C.14 , and shall advise that a
preliminary diagnostic evaluation of the prospective patient
be sought, if that has not already been done. This subsection
does not apply when voluntary admission is sought in accordance
with section 229.41 under circumstances which, in the opinion
of the chief medical officer or that officer’s physician
designee, constitute a medical emergency.
Sec. 30. Section 232.71B, subsection 10, Code 2022, is
amended to read as follows:
10. Physical examination. If the department refers a
child to a physician or physician assistant for a physical
examination, the department shall contact the physician
or physician assistant regarding the examination within
twenty-four hours of making the referral. If the physician
or physician assistant who performs the examination upon
referral by the department reasonably believes the child has
been abused, the physician or physician assistant shall report
to the department within twenty-four hours of performing the
examination.

House File 803, p. 12
Sec. 31. Section 232.78, subsection 4, unnumbered paragraph
1, Code 2022, is amended to read as follows:
The juvenile court may enter an order authorizing a
physician or physician assistant or hospital to provide
emergency medical or surgical procedures before the filing of a
petition under this chapter provided:
Sec. 32. Section 232.78, subsection 5, unnumbered paragraph
1, Code 2022, is amended to read as follows:
The juvenile court, before or after the filing of a petition
under this chapter , may enter an ex parte order authorizing
a physician or physician assistant or hospital to conduct an
outpatient physical examination or authorizing a physician or
physician assistant , a psychologist certified under section
154B.7 , or a community mental health center accredited pursuant
to chapter 230A to conduct an outpatient mental examination
of a child if necessary to identify the nature, extent, and
cause of injuries to the child as required by section 232.71B ,
provided all of the following apply:
Sec. 33. Section 232.79, subsection 1, unnumbered paragraph
1, Code 2022, is amended to read as follows:
A peace officer or juvenile court officer may take a child
into custody, a physician or physician assistant treating
a child may keep the child in custody, or a juvenile court
officer may authorize a peace officer, physician or physician
assistant , or medical security personnel to take a child into
custody, without a court order as required under section 232.78
and without the consent of a parent, guardian, or custodian
provided that both of the following apply:
Sec. 34. Section 232.79, subsection 2, paragraph a, Code
2022, is amended to read as follows:
a. Bring the child immediately to a place designated by
the rules of the court for this purpose, unless the person is
a physician or physician assistant treating the child and the
child is or will presently be admitted to a hospital.
Sec. 35. Section 232.83, subsection 2, unnumbered paragraph
1, Code 2022, is amended to read as follows:
Anyone authorized to conduct a preliminary investigation
in response to a complaint may apply for, or the court on its
own motion may enter an ex parte order authorizing a physician

House File 803, p. 13
or physician assistant or hospital to conduct an outpatient
physical examination or authorizing a physician or physician
assistant , a psychologist certified under section 154B.7 , or a
community mental health center accredited pursuant to chapter
230A to conduct an outpatient mental examination of a child if
necessary to identify the nature, extent, and causes of any
injuries, emotional damage, or other such needs of a child as
specified in section 232.2, subsection 6 , paragraph “c” , “e” , or
“f” , provided that all of the following apply:
Sec. 36. Section 232.95, subsection 2, paragraph c, Code
2022, is amended to read as follows:
c. Authorize a physician , physician assistant, or hospital
to provide medical or surgical procedures if such procedures
are necessary to safeguard the child’s life or health.
Sec. 37. Section 234.22, Code 2022, is amended to read as
follows:
234.22 Extent of services.
Such family planning and birth control services may include
interview with trained personnel; distribution of literature;
referral to a licensed physician or physician assistant
for consultation, examination, tests, medical treatment
and prescription; and, to the extent so prescribed, the
distribution of rhythm charts, drugs, medical preparations,
contraceptive devices and similar products.
Sec. 38. Section 235A.13, subsection 9, Code 2022, is
amended to read as follows:
9. “Near fatality” means an injury to a child that, as
certified by a physician or physician assistant , placed the
child in serious or critical condition.
Sec. 39. Section 237A.5, subsection 1, Code 2022, is amended
to read as follows:
1. All personnel in licensed or registered facilities
shall have good health as evidenced by a report following a
preemployment physical examination taken within six months
prior to beginning employment. The examination shall include
communicable disease tests by a licensed physician as defined
in section 135C.1 or a licensed physician assistant as defined
in section 148C.1 and shall be repeated every three years after
initial employment. Controlled medical conditions which would

