SS SCS HCS HB 2372 -- HEALTH CARE
AWARENESS DAYS (Sections 9.021, 9.025, 9.238, 9.412, 9.418,
9.501, and 9.502, RSMo)
This bill designates the month of January as "Blood Donor
Awareness Month", each September as "Brain Aneurysm Awareness
Month" and "Pediatric Cancer Awareness Month", the last full week
of April each year as "Infertility Awareness Week", March 26th of
each year as “Pediatric Acute-Onset Neuropsychiatric Syndrome
(PANS)/Pediatric Autoimmune Neuropsychiatric Disorder Associated
with Streptococcus (PANDAS) Awareness Day”, the first full week
in September as "June's Week" and "Rare Pediatric Disease Week",
and the week beginning the last Monday in September as
"Frontotemporal Degeneration (FTD) Awareness Week".
HOSPITAL INVESTMENTS AND SERVICE AREAS (Sections 96.192, 96.196,
206.110, and 206.158)
This bill modifies the investment authority of boards of trustees
of municipal hospitals in third class cities and hospital
district hospitals. Current law permits investment of up to 25%
of funds not required for operations of the hospital or other
obligations. This bill permits investment of up to 50% of
"available funds" defined as funds not required for operations or
other obligations in the manner described in the bill, with the
remaining portion to be invested into any investment in which the
state Treasurer is allowed to invest. These provisions will only
apply if the hospital receives less than 3% of its annual
revenues from municipal, county, or state taxes, or appropriated
funds from the municipality in which such hospital is located.
Under this bill, municipal hospitals in third class cities can
operate in areas where hospital district hospitals and county
hospitals operate. Hospital district hospitals can operate in
areas where municipal hospitals in third and fourth class cities
and county hospitals operate.
LYME DISEASE (Sections 103.190, 192.026, 192.027, 192.028, and
192.029)
This bill requires the Missouri consolidated health care plan to
provide coverage for testing, treatment, and management of Lyme
disease and post-treatment Lyme disease syndrome for certain
participants.
The bill requires health care providers, laboratories, and local
health departments to report confirmed or suspected cases of Lyme
disease to the Department of Health and Senior Services (DHSS)
within seven days of diagnosis. The DHSS will then compile an
annual report on the incidence and prevalence of Lyme disease in
Missouri, as described in the bill. The DHSS will also
collaborate with public four-year institutions of higher
education to integrate Lyme disease surveillance data into
existing tick-borne disease monitoring programs.
This bill creates the "Lyme Research and Eradication Fund" within
the State Treasury. The DHSS will use the moneys in the Fund to
distribute grants for the purposes of developing treatments,
studying novel therapies, and researching eradication strategies.
Grants will be prioritized as described in the bill, with no less
than 20% of funds utilized to support eradication efforts in
rural counties.
This bill also establishes within the Department the "Lyme
Disease Task Force", with membership and responsibilities
specified in the bill.
Under this bill, a health care provider will not be subject to
any discipline, suspension, or revocation of license or denial of
a license renewal, solely for prescribing, administering, or
dispensing treatments or therapies for Lyme disease or Post-
Treatment Lyme Disease Syndrome (PTLDS), including extended
antibiotic therapy or similar treatment deemed medically
necessary.
EPINEPHRINE PRODUCTS (Sections 167.627, 167.630, 190.246,
196.990, and 321.621)
This bill changes the term "epinephrine auto-injector" to
"epinephrine delivery system" throughout statute, defined as a
single-use device or system used for the delivery of a
premeasured dose of epinephrine into the human body.
This bill adds epinephrine delivery systems to provisions of
statute that permit the possession and self-administration of the
medication to treat a student's chronic health condition, such as
asthma or anaphylaxis.
The bill authorizes each Board of Education in this State to
grant permission to pupils, as well as each school board in this
State to grant permission to school nurses to use this
medication.
This bill additionally modifies existing provisions for
epinephrine possession, use limitations, and stock supply by
adding epinephrine delivery systems as eligible products and
nursing homes and facilities, as well as child care facilities,
to the list of authorized entities.
