Tracking List: Priority UM System Tracking List

HB1497 - Modifies provisions relating to the authority to confer degrees at public institutions of higher education
Sponsor: Rep. Dave Griffith (R)
Summary: HB 1497 -- DEGREES OF PUBLIC UNIVERSITIES

SPONSOR: Griffith

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 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 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 such 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 such institution (Section 174.160).

This bill is the same as HB 1189 from 2023.
HB1712 - Allows Missouri National Guard member educational assistance grants to be available for tuition at out-of-state educational institutions
Sponsor: Rep. Adam Schnelting (R)
Summary: HB 1712 -- MILITARY STATE TUITION ASSISTANCE

SPONSOR: Schnelting

Currently, Missouri National Guard members can be awarded an educational assistance grant to an approved public institution or an approved private institution in Missouri. Beginning with the 2025-26 academic year, this bill allows those members to receive the grant for tuition costs at any public, private, or virtual postsecondary education institution in the United States.
HB1943 - Enacts provisions relating to payment for health care services
Sponsor: Rep. Brad Christ (R)
Summary: HB 1943 -- HONEST BILLING ACT

SPONSOR: Christ

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 shall be used on all claims submitted to health carriers on or after January 1, 2025.

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 shall not be 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 shall 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 SB 610 (2023)
HB1977 - Creates provisions relating to the 340B drug pricing program
Sponsor: Rep. Melanie Stinnett (R)
Summary: HB 1977 -- 340B PROTECTION

SPONSOR: Stinnett

This bill prevents health carriers, pharmacy benefits managers, or agents thereof from discriminating against a covered entity or a specified pharmacy by doing any of the following:

(1) Reimbursing a covered entity or specified pharmacy for a quantity of a 340B drug in an amount less than it would pay to a similarly situated pharmacy, on the basis that is specified in the bill;

(2) Imposing terms or conditions on covered entities or specified pharmacies that differ from terms and conditions applied to other similarly situated specified pharmacies or entities that are not covered entities, as specified in the bill;

(3) Interfering with a person's choice to receive a 340B drug from a covered entity or specified pharmacy;

(4) Requiring a covered entity or specified pharmacy to identify 340B drugs; or

(5) Refusing to contract with a covered entity or pharmacy for reasons other than those that apply equally to entities that are not covered entities or similarly situated pharmacies, as specified in the bill.

The Director of the Department of Commerce and Insurance shall impose a civil penalty on any health carrier, pharmacy benefits manager, or agent thereof that violates the above. The penalty shall not exceed a rate of $5000 per day.

This bill is similar to HB 1330 and HCS HB 197 (2023).
HB1997 - Requires public institutions of higher education to have opioid overdose rescue kits available for public use on campus
Sponsor: Rep. Doug Mann (D)
Summary: HB 1997 -- OPIOID REVERSAL MEDICATION

SPONSOR: Mann

This bill requires the Department of Higher Education and Workforce Development to consult and collaborate with the Department of Health and Senior Services (DHSS) to implement requirements for each two year and four year state supported institution of higher education to provide an opioid overdose rescue kit before January 1, 2025.

The rescue kits must contain Narcan, Naloxone, or a similar medication approved by DHSS and the US Food and Drug Administration. The kit's location must be registered with campus police. Specific required locations and inspection routines are provided in the bill.

The bill requires that institutions provide training during freshman student orientation programs and additional programs developed by DHSS.
HB2164 - Modifies provisions relating to emergency medical services data
Sponsor: Rep. Kent Haden (R)
Summary: HB 2164 -- EMS DATA

SPONSOR: Haden

This bill authorizes, for the purposes of conducting epidemiological studies, the Department of Health and Senior Services to collaborate with the University of Missouri School of Medicine regarding the analysis of data collected from ambulance services and emergency medical response agencies. The Department and University shall maintain the confidentiality of all personal health information that is abstracted by or reported to the Department, though the University and Department may share de- identified data with other public health authorities, health researchers, local emergency medical response agencies, EMS regions, EMS medical directors, and other legitimate research entities if they abide by the confidentiality restrictions required by state and federal law.

The Department, through the University, is able to use EMS data to collaborate with other pertinent databases for the purposes of quality improvement of the provision of emergency medical services, research, and general reporting. Local emergency medical response agencies shall be provided access to the data they have submitted from the Department and the University without the need for a request made through Chapter 610, RSMo, or the federal Freedom of Information Act.