House File 803, p. 14
not affect the performance of the employee in the capacity
employed shall not prohibit employment.
Sec. 40. Section 237A.13, subsection 1, paragraph d, Code
2022, is amended to read as follows:
d. The child’s parent, guardian, or custodian is absent
for a limited period of time due to hospitalization, physical
illness, or mental illness, or is present but is unable to care
for the child for a limited period as verified by a physician
or physician assistant .
Sec. 41. Section 249.3, subsection 2, paragraph a,
subparagraph (2), Code 2022, is amended to read as follows:
(2) Nursing care in the person’s own home, certified by a
physician or physician assistant as being required, so long
as the cost of the nursing care does not exceed standards
established by the department.
Sec. 42. Section 321.375, subsection 4, paragraph b,
subparagraph (4), Code 2022, is amended to read as follows:
(4) Maintaining a daily log of all glucose test results
for the previous six-month period and providing copies to the
school district or school, the examining physician or examining
physician assistant , and the department of education upon
request.
Sec. 43. Section 321.446, subsection 3, paragraph c, Code
2022, is amended to read as follows:
c. The transportation of a child who has been certified by
a physician licensed under chapter 148 or a physician assistant
licensed under chapter 148C as having a medical, physical, or
mental condition that prevents or makes inadvisable securing
the child in a child restraint system, safety belt, or safety
harness.
Sec. 44. Section 347B.5, Code 2022, is amended to read as
follows:
347B.5 Admission —— labor required.
The county care facility shall maintain a record of the name
and age of each person admitted and the date of admission. The
board may require of any resident of the county care facility,
with approval of a physician or physician assistant , reasonable
and moderate labor suited to the resident’s age and bodily
strength. Any income realized through the labor of residents,

House File 803, p. 15
together with the receipts from operation of the county farm if
one is maintained, shall be appropriated for use by the county
care facility as the board of supervisors directs.
Sec. 45. Section 347B.6, Code 2022, is amended to read as
follows:
347B.6 Order for admission.
No person shall be admitted into the county care facility
as a resident except upon order of the board of supervisors,
which shall be issued only after the person seeking admission
has received a preadmission physical examination by a physician
or physician assistant . However, if the need for admission
of the person to the county care facility is immediate and
no physician or physician assistant is readily available to
perform the examination, the board may order the person’s
admission pending an examination by a physician or physician
assistant , any provisions of sections 135C.3 and 135C.4 to the
contrary notwithstanding. When an admission is so ordered, the
physical examination shall be completed within three days after
the person’s admission to the county care facility.
Sec. 46. Section 514C.17, subsections 1 and 2, Code 2022,
are amended to read as follows:
1. Except as provided under subsection 2 or 3 , if a carrier,
as defined in section 513B.2 , or a plan established pursuant to
chapter 509A for public employees, terminates its contract with
a participating health care provider, a covered individual who
is undergoing a specified course of treatment for a terminal
illness or a related condition, with the recommendation of the
covered individual’s treating physician licensed under chapter
148 or treating physician assistant licensed under chapter 148C
may continue to receive coverage for treatment received from
the covered individual’s physician or physician assistant for
the terminal illness or a related condition, for a period of
up to ninety days. Payment for covered benefits and benefit
levels shall be according to the terms and conditions of the
contract.
2. A covered person who makes a change in health plans
involuntarily may request that the new health plan cover
services of the covered person’s treating physician licensed
under chapter 148 or treating physician assistant licensed

House File 803, p. 16
under chapter 148C who is not a participating health care
provider under the new health plan, if the covered person is
undergoing a specified course of treatment for a terminal
illness or a related condition. Continuation of such coverage
shall continue for up to ninety days. Payment for covered
benefits and benefit levels shall be according to the terms and
conditions of the contract.
Sec. 47. Section 514C.18, subsection 1, unnumbered
paragraph 1, Code 2022, is amended to read as follows:
Notwithstanding the uniformity of treatment requirements of
section 514C.6 , a policy or contract providing for third-party
payment or prepayment of health or medical expenses shall
provide coverage benefits for the cost associated with
equipment, supplies, and self-management training and education
for the treatment of all types of diabetes mellitus when
prescribed by a physician licensed under chapter 148 or a
physician assistant licensed under chapter 148C . Coverage
benefits shall include coverage for the cost associated with
all of the following:
Sec. 48. Section 514C.18, subsection 1, paragraph b,
subparagraphs (1) and (2), Code 2022, are amended to read as
follows:
(1) The physician or physician assistant managing the
individual’s diabetic condition certifies that such services
are needed under a comprehensive plan of care related to the
individual’s diabetic condition to ensure therapy compliance or
to provide the individual with necessary skills and knowledge
to participate in the management of the individual’s condition.
(2) The diabetes self-management training and education
program is certified by the Iowa department of public health.
The department shall consult with the American diabetes
association, Iowa affiliate, in developing the standards for
certification of diabetes education programs that cover at
least ten hours of initial outpatient diabetes self-management
training within a continuous twelve-month period and up to two
hours of follow-up training for each subsequent year for each
individual diagnosed by a physician or physician assistant with
any type of diabetes mellitus.
Sec. 49. Section 514C.20, subsection 1, paragraphs a and b,