Current law authorizes qualified first responders, as defined in
the bill, to administer epinephrine auto-injectors to a person
who is suffering from an apparent anaphylactic reaction. This
bill extends that authorization to epinephrine delivery systems.
PEDIATRIC DISEASE TASK FORCE (Section 173.690)
This bill creates the "Pediatric Disease Task Force" within the
Department of Higher Education and Workforce Development (DHEWD),
with membership as described in the bill, including two members
appointed by the Speaker of the House of Representatives and two
members appointed by the President Pro Tem of the Senate.
Beginning January 1, 2027, the Task Force will meet at least
quarterly, and the Task Force is required to submit an annual
public report to the Governor and the General Assembly by
December 31st of each year. Such report will detail research
initiatives within the sState focused on genetic and pediatric
diseases, including rare pediatric diseases; summarize key
outcomes achieved by the research initiatives; account for funds
expended and leveraged by the research initiatives; and include
any legislative recommendations.
This provision will expire on December 31, 2030.
COMMUNITY PARAMEDIC SERVICES (Sections 190.098 and 190.165)
This bill modifies provisions relating to certification of
community paramedics and the provision of community paramedic
services. "Community paramedic services" mean those services
provided by an entity that employs licensed paramedics certified
by DHSS as community paramedics for services that are provided in
a nonemergent setting, consistent with the education and training
of a community paramedic and the supervisory standard approved by
the medical director, and documented in the entity's patient care
plans or protocols.
Ambulance services will enter into written contracts with other
ambulance service providers to provide community paramedic
services in that provider's service area.
The DHSS will establish regulations for the purpose of
recognizing community paramedic services entities that have met
the standards necessary to provide such services. The DHSS will
endorse such entities to provide community paramedic services for
a period of five years.
EMERGENCY MEDICAL SERVICE SCOPE OF PRACTICE (Section 190.142)
The bill authorizes each level of licensed emergency medical
technicians to perform only patient care that is consistent with
the current National EMS Scope of Practice Model.
SICKLE CELL STANDING COMMITTEE (Section 191.117)
This bill creates the "Lori Zena Baker Act". The bill
establishes the "Sickle Cell Standing Committee" as a
subcommittee of the Missouri Genetic Advisory Committee within
DHSS, with membership as specified in the bill. The Director of
DHSS will appoint the committee members. The Committee will
assess the impact of sickle cell disease on the State and make
recommendations to the General Assembly and Governor regarding
services and policies to address the State's needs, as described
in the bill.
DOULA SERVICES (Sections 191.708, 208.662, 208.1400, 208.1405,
208.1410, 208.1415, 208.1420, and 208.1425)
This bill allows for the chief medical officer or chief medical
director of DHSS, the MO HealthNet division of the Department of
Social Services (DSS), or any licensed physician acting with the
written consent of any of the aforementioned department
directors, to issue nonspecific recommendations for doula
services, a medical standing order for prenatal vitamins, or a
medical standing order for purposes not related to that of
controlled substances or of nonemergency pregnancy termination.
Additionally, the bill adds childbirth education classes to
covered services for unborn children enrolled in the Show-Me
Healthy Babies Program.
The bill also establishes the "Missouri Doula Reimbursement Act".
Under the provisions of this bill, the MO HealthNet program is
required to cover the following doula services:
(1) A combined total of six support sessions, provided that a
participant who needs more than the six is entitled to up to 10
additional support sessions for a combined total of 16 support
sessions;
(2) One birth attendance, including attendance at a scheduled
cesarean section delivery;
(3) Up to two visits for general education and support on
lactation at any time during the prenatal and postpartum periods;
and
(4) Community navigation services, except that those services
provided outside any of the above visits or sessions will only be
billed up to 10 times total over the course of the pregnancy and
postpartum period.
The bill specifies under what conditions a doula is eligible for
participation as a provider of doula services and that once
enrolled as a provider, a doula is eligible to enroll as a
provider with fee-for-service, and managed care payers affiliated
with MO HealthNet program, but that services must be reimbursed
on a fee-for-service schedule.