No individual or organization providing information to the Department in accordance with the provisions of this bill shall be deemed to be or held liable for divulging confidential information unless the individual or organization acted in bad faith or with malicious purpose.

Any Department employee, public health authority, University employee, or co-investigator of a study who knowingly releases information violating the provisions of this bill shall be guilty of a class A misdemeanor.
HB2166 - Modifies provisions relating to veterans' affairs
Sponsor: Rep. Bill Hardwick (R)
Summary: HB 2166 -- VETERANS' AFFAIRS

SPONSOR: Hardwick

The bill proposes to expand the eligibility and benefits of educational assistance for members of the Missouri National Guard.

Currently, a member can qualify for a education assistance grant, if he possesses certain qualifications, to an approved public institution or an approved private institution of his or her choice while he or she is a member of the Missouri National Guard.

This bill changes the schools a member can attend from an approved public institution or approved private institution to an approved private institution or to any institution of postsecondary education that is required by statute to be, and currently is certified to operate by the Coordinating Board for Higher Education, within the Department of Higher Education and Workforce Development; that is institutionally accredited by an accrediting commission recognized by the United States Department of Education; that has operated continuously in this state for 5 or more years; that has no more than 50% of its students in correspondence programs; and that offers a one-year or two-year certificate, associate or baccalaureate degree programs, or graduate or professional degree programs.

This bill also allows the member to make a one-time transfer of his or her educational assistance, or the remaining portion of such educational assistance, to a spouse who is named as a dependant of the member in the Defense Enrollment Eligibility Reporting System and the member has a minimum grade point average of two point five or higher on a four-point scale.

Currently, there is a business loan program for veteran-owned small businesses called the Boots-to-Business Program. The Program includes mentoring for the first 65 days. This bill specifies that the small businesses that received the mentoring must be part of the Boots-to-Business Program.

The bill waives the fees for obtaining a certification, or copy of such certification, of death of a veteran if the request is made by the veteran's legal representative, the executor or administrator of the veteran's estate, any family member of the veteran authorized to obtain a copy of such certification, or a qualified veterans' organization that takes possession of the veteran's remains with the intention of properly disposing of such remains. Only one certificate can be provided without cost. Any additional certificates will have a fee.
HB2267 - Creates provisions relating to insurance coverage of pharmacy services
Sponsor: Rep. Tara Peters (R)
Summary:

HCS HB 2267 -- INSURANCE COVERAGE OF PHARMACY SERVICES (Peters)

COMMITTEE OF ORIGIN: Special Committee on Public Policy

This bill prohibits health carriers and pharmacy benefits managers from imposing any penalty or limitation on providers, patients, or pharmacies for providing or receiving clinician-administered drugs, regardless of the source.

The bill prohibits health carriers and pharmacy benefits managers from discriminating against covered entities or pharmacies that participate in the 340B drug pricing program, and imposes a civil penalty for violations. The penalty cannot exceed $5,000 per violation per day.

This bill requires health carriers and pharmacy benefits managers to provide coverage for reference products and biosimilar products.

This bill is similar to SB 751 (2024).

HB2310 - Modifies the "Higher Education Core Curriculum Transfer Act"
Sponsor: Rep. Cameron Parker (R)
Summary:

HCS HB 2310 -- HIGHER EDUCATION CORE CURRICULA (Parker)

COMMITTEE OF ORIGIN: Standing Committee on General Laws

This bill specifies that, prior to June 30, 2026, 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 at least five applicable degree programs with substantial enrollment beginning in the 2027- 28 academic year. Each public institution of higher education, offering the approved degree programs, shall 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 towards 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 shall report to the House Higher Education Committee and the Senate Education Committee on progress related to the requirements of the bill.

HB2347 - Creates provisions relating to prior authorization for ambulance service transportation from one hospital to another hospital for MO HealthNet participants
Sponsor: Rep. Melanie Stinnett (R)
Summary: HB 2347 -- HOSPITAL-TO-HOSPITAL TRANSPORTATION

SPONSOR: Stinnett

This bill prohibits Medicaid managed care organizations from requiring prior authorization for hospital-to-hospital transportation services for the MO HealthNet participants served by the Medicaid managed care organization, as such terms are defined in the bill.
HB2489 - Modifies provisions relating to employment and creates new requirements relating to the verification of the immigration status of certain persons
Sponsor: Rep. Jim Murphy (R)
Summary: HCS HB 2489 -- EMPLOYMENT PRACTICES (Murphy)

COMMITTEE OF ORIGIN: Special Committee on Innovation and Technology

This bill modifies provisions relating to employment and creates new requirements relating to the verification of the immigration status of certain persons.