House File 803, p. 17
Code 2022, are amended to read as follows:
a. A child under five years of age upon a determination by
a licensed dentist and the child’s treating physician licensed
pursuant to chapter 148 or treating physician assistant
licensed pursuant to chapter 148C , that such child requires
necessary dental treatment in a hospital or ambulatory surgical
center due to a dental condition or a developmental disability
for which patient management in the dental office has proved
to be ineffective.
b. Any individual upon a determination by a licensed dentist
and the individual’s treating physician licensed pursuant to
chapter 148 or treating physician assistant licensed pursuant
to chapter 148C , that such individual has one or more medical
conditions that would create significant or undue medical risk
for the individual in the course of delivery of any necessary
dental treatment or surgery if not rendered in a hospital or
ambulatory surgical center.
Sec. 50. Section 514C.25, subsection 1, paragraph a, Code
2022, is amended to read as follows:
a. Notwithstanding the uniformity of treatment requirements
of section 514C.6 , a policy, contract, or plan providing for
third-party payment or prepayment of health or medical expenses
shall provide coverage benefits for medically necessary
prosthetic devices when prescribed by a physician licensed
under chapter 148 or physician assistant licensed under
chapter 148C . Such coverage benefits for medically necessary
prosthetic devices shall provide coverage for medically
necessary prosthetic devices that, at a minimum, equals
the coverage and payment for medically necessary prosthetic
devices provided under the most recent federal laws for health
insurance for the aged and disabled pursuant to 42 U.S.C.
§1395k, 13951, and 1395m, and 42 C.F.R. §410.100 , 414.202 ,
414.210, and 414.228 , as applicable.
DIVISION II
DUTIES OF PHYSICIAN ASSISTANTS —— RULES
Sec. 51. NEW SECTION . 147.77 Powers, privileges, rights, or
duties provided by rule —— applicability to physician assistants.
1. The following agencies that adopt rules pursuant to
chapter 17A providing a power, privilege, right, or duty to

House File 803, p. 18
a physician licensed under chapter 148 or other profession
licensed under this subtitle relating to the following subjects
shall, consistent with the scope of practice of physician
assistants licensed under chapter 148C, and unless otherwise
inconsistent with state or federal law, provide the same power,
privilege, right, or duty by rule to a physician assistant
licensed under chapter 148C:
a. The department of administrative services, with respect
to rules relating to the following:
(1) Retroactive conversion of vacation time to sick leave
for vacation time spent under the care of a physician.
(2) Certification of a catastrophic illness by a physician
for purposes of donation of leave and second medical
opinions and updates sought from a physician relating to such
certifications.
b. The department on aging, with respect to rules relating
to a written order from a physician for an older individual
requesting a therapeutic diet, and the interpretation of such
orders.
c. The department of corrections, with respect to rules
relating to the following:
(1) That a parolee shall not use, purchase, possess, or
transfer any drugs unless prescribed by a physician.
(2) That a serious medical need is one that has been
diagnosed by a physician as requiring treatment or is one so
obvious that a lay person would easily recognize the necessity
for a physician’s attention.
(3) That each jail shall have a designated licensed
physician, licensed osteopathic physician, or medical resource
designated for the medical supervision, care, and treatment of
prisoners as deemed necessary and appropriate.
(4) That prescription medication, as ordered by a licensed
physician, licensed osteopathic physician, or licensed dentist
shall be provided in accordance with the directions of the
prescribing physician or dentist. Prisoners with medication
from a personal physician, osteopathic physician, or dentist
may be evaluated by a physician, osteopathic physician, or
dentist selected by the jail administrator to determine if the
present medication is appropriate.

House File 803, p. 19
(5) That expired drugs or drugs not in unit dose packaging,
whose administration had been discontinued by the attending
physician, shall be destroyed by the jail administrator or
designee in the presence of a witness.
(6) That special diets in jails prescribed by a physician
shall be followed and documented, that the physician who
prescribes the special diet shall specify a date on which the
diet will be reviewed for renewal or discontinuation, and that
unless specified by the prescribing physician, a certified
dietitian shall develop the menu.
(7) That special diets prescribed by a physician for the
care and treatment of juveniles in nonsecure hold shall be
followed and documented.
(8) For medical services in temporary holding facilities,
that a serious medical need is one that has been diagnosed by
a physician as requiring treatment or one that is so obvious
that a lay person would easily recognize the necessity for a
physician’s attention.
(9) For medical resources in temporary holding facilities,
that each facility shall have a designated licensed physician,
licensed osteopathic physician, or medical resource designated
for the medical supervision, care, and treatment of detainees
as deemed necessary and appropriate.
(10) Medication procedures in temporary holding facilities,
that prescription medication, as ordered by a licensed
physician, licensed osteopathic physician, or licensed dentist
shall be provided in accordance with the directions of the
prescribing physician or dentist. Detainees with medication
from a personal physician, osteopathic physician, or dentist
may be evaluated by a physician, osteopathic physician, or
dentist selected by the facility administrator to determine if
the present medication is appropriate.
(11) For medication storage in temporary holding
facilities, that expired drugs or drugs not in unit dose
packaging, whose administration had been discontinued by
the attending physician, shall be destroyed by the facility
administrator or designee in the presence of a witness.
(12) For medical diets in temporary holding facilities,
that special diets as prescribed by a physician shall be