The MO HealthNet division will promulgate all necessary rules and
regulations for the administration of this provision.
TELEHEALTH (Sections 191.1146 and 334.108)
Currently, the establishment of a physician-patient relationship
for purposes of telehealth must include an interview and a
physical examination. Under this bill, an evaluation is
required, but a physical examination will be required only if
needed to meet the standard of care.
Current law prohibits the use of an internet or telephone
questionnaire completed by a patient from constituting an
acceptable medical interview for the provision of treatment by
telehealth. This bill permits such questionnaires if the
information provided is sufficient as though the medical
evaluation was performed in person, with a report to be provided
to the patient's primary health care provider within 14 days of
evaluation, as described in the bill.
Additionally, current law requires a physician-patient
relationship for purposes of telehealth to include a sufficient
dialogue with the patient regarding treatment. This bill changes
"dialogue" to "exchange" with the patient regarding treatment
options.
Finally, current law prohibits a health care provider from
prescribing any drug, controlled substance, or other treatment to
a patient based solely on an internet request or questionnaire.
Under this bill, a health care provider must not prescribe any
drug, controlled substance, or other treatment to a patient in
the absence of a proper provider-patient relationship and medical
records of such prescriptions must be collected, stored, and
maintained in accordance with the Health Insurance Portability
and Accountability Act of 1996.
DISEASE SURVEILLANCE (Section 192.020)
This bill adds alpha-gal syndrome to the list of diseases that
must be reported to DHSS. Any alpha-gal syndrome case report
must be submitted to DHSS within seven days of receiving a
positive laboratory confirmation.
Subject to appropriations, DHSS can follow up on reported cases
by applying a random sampling method for confirmation that the
cases meet the most current surveillance case definition of
alpha-gal syndrome of the Centers for Disease Control and
Prevention (CDC).
The bill requires DHSS to submit an annual report to the CDC
summarizing its findings related to the reporting and incidence
of alpha-gal syndrome.
The laboratory and DHSS are prohibited from disclosing the
identifiable test result or other protected health information
relating to any individual for which a blood test is obtained to
any person other than the individual for which the blood test is
obtained and the health care provider ordering the blood test.
PREGNANCY-ASSOCIATED MORTALITY REVIEW BOARD (Section 192.990)
This bill modifies the "Pregnancy-Associated Mortality Review
Board" within DHSS. Under this bill, board membership includes at
least one member from each congressional district and membership
will be demographically diverse, including rural and urban
populations. Board members are increased from no more than 18
members to no more than 22 members.
Additionally, the board will, in its study and review of maternal
deaths, consider: the level and timing of prenatal and postnatal
care; the presence or absence of "maternity care deserts", as
defined in the bill; approaches taken in this state and other
states to reduce or eliminate racial inequities in maternal
deaths; and the adequacy of data collected by the board. Data
reported by the board will be disaggregated by race, ethnicity,
language, nationality, age, zip code, and level and timing of
prenatal and postnatal care.
DEMENTIA SERVICES COORDINATOR (Section 192.2155)
This bill requires the Division of Senior and Disability Services
within DHSS to establish a dementia services coordinator as a
full-time position. The coordinator will perform duties
specified in the bill, including, but not limited to,
coordinating information resources affecting Missourians living
with dementia and their caregivers, streamlining applicable
services to increase efficiency and improve the quality of care
in certain settings, identifying any duplicated services,
promoting public awareness and education, and collecting and
monitoring relevant data.
MULTIDISCIPLINARY ADULT PROTECTION TEAMS (Sections 192.2400 and
192.2435)
This bill modifies current law relating to protective services
for elderly and disabled adults by authorizing "multidisciplinary
adult protection teams", as defined in the bill, to access
confidential reports of abuse and neglect and case information to
the extent necessary to conduct team activities and to share such
information with other team members.
DISCLOSURE OF VITAL RECORDS (Section 193.245)
This bill repeals a provision of law permitting DHSS to disclose
a listing of persons who are born or who die on a particular date
upon a person's request.
