Tracking List: Priority UM System Tracking List
| HB90 - Rep. Dave Griffith (R) - Modifies provisions relating to the authority to confer degrees at public institutions of higher education | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | This bill relates to the authority to confer degrees at public institutions of higher education. The bill repeals the following provisions: (1) The University of Missouri is the state?s only public research university and the exclusive grantor of research doctorates and first-professional degrees, including dentistry, law, medicine, optometry, pharmacy, and veterinary medicine (Section 172.280 RSMo); (2) Degrees in podiatry and chiropractic and osteopathic medicine may be conferred only by the University of Missouri or by a public institution of higher education in collaboration with the University of Missouri, with the University of Missouri being the degree-granting institution, unless the University of Missouri declines to collaborate with the institution (Section 173.005); and (3) Degrees in engineering may be conferred only by the University of Missouri or by a public institution of higher education in collaboration with the University of Missouri, with the University of Missouri being the degree-granting institution, unless the University of Missouri declines to collaborate with the institution (Section 174.160, RSMo). This bill is the same as HB 1497 (2024)and HB 1189 (2023). |
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| HB183 - Rep. Cameron Parker (R) - Modifies the "Higher Education Core Curriculum Transfer Act" | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | This bill specifies that, prior to June 30, 2027, the coordinating board, with the assistance of an advisory committee, shall approve a 60 credit hour transferable lower-division courses and common course numbering equivalency matrix for the five applicable degree programs outlined in the bill beginning in the 2027 - 28 academic year. Each public institution of higher education, offering the approved degree programs, must include in its programs of study an approved 60 hour program equivalency matrix. If a student successfully completes the transferable lower-division courses at a public institution of higher education, such courses may be transferred and shall be substituted for core curriculum courses in the same degree program at a receiving institution. The transferring student receives credit toward the student's degree and is not required to take additional core classes for the same degree program at the receiving institution. Transferring students who have not fully completed the transferable coursework curriculum may be required to satisfy further course requirements at the receiving institution. The coordinating board must report to the House Higher Education Committee and the Senate Education Committee on progress related to the requirements of the bill. This bill is similar to HCS HB 2310 (2024). |
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| HB419 - Rep. Don Mayhew (R) - Clarifies that military personnel are eligible for in-state tuition for undergraduate and graduate degree programs | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | This bill clarifies that specified military service personnel, their spouses, and their unemancipated children under 24, individuals serving in the Missouri National Guard, and any individuals serving in a reserve component of the Armed Forces of the United States, be considered Missouri residents for the purposes of any undergraduate or graduate degree program in Missouri institutions of higher education. |
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| HB448 - Rep. Ian Mackey (D) - Prohibits noncompete clauses in physician employment contracts | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | This bill prohibits the enforcement of any noncompete clause of an employment contract between an employer and a physician that restricts the right of the physician to practice medicine in any geographic area for any period of time after the termination of an employment relationship between the employer and the physician. This bill is the same as HB 2725 (2024). |
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| HB502 - Rep. Brad Christ (R) - Enacts provisions relating to payment for health care services | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | This bill creates the "Honest Billing Act", which requires off- campus outpatient departments of medical facilities, as defined in the bill, to apply for, obtain, and use a national provider identifier ("NPI") that is distinct from the NPI used by the main campus of the facility. This unique NPI must be used on all claims submitted to health carriers on or after January 1, 2026. No facility, or entity on behalf of a facility, can submit a claim for a health care service provided at an off-campus outpatient department of a facility, or hold an enrollee liable for the service, unless the service is billed using the unique NPI and on specified forms. A Health carrier is not required to reimburse claims that are not billed in accordance with this requirement. Facilities, and entities acting on behalf of facilities, cannot hold enrollees liable for health care services that are not billed as provided in the bill. Any violation of this requirement is a violation of the Missouri Merchandising Practices Act subject to enforcement by the Attorney General. A facility applying for a license or license renewal by the state must demonstrate it has obtained one or more NPIs as a condition of receiving licensure, and must use its unique NPI on every claim for payment in the manner required. The bill specifies penalties that may be imposed by the Department of Health and Senior Services after an administrative hearing as provided by law, and the Department of Commerce and Insurance has the authority to refer violations of the these provisions to the Department of Health and Senior Services. The Attorney General also has the authority to enforce the provisions of the bill. This bill is similar to HB 1943 (2024) and SB 610 (2023). |