House File 803, p. 20
followed and documented.
(13) For medical care and treatment for juveniles in
nonsecure holds in temporary holding facilities, that special
diets as prescribed by a physician shall be followed and
documented.
d. The economic development authority, with respect to rules
relating to the certification of a person with a disability
for the purpose of the targeted small business program, that
in order to be considered a person with a disability for the
purpose of the targeted small business program, the person must
qualify and receive certification as having a disability from
a licensed medical physician or must have been found eligible
for vocational rehabilitation services by the department of
education, division of vocational rehabilitation services, or
by the department for the blind.
e. The department of education, with respect to rules
relating to the following:
(1) For statements relating to medication administration
policies, that a statement that persons administering
medication shall include authorized practitioners, such as
licensed registered nurses and physicians, and persons to whom
authorized practitioners have delegated the administration
of prescription and nonprescription drugs. Individuals
shall self-administer asthma or other airway constricting
disease medication or possess and have use of an epinephrine
auto-injector with parent and physician consent on file,
without the necessity of demonstrating competency to
self-administer these medications.
(2) For medication administration courses relating
to medication administration policies, that a medication
administration course be conducted by a registered nurse
or licensed pharmacist and include an annual medication
administration procedural skills check completed with a
registered nurse or pharmacist.
(3) For school-based youth services programs, that
preventive and primary health care services shall be delivered
by specifically credentialed providers as specified.
f. The department of human services, with respect to rules
relating to the following:

House File 803, p. 21
(1) That an incident for purposes of accreditation
of providers of services to persons with mental illness,
intellectual disabilities, or developmental disabilities
includes but is not limited to an occurrence involving the
individual using the service that results in a physical injury
to or by the individual that requires a physician’s treatment
or admission to a hospital.
(2) That a mental health professional, for purposes
of accreditation of providers of services to persons with
mental illness, intellectual disabilities, or developmental
disabilities, includes a medical professional licensed in this
state, provided that the professional otherwise meets all of
the conditions to qualify as a mental health professional.
(3) That home health aide services for purposes of
disability services management and regional services may
include medications specifically ordered by a physician.
(4) That payment relating to the state supplementary
assistance program for residential care shall only be made when
there is on file an order written by a physician certifying
that the applicant or recipient being admitted requires
residential care but does not require nursing services.
(5) That a case folder for a facility participating in
the state supplementary assistance program must include a
physician’s statement certifying that a resident does not
require nursing services.
(6) That personnel providing psychological evaluations
and counseling or psychotherapy services for area education
agencies under the medical assistance program include specified
professions endorsed, licensed, or registered in this state,
provided that the professional otherwise meets all of the
conditions to qualify as a mental health professional.
(7) That personnel providing psychological evaluations and
counseling or psychotherapy services for providers of infant
and toddler program services under the medical assistance
program include specified professions endorsed, licensed,
or registered in this state, provided that the professional
otherwise meets all of the conditions to qualify as a mental
health professional.
(8) That personnel providing other services for providers

House File 803, p. 22
of infant and toddler program services under the medical
assistance program include specified professions recognized,
endorsed, or licensed in this state, provided that the
professional otherwise meets all of the conditions to qualify
as a mental health professional.
(9) That personnel providing psychological evaluations
and counseling or psychotherapy services for providers of
local education agency services under the medical assistance
program include specified professions endorsed, licensed,
or registered in this state, provided that the professional
otherwise meets all of the conditions to qualify as a mental
health professional.
(10) That personnel providing other services for providers
of local education agency services under the medical assistance
program include specified professions recognized, endorsed,
or licensed in this state, provided that the professional
otherwise meets all of the conditions to qualify as a mental
health professional.
(11) For payment for medically necessary home health agency
services under the medical assistance program, that payment
shall be approved for medically necessary home health agency
services prescribed by a physician in a plan of home health
care provided by a Medicare-certified home health agency.
(12) For authorization for medically necessary home health
agency services under the medical assistance program, that
services shall be authorized by a physician, evidenced by the
physician’s signature and date on a plan of treatment.
(13) For treatment plans of home health agencies under the
medical assistance program, that a member’s medical condition
shall be reflected by the date last seen by a physician, if
available.
(14) For items included in treatment plans of home health
agencies under the medical assistance program, that a plan of
care shall include a physician’s signature and date and that
the plan of care must be signed and dated by the physician
before the claim for service is submitted for reimbursement.
(15) For skilled nursing services provided by a home health
agency under the medical assistance program, that medical
documentation shall be submitted justifying the need for