The 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.

The provisions relating to municipal sanctuary policies under Section 67.307, RSMo do not apply to qualified immigrant workers registered in the Missouri Department of Labor and Industrial Relations (DOLIR) database established by this bill.

Currently, public employers must enroll and actively participate in a Federal work authorization program, this bill adds private employers and business entities. Beginning January 1, 2025, an employer or business entity is required to verify the employment eligibility of every employee who is hired after the employer or business entity enrolls in the program. If the private employer or business entity fails to comply, it must provide an affidavit as specified in the bill. If a general contractor or subcontractor of any tier knows its direct subcontractor has knowingly employed an unauthorized alien, such contractor or subcontractor must report to DOLIR. If the contractor or subcontractor fails to report to DOLIR, it will be subject to the same penalty for the violation as the direct subcontractor (Section 285.530).

Currently, upon a court's finding that a business entity has knowingly violated Subsection 1 of Section 285.530, the court must direct the applicable county or municipal governing body to suspend the entity's business license and other applicable licenses and exemptions for 14 days. The bill raises the length of the suspension to 120 days. A second or subsequent violation is a class D felony, as is a second or subsequent violation by a business entity awarded a State contract or receiving a State- administered tax credit, tax abatement, or loan from the State (Section 285.535).

The bill establishes the "Immigrant Employment Registration and Taxation Protection Act". The bill defines, among other terms, "alien" and "parolee", and provides that a "qualified immigrant worker" is a person who: (1) Is a parolee or alien, but not an unauthorized alien, legally authorized under Federal law to accept employment;

(2) Has obtained a valid work permit or conditional work permit but whose current immigration status is in a suspended quasi-legal status; and

(3) Is a new hire or employed in the state of Missouri.

The Department is required to maintain a database or registry of qualified immigrant workers, and must provide employers with a mechanism to verify registration of any qualified immigrant worker. Individuals who have certain documentation verifying their legal status are exempt from registering with the Department. A qualified immigrant worker is required to sign an affidavit of understanding detailing the conditions under which the worker may be employed. Further, upon receiving documentation from a qualified immigrant worker, the employer is required to provide the documentation to DOLIR as specified in the bill, and DOLIR must provide written confirmation of the worker's registration. The Attorney General (AG) shall enforce the Act. An enforcement action is initiated through a signed, written complaint to the AG by any State official, business entity, or State resident. The bill details the course of action taken by the AG upon receipt of a valid complaint. The bill authorizes the AG to inform and cooperate with the Department of Revenue for investigation and enforcement of any additional criminal liabilities under Chapter 143. A qualified immigrant worker who fails to provide the employer-requested documentation required to verify work authorization status is guilty of a class D felony. Nothing in the section shall be construed to imply the state of Missouri is an advocate for a legal immigration status relating to a qualified immigrant worker or worker (Section 285.545).

Currently, any State or local agency administering one or more Federal public benefit programs is exempt from the requirements of subsections 1 and 3 of Section 650.475, which prohibit a government entity, or official from restricting a government entity or official from communicating or providing information with respect to the immigration status, lawful or unlawful, of any individual. A qualified immigrant worker registered in the DOLIR database is added to the exemption (Section 650.475).

Certain provisions in this bill have a delayed effective date.

This bill is similar to HB 1515 (2024); and HCS HB 188 (2023).
HB2567 - Creates provisions relating to health care
Sponsor: Rep. Ben Baker (R)
Summary: HB 2567 -- HEALTH CARE

SPONSOR: Baker

This bill establishes the "Do No Harm Act" and provides terms and definitions relating to "academic standards", "health care related academic programs", "medical institutions of higher education" and "Diversity-Equity-Inclusion" or "DEI" among others.

The bill prohibits medical institutions of higher education from expending any funds to establish, sustain, support, or staff a DEI office, as well as contracting, employing, or hiring anyone to serve as a DEI officer. This is not to be construed to affect funding by such an institution of course instruction, research and creative works by those involved with the institution, activities of registered student organizations, arrangements for guest speakers or other short-term engagements, or mental and physical health services offered by licensed professionals.