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| HB616 - Rep. Melanie Stinnett (R) - Modifies provisions relating to the authority to confer degrees at public institutions of higher education | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | This bill relates to the authority to confer degrees at public institutions of higher education. The bill repeals the following provisions: (1) The University of Missouri is the State?s only public research university and the exclusive grantor of research doctorates and first-professional degrees, including dentistry, law, medicine, optometry, pharmacy, and veterinary medicine (Section 172.280, RSMo); (2) Degrees in podiatry and chiropractic and osteopathic medicine may be conferred only by the University of Missouri or by a public institution of higher education in collaboration with the University of Missouri, with the University of Missouri being the degree-granting institution, unless the University of Missouri declines to collaborate with the institution (Section 173.005); and (3) Degrees in engineering may be conferred only by the University of Missouri or by a public institution of higher education in collaboration with the University of Missouri, with the University of Missouri being the degree-granting institution, unless the University of Missouri declines to collaborate with the institution (Section 174.160). This bill is the same as HB 90 (2025) and HB 1497 (2024). |
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| HB618 - Rep. Melanie Stinnett (R) - Creates provisions relating to prior authorization of health care services | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | This bill provides that a health carrier or utilization review entity cannot require health care providers to obtain prior authorization for health care services, except under certain circumstances. Prior authorization is not required unless a determination is made that less than 90% of prior authorization requests submitted by the health care provider in the previous evaluation period, as defined in the bill, were or would have been approved. The bill establishes separate thresholds for requiring prior authorization for individual health care services or requiring prior authorization for all health care services. The bill specifies requirements for notifying the provider of determinations in the bill, requires carriers and utilization review entities to maintain an online portal giving providers access to certain information, and provides that prior authorizations may be required beginning 25 business days after notice to the provider until the end of the evaluation period. Failure to notify providers of a determination as required in the bill will constitute prior authorization of the applicable health care services. Lastly, no health carrier or utilization review entity can deny or reduce payments to a health care provider who had a prior authorization, unless the provider made a knowing and material misrepresentation with the intent to deceive the carrier or utilization review entity, or unless the health care service was not substantially performed. This bill will not apply to Medicaid, except with regard to a Medicaid managed care organization as defined by law. The bill also does not apply to providers who have not participated in a health benefit plan offered by the carrier for at least one full evaluation period. This bill should not be construed to authorize providers to provide services outside the scope of their licenses, nor to require health carriers or utilization review entities to pay for care provided outside the scope of a provider's license. This bill is the same as HB 1976 (2024). |
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| HB688 - Rep. Michael O'Donnell (R) - Modifies provisions relating to state retirement for certain state colleges and universities | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | Beginning on August 28, 2025, in the event that the Board of the Missouri State Employees' Retirement System (MOSERS) certifies a contribution rate that exceeds 28.75%, the Commissioner of the Office of Administration must include in its appropriation request an amount equal to the difference between the certified contribution rate and 28.75% of the compensation of members who are employees of certain state higher education institutions. Except to the extent that state funds have been appropriated and paid to MOSERS, the state higher education institutions must remit the contribution amount. This bill is the same as HB 2760 (2024) and similar to SB 1401 (2024). |