LIMITS ON SALE OF OVER-THE-COUNTER DRUGS (Sections 195.417 and
579.060)
Current law prohibits the sale, purchase, or dispensation of
ephedrine, phenylpropanolamine, or pseudoephedrine to the same
individual in a 12-month period in any total amo
unt greater than 43.2 grams without a valid prescription. This
bill changes the total amount to 61.2 grams.
Beginning October 1, 2026, any manufacturer of any drug product
containing any detectable amount of ephedrine,
phenylpropanolamine, or pseudoephedrine sold in this State must,
on a monthly basis, pay fees to the administrator of the real-
time electronic pseudoephedrine tracking system, as specified in
the bill. A manufacturer who fails to knowingly pay such fee
will have committed the offense of unlawful sale, distribution,
or purchase of over-the-counter methamphetamine precursor drugs,
which is a class A misdemeanor.
CERTIFICATE OF NEED (Section 197.315)
This bill provides that if, within 30 days of an applicant's
receipt of a certificate of need, the Missouri Health Facilities
Review Committee obtains evidence that a material fact was
withheld from or misrepresented to the committee during the
original hearing on the application before the committee, the
committee must, at the next regularly scheduled meeting, vote to
rescind the granted certificate of need and require the applicant
to file a new application that corrects any omissions or
misstatements.
HOSPITAL WORKPLACE VIOLENCE (Section 197.708)
This bill requires hospitals to display a printed sign in the
waiting rooms of the emergency department and the labor and
delivery department with the following text in all capital
letters:
"WARNING: ASSAULTING A HEALTH CARE PROFESSIONAL WHO IS ENGAGED
IN THE PERFORMANCE OF HIS OR HER OFFICIAL DUTIES, INCLUDING
STRIKING A HEALTH CARE PROFESSIONAL, IS A SERIOUS CRIME AND WILL
BE PROSECUTED TO THE FULLEST EXTENT OF THE LAW."
HOSPITAL PRICE TRANSPARENCY (Sections 197.1040 and 197.1045)
Under this bill, a hospital that is not in material compliance
with federal hospital price transparency laws on the date that
items or services are purchased from, or provided to a patient
by, the hospital, will not initiate or pursue a collection action
against the patient for a debt owed for the items or services.
INSPECTIONS OF LONG-TERM CARE FACILITIES (Section 198.022)
Under this bill, DHSS can accept, in lieu of an inspection
conducted by DHSS, a written report of a survey or inspection
conducted by any State or Federal agency, provided the survey or
inspection is comparable in scope or method to DHSS's inspections
and conducted in accordance with Title XVIII of the Social
Security Act. A residential care or assisted living facility
will be subject to an inspection by DHSS if the facility fails to
maintain an accredited status by a recognized accreditation
entity. If a facility exempt from an annual inspection under
this bill has one or more violations of any class I standards,
then the facility must be subject to a full survey by DHSS.
TICKET TO WORK HEALTH ASSURANCE PROGRAM (Section 208.146)
The Ticket to Work Health Assurance Program is a program that
provides medical assistance to certain people with disabilities
who are employed. The Program expired on August 28, 2025. This
bill repeals the expiration date and reinstates the program.
MO HEALTHNET COVERAGE OF CERTAIN CLINICAL PATHOLOGY SERVICES
(Section 208.149)
This bill requires the professional component of clinical
pathology services provided by a hospital-based pathologist to be
recognized as distinct physician services by the MO HealthNet
program, which will reimburse the professional component of
clinical pathology services provided to MO HealthNet
participants. The reimbursement amount will be set at no less
than 30% of the approved MO HealthNet Independent Lab - Technical
Component fee schedule. Payment will be made directly to the
licensed physician providing the services or the entity that has
been assigned the right to receive payment for services provided.
If a state plan amendment is determined by DSS to be required,
DSS must submit the amendment in a timely manner and make all
reasonable efforts to obtain Federal approval.