This bill additionally requires any funds that would have been expended for DEI offices or officers in fiscal year 2025 to be reallocated to merit scholarships for lower-and-middle-income students, and to reduce tuition for in-state students.

The bill requires medical institutions of higher education to file a report with the Department of Higher Education, before the expenditure of any funds appropriated for fiscal year 2025, that discloses the steps taken to comply with the requirements set forth in this bill as well as the number and job titles of those deemed to be required by the obligations of the institution to comply with several applicable federal laws and regulations. The institution is required to make this report available for the public.

This bill requires medical institutions of higher education to publish titles and syllabi for all mandatory courses, seminars, classes and trainings on a public online database, and prohibits institutions from conducting DEI audits or hiring DEI consultants.

The bill requires medical institutions of higher education to submit an annual certification by December 31st to the State Board of Registration for Healing Arts, within the Department of Commerce and Insurance, and the coordinating Board of Higher Education, within the Department of Higher Education, that the institution does not require applicants or students to subscribe to DEI ideologies, does not discriminate against those who do not subscribe to such ideologies, and does not require the study of such ideologies for admitted students. This bill requires medical institutions of higher education, except for open-enrollment institutions, to require applicants to complete a standardized admissions test and outlines academic standards for health care related courses of study, as specified in the bill. If a medical institution of higher education wants to alter the standards for admissions, the new standards must be submitted to the General Assembly and the Coordinating Board for Higher Education. The proposed standards shall not be effective until at least 60 days have passed during which a joint resolution of disapproval may be passed by both chambers and approved by the Governor to invalidate any such submitted standards.

The bill prohibits medical institutions of higher education and medical institutional review boards that may be associated with such institutions from:

(1) Requiring any applicant, employee, student, or contractor to endorse any discriminatory ideology;

(2) Requiring any applicant, employee, student, or contract to provide a statement of diversity, equity, and inclusion;

(3) Giving preferential consideration to any applicant, employee, student, or contractor on the basis of his or her provision of an unsolicited statement related to a discriminatory ideology; or

(3) Preventing an applicant or candidate from providing any information described in this provision of the bill on his or her own accord.

The bill restricts health care-related professional licensing boards from having any requirements for obtaining or renewing licenses associated with DEI related materials or programs. State- required health care-related professional certifications shall not use DEI material or require DEI training as part of the certification process. Such boards and organizations are prohibited from conducting DEI audits or hiring DEI consultants.

Health care providers and medical institutions of higher education are prohibited from receiving state contracts or grants without certifying that the provider or institution will not require specified individuals from subscribing to, studying, or receiving instruction on DEI material. Such providers and institutions must submit annual certification attesting to their compliance.

All state entities applying for any Federal health care related grant relating to DEI shall publish on a public website all materials, requirements, and instructions relating to the grant application along with a copy of the grant proposal to the State Board of Registration for the Healing Arts and to the members of the House and Senate Committees on Health Policy.

The bill provides any aggrieved person a cause of action for any violations of these sections to include declaratory and injunctive relief, damages of at least $100,000 against the health care provider or medical institution of higher education for any violations, compensatory damages, and costs and attorney fees. Furthermore, the bill waives sovereign immunity for such providers and institutions for up to a year after any violation.

This bill requires any medical institution of higher education to annually submit certification of compliance to the State Board of Registration for the Healing Arts with Sections 191.1770 to 191.1810, RSMo, and authorizes the Attorney General to investigate allegations of violations.

The State Board of Registration for the Healing Arts shall publish on its website annually a list of all the health care providers and medical institutions that have provided annual certification.

This bill is similar to HCS HB 489 (2023).
HB2569 - Prohibits state departments from spending money on diversity, equity, and inclusion initiatives
Sponsor: Rep. Ben Baker (R)
Summary: HB 2569 -- EXPENDITURES BY STATE DEPARTMENTS

SPONSOR: Baker

This bill prohibits State departments from using funds for programs related to "diversity, equity, and inclusion"(DEI) or similar initiatives if they promote preferential treatment based on various factors including race, gender, or ethnicity; attribute disparities solely to oppression; advocate collective guilt ideologies; engage in divisive identity activism; or restrict freedom of conscience, thought, or speech.

This bill does not prohibit State departments from adherence to Federal and State employment laws and the Americans with Disabilities Act.

This bill also specifies that State departments cannot compel or incentivize private sector employers to adopt DEI programs as a condition for state contracts.