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| HB781 - Rep. Ben Keathley (R) - Creates provisions relating to the 340B drug program | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HB784 - Rep. Tara Peters (R) - Creates provisions relating to 340B drugs | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| SB11 - Sen. Lincoln Hough (R) - Repeals provisions relating to the authority to confer degrees at public institutions of higher education | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | SB 11 - This act repeals the following provisions of law: (1) That the University of Missouri shall be the state's only public research university and the exclusive grantor of research doctorates and first-professional degrees, including dentistry, law, medicine, optometry, pharmacy, and veterinary medicine (Section 172.280); (2) That degrees in podiatry and chiropractic and osteopathic medicine may be conferred only by the University of Missouri or by a public institution of higher education in collaboration with the University of Missouri, with the University of Missouri being the degree-granting institution, unless the University of Missouri declines to collaborate with such institution (Section 173.005); and (3) That degrees in engineering may be conferred only by the University of Missouri or by a public institution of higher education in collaboration with the University of Missouri, with the University of Missouri being the degree-granting institution, unless the University of Missouri declines to collaborate with such institution (Section 174.160). This act is identical to SB 749 (2024), HB 1497 (2024), HB 2673 (2024), SB 473 (2023), and HB 1189 (2023). OLIVIA SHANNON
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| SB13 - Sen. Justin Brown (R) - Enacts provisions relating to insurance coverage of pharmacy services | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | SB 13 - This act enacts provisions relating to insurance coverage of pharmacy services. CLINICIAN-ADMINISTERED DRUGS (Section 376.411) This act provides that a health carrier or pharmacy benefits manager (PBM) shall not impose any penalty, impediment, differentiation, or limitation on participating providers for providing medically necessary clinician-administered drugs, regardless of whether the participating provider obtains the drugs from an in-network provider, including but not limited to refusing to approve or pay, or reimbursing less than the contracted payment amount. Carriers and PBMs shall not impose any penalty, impediment, differentiation, or limitation on a covered person who is administered medically necessary clinician-administered drugs, regardless of whether the participating provider obtains the drugs from an in-network provider, including but not limited to: limiting coverage or benefits; requiring an additional fee, higher co-payment, or higher coinsurance amount; or interfering with a patient's ability to obtain a clinician-administered drug from the patient's provider or pharmacy of choice by any means, including but not limited to inducing, steering, or offering financial or other incentives. Carriers and PBMs shall not impose any penalty, impediment, differentiation, or limitation on any pharmacy that is dispensing medically necessary clinician-administered drugs, regardless of whether the participating provider obtains the drugs from an in-network provider, including but not limited to requiring a pharmacy to dispense the drugs to a patient with the intention that the patient will transport the medication to a health care provider for administration. These provisions shall not apply if the clinician-administered drug is not otherwise covered by the carrier or PBM. These provisions are identical to provisions in the introduced SB 751 (2024), provisions in HCS/HB 2267 (2024), provisions in SB 26 (2023), provisions in HCS/HB 198 (2023), SB 1129 (2022), and provisions in HB 2305 (2022), and similar to provisions in SB 921 (2022), provisions in SB 1129 (2022), and provisions in HB 2305 (2022). REFERENCE PRODUCTS AND BIOSIMILARS (Section 376.415) A health carrier or PBM providing coverage for a reference product or a biological product that is biosimilar to the reference product shall provide coverage for the reference product and all biological products that have been deemed biosimilar to the reference product. The scope, extent, and amount of the required coverage shall be the same, including but not limited to any payment limitations or cost-sharing obligations. These provisions are identical to provisions in the introduced SB 751 (2024), provisions in HCS/HB 2267 (2024), provisions in SB 26 (2023), provisions in HCS/HB 198 (2023), SB 1129 (2022), and provisions in HB 2305 (2022), and similar to provisions in SB 921 (2022), provisions in SB 1129 (2022), and provisions in HB 2305 (2022). 