Evidence status: PUBLICLY POSTED UNIVERSITY OF IOWA FAMILY MEDICINE POLICY, REVISED 2022. University of Iowa Health Care Family Medicine publicly posts an opioid policy and chronic-pain agreement workflow that is broader than Iowa’s current physician rule.

Institutional agreement policy

The posted Family Medicine policy states that its opioid agreement was developed for chronic-pain patients who require opioids and applies across its prescribing provider workflow.

Agreement process

The policy states that the opioid agreement is reviewed with the patient, the provider addresses questions, the patient and provider sign the agreement at the initial visit, and the agreement is reviewed and re-signed annually.

Broader provider scope

The policy identifies physicians, osteopathic physicians, nurse practitioners, and physician assistants as staff involved in the chronic-opioid workflow. That is an institutional policy choice and is broader than the physician-specific scope of 481—655.2.

Monitoring and documentation

The publicly posted policy also describes history and physical examination, substance-use history, medication review, PMP checking, individualized treatment planning, periodic reassessment, and drug-screening practices as part of chronic-opioid management.

State rule versus institutional policy

Iowa’s current rule does not require every chronic-pain patient to sign an agreement or require annual re-signing. The University of Iowa policy therefore demonstrates how an institution may choose a more universal agreement process than the state physician rule itself.

Source

• University of Iowa Health Care Family Medicine Clinic Policies — Opioid Policy and Guidelines for Chronic Pain (2022)

Reviewed: October 4, 2026.

Evidence boundary: The document is publicly posted and carries a 2022 revision date. This page records an institutional implementation example, not the current statewide legal minimum.