This bill is the same as HB 2365 (2024).
HB2621 - Prohibits medical schools from providing abortion-specific training and partnering with out-of-state entities to provide such training
Sponsor: Rep. Justin Sparks (R)
Summary: HB 2621 -- ABORTION-RELATED TRAINING

SPONSOR: Sparks

This bill prohibits public and private medical schools located in the State from providing medical students, residents, or fellows with any "abortion-specific training", as that term is defined in the bill, and prohibits partnerships between these schools and any public or private medical school, clinic, or facility in another state to provide abortion-specific training.
HB2638 - Prohibits institutions of higher education from withholding student transcripts because of unpaid tuition and fees
Sponsor: Rep. Kevin Windham (D)
Summary: HB 2638 -- HIGHER EDUCATION TRANSCRIPTS

SPONSOR: Windham

This bill prohibits institutions of higher education from refusing to provide a transcript to a student based on a condition of any debt or charge a higher fee for a transcript because a student owes a debt.

This bill is the same as HB 1789 (2022) and HB 972 (2023).
HB2673 - Modifies provisions relating to the authority to confer degrees at public institutions of higher education
Sponsor: Rep. Melanie Stinnett (R)
Summary: HB 2673 -- DEGREES OF PUBLIC UNIVERSITIES

SPONSOR: Stinnett

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 will 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, 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 such 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 such institution (Section 174.160).

This bill is the same as HB 1497 (2024) and HB 1189 (2023).
HB2754 - Creates provisions relating to covenants not to compete involving physicians
Sponsor: Rep. Ben Keathley (R)
Summary: HB 2754 -- COVENANT NOT TO COMPETE INVOLVING PHYSICIANS

SPONSOR: Keathley

The bill specifies that a "covenant not to compete" in which an employee agrees to refrain from competing with an employer for a certain period of time and/or within a certain geographic area after the employment ends is only valid and enforceable between a physician and an employer if:

(1) The physician is providing health care services in a clinical setting;

(2) The employer is not a nonprofit health care entity;

(3) The covenant does not restrict the physician's competitive activities for more than a year; and

(4) The covenant does not restrict the physician's competitive activities in a geographic area of more than 50 miles from the office or facility where the physician works.
HB2826 - Modifies provisions relating to the powers of a hospital district board of trustees
Sponsor: Rep. Doug Richey (R)
Summary: HB 2826 -- POWERS OF A HOSPITAL DISTRICT BOARD OF TRUSTEES

SPONSOR: Richey

Under this bill, no hospital district can enter into an agreement with an academic, nonprofit medical system operated by, affiliated with, or originally established by a public institution of higher education that is chartered outside of this state.

This bill has an emergency clause.
HB2892 - Establishes standards in regards to covenants not to compete
Sponsor: Rep. Betsy Fogle (D)
Summary: HB 2892 -- COVENANTS NOT TO COMPETE

SPONSOR: Fogle

This bill adds a new section of law concerning covenants not to compete. The bill defines the term, which can include time-based and geographic restrictions, and renders any covenant not to compete void and unenforceable to the extent it applies to employees paid by the hour.
HB2905 - Modifies provisions governing funding for higher education
Sponsor: Rep. Brenda Shields (R)
Summary: HCS HB 2905 -- FUNDING FOR HIGHER EDUCATION

SPONSOR: Shields

COMMITTEE ACTION: Voted "Do Pass with HCS" by the Standing Committee on Higher Education by a vote of 7 to 1.

The following is a summary of the House Committee Substitute for HB 2905.

The bill requires the Department of Higher Education and Workforce Development (DHEWD) in consultation with public institutions of higher education to develop a funding model for higher education public institutions.

The funding model will provide a level of stable, sustainable resources, be based on the 2023 study commissioned by the Department, include a process for allocation of core appropriations, and include a performance component designed to enhance student success and efficient operations.

The Department will establish a plan for the testing and implementation of the funding model to be approved by the Coordinating Board for Higher Education and submit the plan to the Governor and General Assembly before January 2025. A report on the effectiveness of the model test shall be submitted to the Speaker of the House, President Pro Tem of the Senate and the Governor before November 1, 2025.

The funding model must be approved by the board before January 1, 2026 and must be approved by the General Assembly by concurrent resolution. Beginning in the 2027-28 fiscal year if approved the funding model will be used for appropriating funding for public institutions of higher education.

The following is a summary of the public testimony from the committee hearing. The testimony was based on the introduced version of the bill.

