ARC 9942C

ARC 9942C

PUBLIC HEALTH DEPARTMENT[641]

Notice of Intended Action

Proposing rulemaking related to state medical examiner
and providing an opportunity for public comment

    The Department of Health and Human Services hereby proposes to rescind Chapter 126, “State Medical Examiner,” Iowa Administrative Code, and to adopt a new Chapter 126 with the same title.

Legal Authority for Rulemaking

    This rulemaking is proposed under the authority provided in Iowa Code sections 331.802, 331.805 and 691.6.

State or Federal Law Implemented

    This rulemaking implements, in whole or in part, Iowa Code sections 331.802, 331.805 and 691.6.

Purpose and Summary

    This proposed chapter underwent a review as a part of the Red Tape Review process laid out in Executive Order 10. As a result of this review, restrictive terms were removed, areas that were duplicative were combined or eliminated, and editorial updates were made to reflect current policies and procedures.

    This proposed chapter provides the foundation for the primary funding source that supports the work of the State Medical Examiner’s Office. Costs of autopsies and related services and expenses are the responsibility of the county of appointment. As part of the Department’s review, the Department is proposing to increase the amount of the autopsy fee by $200 and 2 percent annually thereafter to account for annual adjustments for salaries of pathologists and increasing costs associated with performing autopsies.

Regulatory Analysis

    A Regulatory Analysis for this rulemaking was published in the Iowa Administrative Bulletin on November 26, 2025. A public hearing was held on the following date(s):

     ?   December 16, 2025

Fiscal Impact

    This proposed chapter sets the amount of fees for service that can be collected by the State Medical Examiner’s Office. This includes fees related to autopsies, the cost of requesting autopsy reports, court preparation time, tissue recovery, and cremation permit fees. The Department is increasing the amount of the autopsy fee by $200 and 2 percent annually thereafter to account for annual adjustment costs for salaries of pathologists and increasing costs associated with performing autopsies.

Jobs Impact

    After analysis and review of this rulemaking, no impact on jobs has been found.

Waivers

    Any person who believes that the application of the discretionary provisions of this rulemaking would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to 441—Chapter 6.

Public Comment

    Any interested person may submit written or oral comments concerning this proposed rulemaking, which must be received by the Department no later than 4:30 p.m. on January 27, 2026. Comments should be directed to:

Public Hearing

    Public hearings at which persons may present their views orally or in writing will be held as follows:

    Persons who wish to make oral comments at a public hearing may be asked to state their names for the record and to confine their remarks to the subject of this proposed rulemaking.

    Any persons who intend to attend a public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Department and advise of specific needs.

Review by Administrative Rules Review Committee

    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rulemaking by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rulemaking at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).

    The following rulemaking action is proposed:

    ITEM 1.  Rescind 641—Chapter 126 and adopt the following new chapter in lieu thereof:

CHAPTER 126

STATE MEDICAL EXAMINER

641—126.1(144,331,691) Definitions.

    “Autopsy” means the external and internal postmortem examination of a deceased person.

    “County of appointment” means the county that requests a medical examiner to conduct an investigation, perform or order an autopsy, or prepare a report or reports in a death investigation case. The request may be authorized by the county attorney or the county medical examiner. The county of appointment shall be the county in which the death occurred.

641—126.2(691) Fees for autopsies and related services and reimbursement for related expenses. Autopsies performed by the state medical examiner are provided on a fee-for-service basis. Costs of autopsies and related services and expenses are the responsibility of the county of appointment. The county of residence of the deceased shall reimburse the county of appointment.

    126.2(1) Fee schedule. The following fees apply as specified in this subrule.

    a.  The following fees apply to autopsies conducted by the state medical examiner:

    (1)  EXCEPTIONS: A copy of the autopsy report is automatically sent to the county medical examiner and to the county attorney without fee. A single copy of an autopsy report may be provided to the immediate next of kin of the deceased without fee. Copies of autopsy reports may be provided to public officials and physicians of record for official purposes without fee.

    (2)  Beginning with the fiscal year starting July 1, 2027, the amount of the autopsy fee will increase annually by 2 percent each July 1.

    b.  The following fee is for time spent reviewing case materials, preparing for deposition or court, testifying in deposition or court, and travel time.

    c.  A cremation permit fee of $75 will be assessed for each permit investigated and authorized by the state medical examiner’s office.

    126.2(2) Expense reimbursement. Other laboratory services associated with an autopsy, which include but are not limited to photography, toxicology, radiology, microbiology, and morgue fees, will be billed by the department to the county of appointment. Moneys collected pursuant to this subrule will be paid by the department to the laboratory or other entity providing the service.

    126.2(3) State medical examiner acting as county medical examiner. When the state medical examiner acts in the capacity of county medical examiner, the state medical examiner receives from the county of appointment a fee of $100 per hour, with a one-hour minimum, for each report prepared plus the state medical examiner’s actual expenses. Counties should not depend on the state medical examiner for full-time coverage.

641—126.3(691) Fees for tissue recovery. When the tissue recovery room located within the office of the state medical examiner is utilized by an authorized tissue recovery agency, a fee of $400 per case will be assessed. The tissue recovery agency is responsible for this fee, payable to the office of the state medical examiner.

These rules are intended to implement Iowa Code section 691.6.