House File 803, p. 23
continued visits, including the physician’s estimate of the
length of time that additional visits will be necessary, and
that daily skilled nursing visits or multiple daily visits for
wound care or insulin injections shall be covered when ordered
by a physician and included in the plan of care.
(16) For physical therapy services provided by a home health
agency under the medical assistance program, that payment shall
be made for physical therapy services when the services follow
a treatment plan established by the physician after any needed
consultation with the qualified physical therapist.
(17) For occupational therapy services provided by a
home health agency under the medical assistance program,
that payment shall be made for occupational therapy services
when the services follow a treatment plan established by the
physician.
(18) For speech therapy services provided by a home health
agency under the medical assistance program, that payment shall
be made for speech therapy services when the services follow a
treatment plan established by the physician.
(19) For home health aide services provided by a home health
agency under the medical assistance program, that the service
as well as the frequency and duration are stated in a written
plan of treatment established by a physician.
(20) For home health aide services provided by a home health
agency under the medical assistance program, that services
provided for specified durations when ordered by a physician
and included in a plan of care shall be allowed as intermittent
services.
(21) For home health aide services provided by a home health
agency under the medical assistance program, that personal
care services include helping the member take medications
specifically ordered by a physician.
(22) For private duty nursing or personal care services for
persons aged twenty and under, under the medical assistance
program, that private duty nursing services are those services
which are provided by a registered nurse or a licensed
practical nurse under the direction of the member’s physician
to a member in the member’s place of residence or outside the
member’s residence, when normal life activities take the member

House File 803, p. 24
outside the place of residence.
(23) For private duty nursing or personal care services for
persons aged twenty and under, under the medical assistance
program, that services shall be provided according to a written
plan of care authorized by a licensed physician.
(24) For private duty nursing or personal care services for
persons aged twenty and under, under the medical assistance
program, that personal care services are those services
provided by a home health aide or certified nurse’s aide and
which are delegated and supervised by a registered nurse under
the direction of the member’s physician to a member in the
member’s place of residence or outside the member’s residence,
when normal life activities take the member outside the place
of residence, and that these services shall be in accordance
with the member’s plan of care and authorized by a physician.
(25) For requirements for private duty nursing or personal
care services for persons aged twenty and under, under the
medical assistance program, that private duty nursing or
personal care services shall be ordered in writing by a
physician as evidenced by the physician’s signature on the plan
of care.
(26) For obtaining prescription medications for children in
juvenile detention and shelter care homes, that prescription
medication provided to residents shall be dispensed only from a
licensed pharmacy in this state in accordance with state law,
from a licensed pharmacy in another state according to the laws
of that state, or by a licensed physician.
(27) For health and dental programs provided by agencies
providing foster care services, that a child’s physical
examination shall be performed by a licensed physician or
licensed nurse practitioner.
(28) For health and dental programs provided by agencies
providing foster care services, that if documentation of prior
immunization is unavailable, immunizations required by the
department of public health shall begin within thirty days of
placement, unless contraindicated and unless a statement from
a physician to that effect is included in the child’s medical
record, and that a statement from a physician, referring
agency, parent, or guardian indicating immunizations are

House File 803, p. 25
current is sufficient documentation of immunizations.
(29) For the dispensing, storage, authorization, and
recording of medications in child care centers, that all
medications shall be stored in their original containers, with
accompanying physician or pharmacist’s directions and label
intact and stored so they are inaccessible to children and the
public.
(30) For an infants’ area in a child care center, that
upon the recommendation of a child’s physician or the area
education agency serving the child, a child who is two years
of age or older with a disability that results in significant
developmental delays in physical and cognitive functioning who
does not pose a threat to the safety of the infants may, if
appropriate and for a limited time approved by the department,
remain in the infant area.
(31) For facility requirements for a child development
home, that the telephone number for each child’s physician
shall be written on paper and readily accessible by the
telephone.
(32) For medications and hazardous materials in a child
development home, that medications shall be given only with
the parent’s or doctor’s written authorization, and that each
prescribed medication shall be accompanied by a physician’s or
pharmacist’s direction.
(33) For medical reports regarding the health of a family
in a family life home, that a medical report shall provide
significant findings of a physician, such as the presence or
absence of any communicable disease.
(34) For medical reexaminations of a family in a family
life home, that medical reexaminations may be required at the
discretion of a physician.
(35) For medical examinations of a client in a family life
home, that a physician shall certify that the client is free
from any communicable disease and does not require a higher
level of care than that provided by a family life home.
(36) For the records of a client in a family life home,
that the family shall have available at all times, the name,
address, and telephone number of the client’s physician.
(37) For the facility requirements for a child care home,