340B DRUG PRICING PROGRAM (Section 376.416) Under this act, no health carrier or pharmacy benefits manager (PBM) shall discriminate against a covered entity or a pharmacy, as such terms are defined in the act, by: • Reimbursing a covered entity or pharmacy for a quantity of a 340B drug, as defined in the act, in an amount less than the carrier, PBM, or affiliate would pay to any other similarly situated pharmacy for such quantity of the drug on the basis that the entity or pharmacy is a covered entity or a pharmacy, or that the entity or pharmacy dispenses 340B drugs. (Section 376.416.2(1)); • Imposing any terms or conditions on covered entities or pharmacies which differ from the terms or conditions applicable to other similarly situated pharmacies or entities on the basis that the entity or pharmacy is a covered entity or dispenses 340B drugs, including but not limited to certain terms and conditions described in the act. (Section 376.416.2(2)); • Interfering with an individual's choice to receive a 340B drug from a covered entity or pharmacy. (Section 376.416.2(3)); • Discriminating in reimbursement to a covered entity or pharmacy based on the determination or indication a drug is a 340B drug. (Section 376.416.2(4)); • Requiring a covered entity or pharmacy to identify a 340B drug sooner than 45 days after the point of sale of the drug. (Section 376.416.2(5)); • Refusing to contract with a covered entity or pharmacy for reasons other than those that apply equally to entities or pharmacies that are not covered entities or similarly situated pharmacies, or on the basis that the entity or pharmacy is a covered entity as described under federal law, or on the basis that the entity or pharmacy is described as a covered entity under provisions of federal law. (Section 376.416.2(6)); • Denying the covered entity the ability to purchase drugs at 340B program pricing by substituting a rebate discount. (Section 376.416.2(7)); • Refusing to cover drugs purchased under the 340B drug pricing program. (Section 376.416.2(8)); or • Requiring a covered entity or pharmacy to reverse, resubmit, or clarify a 340B-drug pricing claim after the initial adjudication unless these actions are in the normal course of pharmacy business and not related to the 340B drug pricing, except as required by federal law. (Section 376.416.2(9)). The Director of the Department of Commerce and Insurance shall impose a civil penalty on any health carrier or PBM violating certain provisions of the act, not to exceed $5,000 per violation per day. (Section 376.416.3). These provisions are similar to provisions in the introduced SB 751 (2024), provisions in SCS/SBs 978 & 1035 (2024), provisions in SB 1213 (2024), provisions in HCS/HB 2267 (2024), provisions in HB 1977 (2024), provisions in SB 26 (2023), provisions in HCS/HB 198 (2023), provisions in SB 426 (2023), HB 197 (2023), provisions in SB 921 (2022), provisions in HCS/HB 1677 (2022), provisions in SB 1129 (2022), and provisions in HB 2305 (2022). ERIC VANDER WEERD |
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| SB71 - Sen. David Gregory (R) - Creates the "First Responder Recruitment and Retention Act" to provide free college tuition for first responders and their legal dependents | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | SB 71 - This act establishes the "First Responder Recruitment and Retention Act" to provide free college tuition for first responders and their legal dependents. The act defines a "first responder" as any person who is trained and authorized by law or rule to render emergency medical assistance or treatment, including, but not limited to, police officers, firefighters, paramedics, and other professionals described in the act. A first responder shall be entitled to a waiver of 100% of the resident tuition charges of a public institution of higher education if the first responder presents to the Department of Higher Education and Workforce Development (DHEWD) verification of his or her current, valid license in a profession specified in the act, if applicable, along with a certificate of verification signed by his or her employer verifying that the individual is a first responder who is trained and authorized to render emergency medical assistance or treatment. The first responder shall also meet all admission requirements of the public institution of higher education and pursue an associate degree or baccalaureate degree that relates to a career as a first responder. Each year the first responder or legal dependent applies for and receives the tuition waiver, the first responder shall file with DHEWD documentation showing proof of employment as a first responder and proof of residence in Missouri. A legal dependent of a first responder is also eligible for a tuition waiver if he or she executes an agreement with the public institution of higher education he or she attends outlining the terms and conditions of the tuition waiver, including the legal dependent's commitment to reside in Missouri for the next five years, as well as a commitment provide a copy of his or her state income tax return annually to DHEWD in order to prove his or her residency in Missouri. The agreement shall also include a provision that if the tuition waiver recipient fails to provide proof of residency in Missouri for the five-year period following the use of the tuition waiver, he or she shall repay the public institution of higher education the amount of tuition that was waived. Finally, the agreement shall provide that any residency, filing, or payment obligation incurred by the tuition waiver recipient under the act is canceled in the event of the tuition waiver recipient's total and permanent disability or death. The legal dependent shall satisfy certain other criteria to be eligible for a tuition waiver. The legal dependent shall not have previously earned a baccalaureate degree, and he or she shall meet all admission requirements of the public institution of higher education he or she wishes to attend. The legal dependent shall also complete and submit a Free Application for Federal Student Aid and provide verification of the first responder's eligibility for the tuition waiver