MO HEALTHNET THIRD PARTY LIABILITY (Section 208.215)
Under this bill, any health benefit plan, third-party
administrator, administrative service organization, or pharmacy
benefits manager paying all properly submitted medical assistance
subrogation claims or MO HealthNet subrogation claims will
respond to any inquiry by the state regarding a claim for payment
for any health care item or service not later than 60 days after
receiving the inquiry. Additionally, such entity will not deny a
claim submitted by the state for failure to provide prior
authorization for the item or service, except that this provision
will not apply to certain programs or plans, including the
original Medicare fee-for-service program, a Medicare Advantage
plan, a reasonable cost reimbursement plan, a health care
prepayment plan, or a prescription drug plan.
A health benefit plan, third-party administrator, administrative
service organization, or pharmacy benefits manager will accept
authorization provided by the State that an item or service is
covered under the state plan or a waiver for the individual as if
the authorization were the prior authorization made by the third
party, except that this provision does not apply to certain
programs or plans, including the original Medicare fee-for-
service program, a Medicare Advantage plan, a reasonable cost
reimbursement plan, a health care prepayment plan, or a
prescription drug plan.
MO HEALTHNET WAIVER FOR NUTRITION SERVICES (Section 208.270)
This bill establishes the "Food is Medicine Act", allowing DSS to
apply to the Centers for Medicare and Medicaid Services, within
the Federal Department of Health and Human Services, for a
Section 1115 demonstration waiver to implement the "Food is
Medicine" program.
The program will be designed to improve health outcomes for MO
HealthNet participants with nutrition-related chronic diseases
through nutrition services and to reduce the need for medical
care for those participants.
The bill specifies the covered nutrition services under this
program, and specifies that whenever feasible, the MO HealthNet
Division within DSS will prioritize the inclusion of community-
based organizations and local growers to support the purchase of
locally grown food in nutrition prescriptions.
The bill requires DSS to promulgate all the necessary rules and
regulations for the administration of this bill.
PRIOR AUTHORIZATION (Sections 208.440 and 376.1364)
Beginning July 1, 2028,health carriers will establish and
maintain an online process that links directly to all e-
prescribing systems and electronic health record systems that can
accept and approve electronic prior authorization requests, as
described in the bill. No health carrier will impose a fee or
charge on any person accessing the online process under this
provision. No later than July 1, 2028, a health carrier will
provide the contact information of any third party vendor or
other entity that the carrier will use to meet these requirements
to any provider that requests such information. A carrier that
fails to implement and maintain an online process for prior
authorization of prescription drugs as required by this bill must
not require providers to obtain prior authorization for
prescription drugs, except as may be specified by the Department
of Commerce and Insurance (DCI) by rule.
By January 1, 2028, health carriers and utilization review
entities will implement and maintain a prior authorization
application programming interface (API) that conforms with
federal law. If a health carrier cannot implement the prior
authorization API by January 1, 2028, the health carrier must
provide written notice to DCI requesting an extension,
accompanied by a documented plan to come into compliance. By
January 1, 2028, an enrollee's health care provider may use the
prior authorization API to submit requests for prior
authorization of health care services, excluding prescription
drugs. A health carrier must accept prior authorization requests
submitted through the API.
For contracts between health carriers and participating health
care providers entered into or renewed on or after January 1,
2028, a health carrier may include a provision that requires
health care providers to submit prior authorization requests
using the API. If a health care provider fails to utilize the
API, cost-sharing for which the enrollee would have otherwise
been responsible will not be affected.
For plan years beginning on or after January 1, 2027, a health
carrier using prior authorization will make statistics available
regarding prior authorization approvals and denials for health
care services, excluding drugs, on its website in a readily
accessible format. The statistics will be updated annually, no
later than June 30th, and include the required information as
described in the bill. The URL for the statistics will be
provided to DCI and DCI will publish the website locations in a
central location on the Department's website.
Every health carrier in this state offering a health benefit plan
with a managed care component must report annually to DCI with a
complete list of the health care services, excluding drugs, for
which prior authorization is required. The DCI will review the
reports and compile an annual report to be published on DCI's
website no later than October 1st of each year.