House File 803, p. 26
that the telephone number for each child’s physician shall be
written on paper and readily accessible by the telephone.
(38) For the administration of medications at a child care
home, that medications shall be given only with the parent’s or
doctor’s written authorization and each prescribed medication
shall be accompanied by a physician’s or pharmacist’s
direction.
(39) For payments for foster care, that an intellectual
disabilities professional includes specified professions,
provided that the professional otherwise meets all of
the conditions to qualify as an intellectual disabilities
professional.
(40) For payments for foster care, that a mental health
professional includes specified professions, provided that the
professional otherwise meets all of the conditions to qualify
as a mental health professional.
(41) For the subsidized adoption program, that a qualified
intellectual disability professional includes specified
professions, provided that the professional otherwise meets
all of the conditions to qualify as a qualified intellectual
disability professional.
(42) For the subsidized adoption program, that a qualified
mental health professional includes specified professions,
provided that the professional otherwise meets all of
the conditions to qualify as a qualified mental health
professional.
(43) For the information provided to a foster care provider
by a department worker at the time of placement, that the
information shall include the names, addresses, and telephone
numbers of the child’s physician and dentist.
g. The department of inspections and appeals, with respect
to rules relating to the following:
(1) For the qualifications of an attending physician at a
hospice, that the person shall have an active Iowa license to
practice medicine.
(2) For residential care facilities for persons with
intellectual disabilities, that a qualified intellectual
disability professional includes specified professions,
provided that the professional otherwise meets all of the

House File 803, p. 27
conditions to qualify as a qualified intellectual disability
professional.
(3) For nursing facilities, that a qualified intellectual
disabilities professional includes specified professions,
provided that the professional otherwise meets all of the
conditions to qualify as a qualified intellectual disabilities
professional.
(4) For intermediate care facilities for persons with
mental illness, that a qualified mental health professional
includes specified professions, provided that the professional
otherwise meets all of the conditions to qualify as a qualified
mental health professional.
(5) For notifications submitted to the department from
a subacute mental health care facility in the event of an
accident causing a major injury, including as a major injury an
injury which requires consultation with the attending physician
or designee of the physician or advanced registered nurse
practitioner who determines that an injury is a major injury.
h. The racing and gaming commission, with respect to rules
relating to the following:
(1) For the grounds for denial, suspension, or revocation
of an occupational or vendor license, that a license shall be
denied if the applicant has a history of mental illness without
demonstrating successful treatment by a licensed medical
physician.
(2) For the qualifications for jockeys, that a jockey shall
pass a physical examination by a licensed physician affirming
fitness to participate as a jockey.
(3) For the regulation of licensees in restricted areas of
a racing facility, that licensees whose duties require them to
be in a restricted area of a racing facility shall not have
present within their systems any controlled substance as listed
in schedules I to V of U.S.C. Tit. 21 (Food and Drug Section
812), chapter 124, or any prescription drug unless it was
obtained directly or pursuant to valid prescription or order
from a duly licensed physician who is acting in the course of
professional practice.
i. The Iowa law enforcement academy, with respect to rules
relating to the following:

House File 803, p. 28
(1) For the minimum standards for law enforcement officers,
that an officer is examined by a licensed physician or surgeon.
(2) For hiring standards must be reverified if an individual
is not hired by an Iowa law enforcement agency during a
specified period of time following completion of the course
of study, that the individual must be examined by a licensed
physician or surgeon.
(3) For the selection or appointment of reserve peace
officers, that the person shall be examined by a licensed
physician or surgeon.
j. The natural resource commission, with respect to rules
relating to the following:
(1) That the grounds for revoking or suspending an
instructor license include participation in a course while
ingesting prescription medication in a manner contrary to the
dosing directions given by the prescribing physician.
(2) For applications for use of a crossbow for deer and
turkey hunting by handicapped individuals, that an application
must include a statement signed by the applicant’s physician
declaring that the individual is not physically capable of
shooting a bow and arrow.
(3) For authorization for the use of a crossbow for deer
and turkey hunting by handicapped individuals, that if a
conservation officer has probable cause to believe the person’s
handicapped status has improved, making it possible for the
person to shoot a bow and arrow, the department of natural
resources may, upon the officer’s request, require the person
to obtain in writing a current physician’s statement.
(4) For licenses for nonresidents to participate in a
special deer hunting season for severely disabled persons,
that a nonresident applying for the license must have on file
with the department of natural resources either a copy of a
disabilities parking permit issued by a state department of
transportation or an Iowa department of natural resources form
signed by a physician that verifies their disability.
k. The Iowa department of public health, with respect to
rules relating to the following:
(1) That “impaired glucose tolerance” , for purposes of
outpatient diabetes education programs, means a condition in