PROPONENTS: Supporters say that this bill will authorize DHEWD to work with the institutions of higher education and community colleges to create a less subjective model for financing such institutions and colleges. This language provides for timelines with anticipation of a working model to be used for testing purposes before full implementation. There are 18 other states with similar performance funding models and the focus should be on using the best parts of those. Previous models have had performance criteria but were not used by previous legislations to disburse funding. Testifying in person for the bill were Representative Shields; Charles R. Brazeale, University of Missouri Flagship Council; Council on Public Higher Education; and University of Missouri System.

OPPONENTS: There was no opposition voiced to the committee.

OTHERS: Others testifying on the bill say that this is a starting point built around a cost-based approach with three pillars. The fixed costs provided on a "frugal" base, institutional programs and student makeup, and performance. There are several aspects that must be worked on in a transparent manner with the institutions.

Testifying in person on the bill was Leroy Wade, DHEWD .



Written testimony has been submitted for this bill. The full written testimony and witnesses testifying online can be found under Testimony on the bill page on the House website.
SB751 - Enacts provisions relating to insurance coverage of pharmacy services
Sponsor: Sen. Justin Brown (R)
Summary: SB 751 - 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 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), provisions in HB 2305 (2022), provisions in SB 971 (2020), provisions in HCS/HB 2412 (2020), provisions in the truly agreed to and finally passed SS/SCS/HCS/HB 1682 (2020), provisions in HB 1910 (2020), provisions in SB 413 (2019), and provisions in HB 1165 (2019).

340B DRUG PRICING PROGRAM (Section 376.414)

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 specified 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 376.414.2(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 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 376.414.2(2));

• Interfering with an individual's choice to receive a 340B drug from a covered entity or pharmacy. (Section 376.414.2(3));

• Requiring a covered entity or specified pharmacy to identify 340B drugs, either directly or through a third party, except as required to comply with rebate transparency requirements of a pharmaceutical manufacturer. (Section 376.414.2(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 376.414.2(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 376.414.2(6));

• Denying the covered entity the ability to purchase drugs at 340B program pricing by substituting a rebate discount. (Section 376.414.2(7));

• Refusing to cover drugs purchased under the 340B drug pricing program. (Section 376.414.2(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 376.414.2(9)).

Under the act, a pharmaceutical manufacturer shall not discriminate against the acquisition or delivery of 340B drugs to pharmacies that are under contract with a covered entity to receive and dispense 340B drugs on behalf of the covered entity. Violation of this provision shall be an unlawful merchandising practice. (Section 376.414.3).

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 376.414.4).

These provisions are similar to 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), provisions in HB 2305 (2022), provisions in SB 971 (2020), provisions in HCS/HB 2412 (2020), provisions in the truly agreed to and finally passed SS/SCS/HCS/HB 1682 (2020), provisions in HB 1910 (2020), provisions in SB 413 (2019), and provisions in HB 1165 (2019).

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 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), provisions in HB 2305 (2022), provisions in SB 971 (2020), provisions in HCS/HB 2412 (2020), provisions in the truly agreed to and finally passed SS/SCS/HCS/HB 1682 (2020), provisions in HB 1910 (2020), provisions in SB 413 (2019), and provisions in HB 1165 (2019).

ERIC VANDER WEERD

SB789 - Modifies provisions relating to the powers of a hospital district board of trustees
Sponsor: Sen. Greg Razer (D)
Summary: SB 789 - Under this act, no hospital district board of trustees shall approve any agreement to partner or otherwise collaborate with any health care system operated by an institution of higher education that is located outside of Missouri for the purpose of providing health care services to Missouri residents unless the agreement is first submitted to the voters of the district and approved by two-thirds of votes cast.