No later than May 31, 2028, and annually thereafter, every health
carrier in this State offering a health benefit plan with a
managed care component will provide a report to DCI with
aggregated data related to practices and experience of the health
carrier for the prior plan year for health care services
submitted for payment, excluding drugs, as described in the bill.
By July 1, 2027, MO HealthNet managed care organizations, MO
HealthNet managed care plans, and the MO HealthNet division are
required to comply with these provisions relating to the
publishing of statistics regarding prior authorization approvals
and denials for health care services; the annual reporting of a
complete list of the health care services for which prior
authorization is required; and the annual reporting of aggregated
data related to practices and experience of the health carrier
for the prior plan year for health care services submitted for
payment. By July 1, 2028, in addition to compliance with the
above-mentioned provisions, MO HealthNet managed care
organizations, MO HealthNet managed care plans, and the MO
HealthNet division are required to comply with these provisions
relating to the implementation and maintenance of an API.
CHILDREN'S HEALTH SCREENINGS (Section 210.110)
Under this provision, a physician or nurse practitioner will
perform a physical health screening on an abused or neglected
child within 72 hours of the child entering the custody of the
State, as described in the bill. No vaccine can be administered
to the child during the physical without the consent of the
parent or legal guardian. Within 30 days of the physical, a
referral will be made for additional screenings, which may be
performed by a licensed mental health professional or a primary
care physician using a standardized assessment tool.
ELIJAH’S LAW (Section 210.225)
The bill establishes "Elijah's Law" and requires licensed child
care providers to adopt a policy on allergy prevention and
response, with priority given to addressing deadly foodborne
allergies. The policy must contain elements specified in the
bill and be adopted before July 1, 2028. The adoption of this
policy is required for licensure.
The Department of Elementary and Secondary Education (DESE) must
develop a model policy or policies on allergy prevention and
response before July 1, 2027.
LICENSE PLATES AND PLACARDS FOR PERSONS WITH DISABILITIES
(Section 301.142)
This bill adds occupational therapists to the list of licensed
professionals who can issue a statement so that disabled plates
or a disabled windshield placard can be obtained by a patient.
Additionally, removable windshield placards will be renewed every
eight years, instead of the four years in current law. The
Department of Transportation will have the authority to
automatically renew placards, as described in the bill.
PRACTICE OF DENTISTRY IN CORRECTIONAL CENTERS (Section 332.081)
Current law provides that no corporation will practice dentistry
unless that corporation is a nonprofit corporation or a
professional corporation under Missouri law. This bill provides
that such provision will not apply to entities contracted with
the State to provide care in correctional centers.
LICENSURE OF PHYSICIANS (Section 334.031)
This bill requires a candidate applying for licensure as a
physician to submit to a criminal background check and furnish
certain educational and experience documents. This bill also
allows the Board of Registration for the Healing Arts (Board) to
require applicants to list all licenses to practice as a
physician currently or previously held in another state,
territory, or country and to disclose any past or pending
investigations, discipline, or sanctions for such licenses. The
Board can also obtain a report on the applicant from the National
Practitioner Data Bank or the Federation of State Medical Boards.
ADMINISTRATION OF MEDICATIONS (Section 335.081)
This bill provides that the administration by technicians,
nurses' aides, or their equivalent in long-term care facilities
of epinephrine delivery systems and subcutaneous injectable
medications to treat diabetes must not be prohibited by nurse
licensing laws.
SOCIAL WORKERS (Section 337.600)
This bill modifies the definitions of a "qualified advanced macro
supervisor," "qualified baccalaureate supervisor," and "qualified
clinical supervisor" to provide that such person is a licensed
social worker who has practiced social work for which he or she
is supervising the applicant for a minimum of three, instead of
five, years.
ADMINISTRATION OF CERTAIN VACCINES (Section 338.010)
Currently, the practice of pharmacy includes the ordering and
administration of vaccines approved or authorized by the FDA, but
excludes certain vaccines and those vaccines approved after
January 1, 2023. This bill instead provides that the practice of
pharmacy includes the ordering and administration of certain
vaccines approved or authorized by the FDA as of January 1, 2026,
but excludes certain vaccines and those that are not included by
joint rules promulgated by the Board of Pharmacy and the State
Board of Registration for the Healing Arts.