House File 803, p. 29
which blood glucose levels are higher than normal, diagnosed by
a physician, and treated with a food plan, exercise, or weight
control.
(2) For instructors for programs not recognized by the
American diabetes association or accredited by the American
association of diabetes educators, that the primary instructors
shall be one or more of specified health care professionals who
are knowledgeable about the disease process of diabetes and the
treatment of diabetes.
(3) For the written form for participation in the
prescription drug donation repository program, that the form
shall include the name and telephone number of the responsible
pharmacist, physician, or nurse practitioner who is employed
by or under contract with the pharmacy or medical facility,
and shall also include a statement, signed and dated by the
responsible pharmacist, physician, or nurse practitioner,
indicating that the pharmacy or medical facility meets the
eligibility requirements and shall comply with the requirements
established by rule.
(4) For the dispensing of donated prescription drugs and
supplies, that donated drugs and supplies may be dispensed
only if the drugs or supplies are prescribed by a health
care practitioner for use by an eligible individual and
are dispensed by a licensed pharmacist, physician, or nurse
practitioner.
l. The department of public safety, with respect to rules
relating to permits to carry weapons, that an unlawful user of
or addicted to any controlled substance includes any person who
is a current user of a controlled substance in a manner other
than as prescribed by a licensed physician.
m. The department of transportation, with respect to rules
relating to exemptions from motor vehicle window transparency
requirements, that a motor vehicle fitted with a front
windshield, a front side window, or a front sidewing with less
than seventy percent but not less than thirty-five percent
light transmittance before July 4, 2012, may continue to be
maintained and operated with a front windshield, a front side
window, or a front sidewing with less than seventy percent but
not less than thirty-five percent light transmittance on or

House File 803, p. 30
after July 4, 2012, so long as the vehicle continues to be used
for the transport of a passenger or operator who documented in
the manner specified by the department a medical need for such
reduced transparency, which document was signed by the person’s
physician before July 4, 2012.
n. The Iowa department of veterans affairs, with respect
to rules relating to expenses relating to the purchase of
durable equipment or services, that individuals requesting
reimbursement who need durable equipment as a medical necessity
should provide information from a physician.
o. The department of workforce development, with respect to
rules relating to the following:
(1) That a voluntary quit shall be presumed to be without
good cause attributable to the employer for purposes of
unemployment compensation if a claimant left employment because
of illness or injury which was not caused or aggravated by the
employment or pregnancy and failed to obtain the advice of a
licensed and practicing physician, obtain certification of
release for work from a licensed and practicing physician, or
return to the employer and offer services upon recovery and
certification for work by a licensed and practicing physician.
(2) That for purposes of unemployment compensation, it is
a reason for a claimant leaving employment with good cause
attributable to the employer if the claimant left employment
because of illness, injury, or pregnancy upon the advice of
a licensed and practicing physician, and upon recovery, when
recovery was certified by a licensed and practicing physician,
the claimant returned and offered to perform services to the
employer, but no suitable, comparable work was available.
(3) That for purposes of unemployment compensation it is
a reason for a claimant leaving employment with good cause
attributable to the employer if the claimant left employment
upon the advice of a licensed and practicing physician for the
sole purpose of taking a family member to a place having a
different climate and subsequently returned to the claimant’s
regular employer and offered to perform services, but the
claimant’s regular or comparable work was not available.
p. The labor services division of the department of
workforce development, with respect to rules relating to the

House File 803, p. 31
following:
(1) For the disclosure of a trade secret relating to a
hazardous chemical during a medical emergency, that where a
treating physician or nurse determines that a medical emergency
exists and the specific chemical identity of a hazardous
chemical is necessary for emergency or first-aid treatment, the
chemical manufacturer, importer, or employer shall immediately
disclose the specific chemical identity of a trade secret
chemical to that treating physician or nurse, regardless of the
existence of a written statement of need or a confidentiality
agreement.
(2) For the disclosure of a trade secret relating to
a hazardous chemical in a nonemergency situation, that in
nonemergency situations, a chemical manufacturer, importer,
or employer shall, upon request, disclose a specific chemical
identity, otherwise permitted to be withheld by rule, to a
specified health professional providing medical or other
occupational health services to exposed employees or designated
representatives in specified circumstances.
(3) For applications for a license to practice asbestos
removal, that except as noted in rule, only worker and
contractor/supervisor license applicants must submit a
respiratory protection and physician’s certification forms.
(4) For documentation held by persons licensed for asbestos
abatement in an area that is subject to a disaster emergency
proclamation, that the labor commissioner deems an individual
contractor, supervisor, or worker to be licensed and authorized
for asbestos abatement if the individual, in addition to other
specified conditions, makes immediately available on the
work site a copy of a physician’s statement indicating that,
consistent with federal law, a licensed physician has examined
the individual within the past twelve months and approved the
individual to work while wearing a respirator.
(5) That the contents of an application for an event
license for a covered athletic event other than a professional
wrestling event shall contain, along with other requirements,
a copy of the medical license of the ringside physician and
the date, time, and location of the ringside physician’s
examination of the contestants.