SARAH HASKINS

SB978 - Enacts provisions relating to payments for prescription drugs
Sponsor: Sen. Curtis Trent (R)
Summary: SCS/SBs 978 & 1035 - Under this act, no health carrier or pharmacy benefits manager (PBM) shall discriminate against a federally-qualified health center (FQHC) or a specified pharmacy, as such term is defined in the act, by:

• Reimbursing a FQHC 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 FQHC or specified pharmacy, or that the entity or pharmacy dispenses 340B drugs. (Section 376.414.2(1));

• Imposing any terms or conditions on FQHCs 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 FQHC or specified pharmacy or dispenses 340B drugs, including but not limited to certain terms and conditions described in the act. (Section 376.414.2(2));

• Interfering with an individual's choice to receive a 340B drug from a FQHC or specified pharmacy. (Section 376.414.2(3));

• Requiring a FQHC or specified pharmacy to identify 340B drugs, either directly or through a third party. (Section 376.414.2(4)); or

• Refusing to contract with a FQHC or specified pharmacy for reasons other than those that apply equally to entities or pharmacies that are not FQHCs or specified pharmacies, or on the basis that the entity or pharmacy is a FQHC or specified pharmacy, or on the basis that the entity or pharmacy is described as a FQHC under provisions of federal law. (Section 376.414.2(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 376.414.3).

This act is similar to SB 679 (2023), SB 426 (2023), provisions in SB 402 (2023), HB 197 (2023), HB 198 (2023), provisions in HCS/HB 442 (2023), HB 1330 (2023), SB 921 (2022), provisions in HCS/HB 1677 (2022), provisions in SB 1129 (2022), and provisions in HB 2305 (2022).

ERIC VANDER WEERD

SB986 - Enacts provisions relating to payment for health care services
Sponsor: Sen. Mary Elizabeth Coleman (R)
Summary: SB 986 - This act creates the "Honest Billing Act", which requires off-campus outpatient departments of medical facilities, as defined in the act, 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 shall be used on all claims submitted to health carriers on or after January 1, 2025.

No facility, or entity on behalf of a facility, shall 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 in a form specified in the act. Health carriers shall not be required to reimburse claims that are not billed in accordance with this requirement.

Facilities, and entities acting on behalf of facilities, shall not hold enrollees liable for health care services that are not billed as provided in the act. Violations of this requirement shall be 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 shall demonstrate it has obtained one or more NPIs as a condition of receiving licensure, and shall use its unique NPI on every claim for payment in the manner required under the act.

The act 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 shall have authority to refer violations of the act to the Department of Health and Senior Services. The Attorney General shall also have authority to enforce the act.

This act is identical to SB 610 (2023).

ERIC VANDER WEERD

SB1035 - Enacts provisions relating to payments for prescription drugs
Sponsor: Sen. Doug Beck (D)
Summary: SB 1035 - Under this act, no health carrier or pharmacy benefits manager (PBM) shall discriminate against a federally-qualified health center (FQHC) or a specified pharmacy, as such term is defined in the act, by:

• Reimbursing a FQHC 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 FQHC or specified pharmacy, or that the entity or pharmacy dispenses 340B drugs. (Section 376.414.2(1));

• Imposing any terms or conditions on FQHCs 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 FQHC or specified pharmacy or dispenses 340B drugs, including but not limited to certain terms and conditions described in the act. (Section 376.414.2(2));

• Interfering with an individual's choice to receive a 340B drug from a FQHC or specified pharmacy. (Section 376.414.2(3));

• Requiring a FQHC or specified pharmacy to identify 340B drugs, either directly or through a third party. (Section 376.414.2(4)); or

• Refusing to contract with a FQHC or specified pharmacy for reasons other than those that apply equally to entities or pharmacies that are not FQHCs or specified pharmacies, or on the basis that the entity or pharmacy is a FQHC or specified pharmacy, or on the basis that the entity or pharmacy is described as a FQHC under provisions of federal law. (Section 376.414.2(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 376.414.3).

This act is similar to SB 679 (2023), SB 426 (2023), provisions in SB 402 (2023), HB 197 (2023), HB 198 (2023), provisions in HCS/HB 442 (2023), HB 1330 (2023), SB 921 (2022), provisions in HCS/HB 1677 (2022), provisions in SB 1129 (2022), and provisions in HB 2305 (2022).

ERIC VANDER WEERD

SB1113 - Modifies provisions relating to fiduciary duties for investments of public employee retirement systems
Sponsor: Sen. Rusty Black (R)
Summary: SB 1113 - This act modifies provisions relating to duties of fiduciaries for public employee retirement systems. Specifically, investment fiduciaries are required to:

· Not consider environmental, social, or governance characteristics in a manner that would override his or her fiduciary duties;

· Not be subject to any legislative, regulatory, or other mandates to invest with environmentally, socially, or other noneconomically motivated influence unless the mandates are consistent with the fiduciary's responsibility or as provided in the system's governing statutes, ordinances, charter, or documents with respect to the investment of system assets or other duties imposed by law relating to the investment, management, deposit, or custody of system assets; and

· Not be subject to any legislative, regulatory, or other mandates for divestment from any indirect holdings in actively or passively managed investment funds or in private assets.