DUTIES OF A PHARMACIST (Sections 338.012 and 338.206)
Currently, a pharmacist with a certificate of medication
therapeutic plan authority can provide certain medication therapy
services if there is a statewide order issued by the Director or
the Chief Medical Officer of DHSS if such person is a licensed
physician or by a licensed physician designated by DHSS. This
bill repeals this language and authorizes the provision of such
medication therapy services pursuant to rules established by the
Board of Pharmacy and the State Board of Registration for the
Healing Arts.
This bill authorizes pharmacists to prescribe medical devices, as
defined in the bill. The Board of Pharmacy and the State Board of
Registration for the Healing Arts will jointly promulgate rules
to implement this provision within six months of the effective
date of this bill.
IVERMECTIN AND HYDROXYCHLOROQUINE (Section 338.208)
Under this bill, a pharmacist can dispense ivermectin and
hydroxychloroquine to a person, without a prescription order,
upon the approval of a warning label for the use and indication
in accordance with any written, standardized procedures or
protocols issued by the Board of Pharmacy. Any ivermectin or
hydroxychloroquine that is dispensed by a pharmacist or by a
pharmacy technician under a pharmacist's supervision without a
prescription must be kept behind the counter or otherwise not
available in a self-service area and be stored in a secure area
accessible only to pharmacy personnel.
LICENSURE OF WHOLESALE DRUG DISTRIBUTORS (Section 338.333)
Under this bill, the Board of Pharmacy can permit an out-of-state
wholesale drug distributor or third-party logistics provider to
be licensed in this State despite not having a license issued by
the distributor's or provider's resident state if the distributor
or provider has a current and valid drug distributor
accreditation from the National Association of Boards of
Pharmacy.
RX CARES FOR MISSOURI PROGRAM (Section 338.710)
This bill removes the expiration date of August 28, 2026, from
the RX Cares for Missouri Program.
SPEECH-LANGUAGE PATHOLOGISTS (Section 345.050)
Currently, a requirement for licensure for speech-language
pathologists and audiologists is submitting evidence of
completion of a clinical fellowship from supervisors. The period
of employment must be under the direct supervision of a person
who is licensed by the State of Missouri in the profession in
which the applicant seeks to be licensed. This bill changes the
period of employment to be under the direct supervision of a
licensed speech-language pathologist in good standing.
340B DRUGS (Section 376.417)
Under this bill, a health carrier, a pharmacy benefits manager,
or an agent or affiliate of such, can not discriminate against a
"covered entity", as defined in the bill, including by
reimbursing the covered entity for a quantity of a 340B drug in
an amount less than it would pay similarly situated non-covered
entities for such drugs, imposing different terms and conditions
as compared to similarly situated entities, refusing to cover
340B drugs or discriminating in reimbursement for 340B drugs, and
other situations described under this bill. The Director of DCI
must impose a civil penalty on any health carrier, pharmacy
benefits manager, or agent or affiliate of such, that violates
this provision, not to exceed $5,000 per violation, per day.
MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS (Sections 376.1000,
376.1012, and 376.1017)
This bill changes the definition of "multiple employer self-
insured health plans" to include plans established for the
purpose of offering benefits to two or more self-employed
individuals, each with at least one common-law employee, and
their dependents.
Current law requires funds collected from participating employers
under multiple employer self-insured health plans to be held in
trust subject to certain requirements, including filing an annual
report with the director of DCI showing the condition and affairs
of the plan.
This bill modifies that requirement by adding the report must be
in compliance with Section 375.041 and also requires that the
plan file an RBC report with the director.
Additionally, current law requires health plans to establish loss
reserves for incurred losses and unearned premiums, as well as
surplus accounts equal to certain amounts. This bill requires
the surplus accounts to be equal to the greater of the following:
(1) $600,000; or
(2) An amount equal to two times the authorized control level
risk-based capital.