House File 803, p. 32
(6) For the responsibilities of the promoter of an athletic
event, that the promoter submit test results to the ringside
physician no later than at the time of the physical showing
that each contestant scheduled for the event tested negative
for the human immunodeficiency, hepatitis B, and hepatitis C
viruses within the one-year period prior to the event, and that
the contestant shall not participate and the physician shall
notify the promoter that the contestant is prohibited from
participating for medical reasons if specified circumstances
occur.
(7) For injuries during a professional boxing match, that if
a contestant claims to be injured during the bout, the referee
shall stop the bout and request the attending physician to make
an examination. If the physician decides that the contestant
has been injured as the result of a foul, the physician shall
advise the referee of the injury. If the physician is of the
opinion that the injured contestant may be able to continue,
the physician shall order an intermission, after which the
physician shall make another examination and again advise
the referee of the injured contestant’s condition. It shall
be the duty of the promoter to have an approved physician in
attendance during the entire duration of all bouts.
(8) For persons allowed in a ring during a professional
boxing match, that no person other than the contestants and the
referee shall enter the ring during the bout, excepting the
seconds between the rounds or the attending physician if asked
by the referee to examine an injury to a contestant.
(9) For the weighing of contestants in a professional boxing
match, that contestants shall be weighed and examined on the
day of the scheduled match by the attending ring physician at a
time and place to be determined by the commissioner.
(10) For attending ring physicians during a professional
boxing match, that when a boxer has been injured seriously,
knocked out, or technically knocked out, the referee shall
immediately summon the attending ring physician to aid the
stricken boxer, and that managers, handlers, and seconds shall
not attend to the stricken boxer, except at the request of the
physician.
(11) For the keeping of time during a professional boxing

House File 803, p. 33
match, that the timekeeper shall keep an exact record of time
taken out at the request of a referee for an examination of a
contestant by the physician.
(12) For the suspension of contestants during a
professional boxing match that is an elimination tournament,
that a contestant who for specified reasons is not permitted
to box in the state for a period of time shall be examined by a
physician approved by the commissioner before being permitted
to fight again.
(13) For the designation of officials for professional
kickboxing, that the designation of physicians is subject to
the approval of the commissioner or designee.
(14) For officials for a mixed martial arts event, that
officials shall include a physician.
(15) For the keeping of time for a mixed martial arts
event, that the timekeeper shall keep an exact record of time
taken out at the request of a referee for an examination of a
contestant by the physician.
(16) For persons allowed in the cage during a mixed martial
arts event, that a physician may enter the cage to examine a
contestant upon the request of the referee.
(17) For the decorum of persons involved in a mixed martial
arts event, that a contestant is exempt from prohibitions on
specified conduct while interacting with the contestant’s
opponent during a round, but if the round is stopped by the
physician or referee for a time out, the prohibitions shall
apply to the contestant.
(18) For the examination of contestants in a mixed martial
arts event, that on the day of the event, at a time and place
to be approved by the commissioner, the ringside physician
shall conduct a rigorous physical examination to determine the
contestant’s fitness to participate in a mixed martial arts
match, and that a contestant deemed not fit by the physician
shall not participate in the event.
(19) For injuries during a mixed martial arts event, that if
a contestant claims to be injured or when a contestant has been
injured seriously or knocked out, the referee shall immediately
stop the fight and summon the attending ring physician to make
an examination of the stricken fighter. If the physician

House File 803, p. 34
decides that the contestant has been injured, the physician
shall advise the referee of the severity of the injury. If
the physician is of the opinion the injured contestant may be
able to continue, the physician shall order an intermission,
after which the physician shall make another examination and
again advise the referee of the injured contestant’s condition.
Managers, handlers, and seconds shall not attend to the
stricken fighter, except at the request of the physician.
2. This section shall not be construed to expand, diminish,
or otherwise modify the scope of practice of any profession
licensed under this subtitle.
3. The rulemaking requirements provided in this section
shall not be construed to prohibit the agencies listed in
subsection 1 from engaging in further rulemaking not in
conflict with this section or state or federal law relating to
the subject matter of this section or to otherwise diminish the
authority to engage in rulemaking provided to those agencies by
any other statute.
______________________________ ______________________________
PAT GRASSLEY JAKE CHAPMAN
Speaker of the House President of the Senate
I hereby certify that this bill originated in the House and
is known as House File 803, Eighty-ninth General Assembly.
______________________________
MEGHAN NELSON
Chief Clerk of the House
Approved _______________, 2022 ______________________________
KIM REYNOLDS
Governor