All shares of common stock held directly by a retirement system shall be voted solely in the economic interest of participants of the system. Voting shares for the purposes of furthering noneconomic environmental, social, political, ideological, or other goals is prohibited. The act creates provisions on proxy voting for such purposes.

This act is substantially similar to HB 769 (2023) and provisions in HCS/HB 863 (2023).

KATIE O'BRIEN

SB1212 - Modifies provisions relating to hospital price transparency laws
Sponsor: Sen. Mike Moon (R)
Summary: SB 1212 - 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 HB 1161 (2023).

SARAH HASKINS

SB1295 - Modifies provisions relating to emergency medical services
Sponsor: Sen. Greg Razer (D)
Summary: SB 1295 - This act requires the Department of Health and Senior Services to collaborate with the University of Missouri, School of Medicine to analyze emergency medical services (EMS) data collected from ambulance services and emergency medical response agencies under state law. The Department and the University shall maintain the confidentiality of personal health information, as described in the act.

The Department's collaboration with the University shall be for the purpose of quality improvement in the provision of emergency medical services, research, and reporting to EMS entities and state agencies. Local EMS agencies reporting data to the Department shall be provided with access, at no cost, to the data the agencies have submitted.

Any employee of the Department, the University, a public health authority, or other person with access to the information collected under this act who knowingly releases the information in violation of this act shall be guilty of a Class A misdemeanor.

SARAH HASKINS

SB1396 - Creates provisions relating to covenants not to compete involving physicians
Sponsor: Sen. Travis Fitzwater (R)
Summary: SB 1396 - 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.

SARAH HASKINS

SB1402 - Provides that students enrolled in the Reserve Officer Training Corps at a state college or university shall be eligible for in-state tuition fees
Sponsor: Sen. Bill Eigel (R)
Summary: SB 1402 - This act provides that any student who is enrolled in a Reserve Officer Training Corps program of the United States Armed Forces at a state college or university shall be deemed to be domiciled in this state for purposes of eligibility for in-state tuition fees. To be eligible for in-state tuition as provided in the act, such student shall demonstrate his or her presence in the state of Missouri and report the full amount of any other federal or state aid he or she receives to the Coordinating Board for Higher Education. No student shall receive more financial assistance under this act than the actual cost of college attendance when the in-state tuition fees are combined with any other state or federal aid made available to such student.

OLIVIA SHANNON

SB1406 - Creates provisions relating to hospitals with emergency departments
Sponsor: Sen. Karla Eslinger (R)
Summary: SB 1406 - 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 HB 2548 (2024).

SARAH HASKINS

SB1457 - Prohibits public institutions of higher education chartered outside of Missouri from operating an educational facility in this state
Sponsor: Sen. Greg Razer (D)
Summary: SB 1457 - This act prohibits any public institution of higher education chartered outside of Missouri from operating an educational facility in this state. The Attorney General shall have the authority to seek injunctive relief to close an educational facility operating in violation of the provisions of this act.

OLIVIA SHANNON

SCR22 - Modifies the statewide mission of Missouri Southern State University
Sponsor: Sen. Jill Carter (R)
Summary: SCR 22 - This concurrent resolution adds health and life sciences and immersive learning experiences to the mission of Missouri Southern State University.

OLIVIA SHANNON

SJR86 - Places limitations on state spending
Sponsor: Sen. Jill Carter (R)
Summary: SJR 86 - This constitutional amendment, if approved by the voters, prohibits total state general revenue appropriations for any fiscal year, as defined in the amendment, from exceeding the level from the previous fiscal year, allowing for growth in an amount equal to the annual rate of inflation plus the annual percentage change in state population. Total state general revenue appropriations may exceed the previous fiscal year’s amount only under certain conditions, as described in the amendment.

For any fiscal year in which net general revenue collections exceed total state general revenue appropriations by more than one percent of allowable total state general revenue appropriations, an amount equal to such excess revenue shall be refunded to taxpayers.

This amendment is similar to SJR 53 (2024), SJR 7 (2023), SJR 6 (2021), SJR 42 (2020), SJR 4 (2019), SJR 31 (2018), and SJR 12 (2017), and to a provision contained in HCS/HJR 56 (2016).

JOSH NORBERG