CONTRAST ENHANCED MAMMOGRAPHY (Section 376.1183)
Currently, each health carrier or health benefit plan that
provides coverage for diagnostic breast examinations,
supplemental breast examinations, coverage required under current
law, or any combination of such coverage must not impose any
cost-sharing requirements on diagnostic breast examinations or
supplemental breast examinations. This bill modifies when
supplemental breast examinations may be necessary and specifies
that diagnostic and supplemental examinations may include
contrast enhanced mammographies.
INSURANCE COVERAGE OF SELF-ADMINISTERED HORMONAL CONTRACEPTIVES
(Section 376.1240)
This bill requires health benefit plans issued or renewed on or
after January 1, 2027, that provide coverage for self-
administered hormonal contraceptives, as defined in the bill, to
cover a supply of the contraceptives that is intended to last up
to one year.
INSURANCE COVERAGE OF ANESTHESIA SERVICES (Section 376.1245)
The bill prohibits health carriers or health benefit plans from
establishing or implementing any policy or practice that imposes
a time limit for the payment of anesthesia services provided
during a medical or surgical procedure. Moreover, health
carriers or health benefit plans are prohibited from establishing
or implementing any policy or practice that restricts or excludes
all anesthesia time in calculating the payment of anesthesia
services. Excepted benefit plans will be subject to the
requirements of this bill. These provisions do not apply to
anesthesia services provided in connection with dental
procedures.
INSURANCE COVERAGE OF HOME BLOOD PRESSURE MONITORING DEVICES AND
SERVICES (Section 376.1960)
This bill creates "Nora's Law" and requires health benefit plans
delivered, issued for delivery, continued, or renewed in this
State to provide coverage for prescribed home blood pressure
monitoring devices and home blood pressure monitoring device
services for pregnant women and women within 12 months postpartum
when determined to be medically appropriate by the prescribing
practitioner in accordance with American College of Obstetricians
and Gynecologist guidelines. Home blood pressure monitoring
devices or home blood pressure monitoring device services
prescribed will meet the requirements for medical necessity only
and can only be prescribed again if the condition being monitored
deteriorates as to necessitate another prescription, or as
necessary for subsequent pregnancies.
MEDICAL MALPRACTICE JOINT UNDERWRITING ASSOCIATION (Section
383.155)
Current law authorizes the establishment of a medical malpractice
joint underwriting association upon a determination that medical
malpractice liability insurance is not reasonably available in
the voluntary market. This bill authorizes the directors of the
board of the association to suspend the operations of the
association if such directors determine that medical malpractice
insurance is reasonably available. The suspension will be in
accordance with the plan of operations, and will include
provisions for the administration of association funds. During
any suspension of operations, the association will not collect
dues or fees from its members, unless authorized by the Director
of DCI.
CRITICAL INCIDENT STRESS MANAGEMENT PROGRAM (Section 590.192)
Under current law, all peace officers and first responders are
required to have a mental health check-in with a program service
provider once every three to five years. This bill allows a
department to satisfy this requirement if they have an
established behavioral health or mental health program that meets
enumerated requirements. This bill also adds first responder
commanding officers to the list of people approved to receive
notification that the check-in requirement has been met.
DETENTION FOR EVALUATION AND TREATMENT FOR MENTAL HEALTH (Section
632.305)
Currently, an application for detention and evaluation for
treatment at a mental health facility may be executed by any
adult person, who is not required to be an attorney or
represented by an attorney, without a notarization requirement.
This bill repeals the provision that notarization is not required
and specifies that no notarization will be required for any
application, or for any affidavits, declarations, or other
supporting documents, that were completed or executed by certain
peace officers, licensed physicians, mental health professionals,
registered professional nurses, or employees acting on behalf of
a hospital, as specified in the bill.
STATE-BASED HEALTH EXCHANGES (Repeal of section 376.1186)
This bill repeals a provision of current law prohibiting the
establishment of a state-based health benefit exchange under
certain circumstances.