to the public institution of higher education, as provided in the act. A first responder or his or her legal dependent may receive a tuition waiver under the act for up to five years if he or she otherwise continues to be eligible for the waiver. The five years of tuition waiver eligibility starts once the first responder or his or her legal dependent applies for and receives the tuition waiver for the first time and is available to such first responder or legal dependent for the next five consecutive years. A public institution of higher education shall waive 100% of the first responder's or legal dependent's tuition remaining due after subtracting awarded federal financial aid grants and state scholarships and grants for an eligible first responder or legal dependent. An application for a tuition waiver shall include a verification of the first responder's satisfaction of the requirements of the act, including proof of the first responder's employment and residency status. The first responder shall include such verification when the first responder or the first responder's legal dependent is applying to the public institution of higher education in order to obtain a tuition waiver upon initial enrollment. The death of a first responder in the line of duty shall not disqualify such first responder's otherwise eligible legal dependent from receiving the tuition waiver. In such a case, in lieu of submitting verification that the first responder is employed as a first responder, the legal dependent shall submit a statement attesting that, at the time of death, the first responder satisfied the requirements of the act, and the first responder died in the line of duty, as described in the act. Within 45 days after receipt of a completed application for a tuition waiver, the public institution of higher education shall send written notice of the first responder's or legal dependent's eligibility or ineligibility for the tuition waiver. If the first responder or legal dependent is determined not to be eligible for the tuition waiver, the notice shall include the reason or reasons for such determination. The five-year residency requirement for a legal dependent who receives a tuition waiver begins once the legal dependent applies for and receives the tuition waiver and continues until the tuition waiver recipient (a) completes the five-year tuition waiver eligibility period, (b) completes a baccalaureate degree, (c) completes an associate degree and notifies DHEWD that he or she does not intend to pursue a baccalauareate degree or additional associate degree using tuition waivers, or (d) notifies DHEWD that he or she does not plan to use additional tuition waivers. OLIVIA SHANNON |
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| SB230 - Sen. Ben Brown (R) - Enacts provisions relating to prior authorization of health care services | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | SB 230 - This act provides that a health carrier or utilization review entity shall not require health care providers to obtain prior authorization for health care services, except under certain circumstances. Prior authorization shall not be required unless the health carrier or utilization review entity makes a determination that less than 90% of prior authorization requests submitted by that health care provider in the previous evaluation period, as defined in the act, were or would have been approved. The act establishes separate 90% thresholds for requiring prior authorization for individual health care services or requiring prior authorization for any health care service. The act specifies requirements for notifying the provider of determinations under the act, requires health carriers and utilization review entities to establish an appeals process for determinations under the act, and requires carriers and utilization review entities to maintain an online portal giving providers access to certain information. Lastly, no health carrier or utilization review entity shall deny or reduce payments to a health care provider who had a prior authorization, unless the provider made a knowing and material misrepresentation with the intent to deceive the carrier or utilization review entity, or unless the health care service was not substantially performed. This act shall not apply to Medicaid, except with regard to a Medicaid managed care organization as defined by law. The act also does not apply to providers who have not participated in a health benefit plan offered by the carrier for at least one full evaluation period. This act shall not be construed to authorize providers to provide services outside the scope of their licenses, nor to require health carriers or utilization review entities to pay for care provided outside the scope of a provider's license. This act is identical to HB 1976 (2024), and similar to SB 983 (2024) and SB 576 (2023), and to HB 1045 (2023). ERIC VANDER WEERD |
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| SB336 - Sen. Mike Moon (R) - Modifies provisions relating to hospital price transparency laws | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | SB 336 - Under this act, 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 shall not initiate or pursue a collection action against the patient for a debt owed for the items or services. The patient may file suit against the hospital for a prohibited collection and the hospital, if found to be materially out of compliance with federal price transparency laws, shall refund any amount of debt the payor has paid, pay a penalty to the patient in an amount equal to the debt, dismiss or cause to be dismissed any court action with prejudice and pay the patient's attorney fees and costs, and remove or cause to be removed any report made to a consumer reporting agency relating to the debt. This act is identical to SB 1212 (2024) and HB 1161 (2023). SARAH HASKINS |
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| SB337 - Sen. Mike Moon (R) - Modifies provisions relating to certificates of need | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | SB 337 - This act repeals provisions of the certificate of need law relating to hospitals, excluding long-term care beds in hospitals, and major medical equipment. This act also makes technical changes to the certificate of need statutes. This act is identical to SB 192 (2021). SARAH HASKINS |
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| SB372 - Sen. Mike Moon (R) - Enacts provisions relating to payments for prescription drugs | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | SB 372 - This act enacts provisions relating to payments for prescription drugs. MISSOURI CONSOLIDATED HEALTH CARE PLAN PHARMACY BENEFITS MANAGER (Section 103.200) Before March 1, 2027, and annually thereafter, the pharmacy benefits manager ("PBM") utilized by the Missouri Consolidated Health Care Plan ("the Plan") shall file a report with the Plan for the immediately preceding calendar year. The report shall include certain information regarding the Plan, including the aggregate dollar amount of rebates the PBM collected from pharmaceutical manufacturers, and the aggregate dollar amount of the rebates that were not passed on to the Plan. (Section 103.200.2). The Plan shall establish a form for the reporting, in consultation with its PBM, designed to minimize administrative burden and cost. (Section 103.200.3). Documents, materials, and other information submitted to the Plan under these provisions shall not be subject to disclosure under the Sunshine Law, except to the extent they are reported in the aggregate in the reports submitted to the General Assembly or Director of the Department of Commerce and Insurance under the act. The Plan shall not disclose any information under these provisions in a manner that would compromise the financial, competitive, or proprietary nature of the information, or allow a third party to identify rebate values for a particular outpatient prescription drug or class of outpatient prescription drugs. (Section 103.200.4). The Plan shall also annually report to the General Assembly the aggregate dollar amount of pharmaceutical rebates received for covered drugs utilized by enrollees during the calendar year. (Section 103.200.5(1)). The Plan shall annually produce and provide to the General Assembly and Director of the Department of Commerce and Insurance a report for the immediately preceding calendar year describing the rebate practices of the Plan and its pharmacy benefits manager, as specified in the act. (Section 103.200.5(2)). The Plan may impose a penalty of up to $7,500 on its PBM for each violation of these provisions. (Section 103.200.6). These provisions are identical to provisions in SB 1213 (2024), provisions in SB 402 (2023), provisions in HB 197 (2023), and substantially similar to provisions in SB 921 (2022), and provisions in HCS/HB 1677 (2022). FREEDOM OF CHOICE FOR PHARMACY SERVICES (Sections 338.015) The act specifies that certain provisions of law pertaining to pharmacists and pharmacies shall not be construed to prohibit patients' ability to obtain prescription services from any licensed pharmacist "or pharmacy", and repeals language specifying that the provisions do not remove patients' ability to waive their freedom of choice under a contract with regard to payment or coverage of prescription expenses. (Section 338.015.1). Under the act, no PBM shall penalize or restrict a covered person from obtaining services from a contracted pharmacy, as such terms are defined by law. (Section 338.015.4). These provisions are identical to provisions in SB 1213 (2024), provisions in SB 843 (2024), provisions in SB 1105 (2024), provisions in HB 1627 (2024), provisions in HB 197 (2023), and substantially similar to provisions in SB 921 (2022), and provisions in HCS/HB 1677 (2022). PHARMACY BENEFITS MANAGERS (Section 376.387 and 376.388) Additionally, the act modifies the applicable definition of "covered person" for purposes of certain statutes governing PBMs to apply only to individuals who receive prescription drug coverage through a PBM (Section 376.387.1(1)), repeals a provision of law allowing PBMs to hold pharmacists or pharmacies responsible for fees related to charges for administering a health benefit plan (Section 376.387.4), and repeals a provision of law specifying that certain PBM regulations shall not apply with regard to Medicare Part D or other health plans regulated under federal law. (Former section 376.387.5). Pharmacy benefits managers shall notify contracted health carriers in writing of any conflict of interest, any commonality of ownership, or any other relationship between the PBM and any other health carrier with which the PBM contracts. (Section 376.387.5). The act provides standardized definitions for the terms "generic" and "rebate" applicable to PBMs and health carriers (Section 376.387.6-7), and specifies that PBMs shall owe a fiduciary duty to any entity with which it contracts. (Section 376.387.8). The act repeals a portion of a definition to specify that certain provisions relating to the maximum allowable cost of a prescription drug are applicable to all pharmacies, rather than only to contracted pharmacies (Section 376.388.1(1)), and modifies the applicable definition of PBM to refer to any entity that administers or manages a pharmacy benefits plan or program, as defined in the act. (Section 376.388.1(5)). If the reimbursement for a drug to a contracted pharmacy is below the pharmacy's cost to purchase the drug, the PBM shall sustain an appeal and increase reimbursement for the pharmacy and other contracted pharmacies to cover the cost of purchasing the drug. (Section 376.388.5(2)). No PBM shall reimburse a pharmacist or pharmacy in the state an amount less than the amount that the PBM reimburses a PBM affiliate, as defined in the act, for providing the same pharmacist services. (Section 376.388.5(3)). These provisions are identical to provisions in SB 1213 (2024), similar to provisions in SB 843 (2024), provisions in SB 1105 (2024), and provisions in HB 1627 (2024), identical to provisions in SB 402 (2023), provisions in HB 197 (2023), substantially similar to provisions in SB 921 (2022), and similar to provisions in HCS/HB 1677 (2022). 340B DRUG PRICING PROGRAM (Section 376.416) No health carrier or PBM shall discriminate against a covered entity or a specified pharmacy, as such terms are defined in the act, by: • Reimbursing a covered entity or specified pharmacy for a quantity of a 340B drug, as defined in the act, in an amount less than the carrier or PBM would pay to any other similarly situated pharmacy for such quantity of the drug on the basis that the entity or pharmacy is a covered entity or specified pharmacy, as defined in the act, or that the entity or pharmacy dispenses 340B drugs (Section 376.416.2(1)); • Imposing any terms or conditions on covered entities or specified pharmacies which differ from the terms or conditions applicable to other similarly situated pharmacies on the basis that the entity or pharmacy is a covered entity or specified pharmacy or dispenses 340B drugs, including but not limited to certain terms and conditions described in the act. (Section 376.416.2(2));
• Interfering with an individual's choice to receive a 340B drug from a covered entity or specified pharmacy. (Section 376.416.2(3));
• Requiring a covered entity or specified pharmacy to identify 340B drugs, either directly or through a third party. (Section 376.416.2(4)); or
• Refusing to contract with a covered entity or specified pharmacy for reasons other than those that apply equally to entities or pharmacies that are not covered entities or specified pharmacies, or on the basis that the entity or pharmacy is a covered entity or specified pharmacy, or on the basis that the entity or pharmacy is described as a covered entity under provisions of federal law. (Section 376.416.2(5)). The Director of the Department of Commerce and Insurance shall impose a civil penalty on any PBM violating certain provisions of the act, not to exceed $5,000 per violation per day. (Section 376.416.3). These provisions are substantially similar to provisions in SB 1213 (2024), similar to provisions in the truly agreed to and finally passed SS/SB 751 (2024), SCS/SB 978 (2024), SB 1035 (2024), HB 1977 (2024), provisions in HCS/HB 2267 (2024) identical to provisions in SB 402 (2023), provisions in HB 197 (2023), and similar to SB 426 (2023), provisions in HCS/HB 442 (2023), SB 679 (2023), HB 198 (2023), HB 1330 (2023), SB 921 (2022), provisions in HCS/HB 1677 (2022), provisions in SB 1129 (2022), and provisions in HB 2305 (2022). PHARMACEUTICAL REBATE CERTIFICATION (Section 376.2066) Beginning no later than March 1, 2027, this act requires health carriers to annually certify that they have accounted for rebates, as defined in the act, in calculating health benefit plan premiums. These provisions are identical to provisions in SB 1213 (2024) and similar to provisions in SB 971 (2020). ERIC VANDER WEERD |
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| SB383 - Sen. Travis Fitzwater (R) - Creates provisions relating to covenants not to compete involving physicians | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | SB 383 - Under this act, a covenant not to compete between a physician and an employer shall only be enforceable if the physician is providing health care services in a clinical setting and the employer is not a health care entity owned or operated by a nonprofit corporation. A valid covenant not to compete shall be for a period of no longer than 365 days and not extend further than 50 miles from the physician's office address. This act is identical to SB 1396 (2024) and similar to HB 2754 (2024). SARAH HASKINS |
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| SB520 - Sen. Jill Carter (R) - Creates provisions relating to hospitals with emergency departments | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary: | SB 520 - Under this act, a hospital with an emergency department shall have at least one physician on site and on duty who is responsible for the emergency department at all times the emergency department is open. This act is identical to SB 1406 (2024) and HB 2548 (2024). SARAH HASKINS |
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