Health & Hospital Law

SS#2 SCS HCS HB 111 – Judicial procedures (See Judicial Administration)

HB 151 – Designation of tax refunds to the organ donor program fund (See Taxation Law)

HB 182 – Colon cancer awareness day Designates the first Friday in March of each year as “Dress in Blue for Colon Cancer Awareness Day” to increase awareness of colon cancer. (Signed 5/5/11)

HCS HB 197 – Cord blood banking Requires the Director of the Department of Health and Senior Services to post on its website certain resources relating to umbilical cord blood organization which includes an explanation of the potential value and uses of umbilical cord blood.  Beginning October 1, 2011, a licensed obstetrician or gynecologist can make available to the patient prior to the beginning of her third trimester or, if later, at her first visit the information posted on the department’s website regarding umbilical cord blood banking. (Signed 7/8/11)

SS HCS HB 213 – Late-term abortions This bill revises the definition of “abortion” to mean the act of using or prescribing an instrument, device, medicine, drug, or any other means or substance with the intent to destroy the life of an embryo or fetus in his or her mother’s womb or the intentional termination of the pregnancy of a mother by using or prescribing any instrument, device, medicine, drug, or other means or substance with an intention other than to increase the probability of a live birth or to remove a dead or dying unborn child.  No abortion of a viable, unborn child can be performed or induced, except in the case of a medical emergency, where the abortion is necessary to preserve the life of the pregnant woman whose life is endangered by a physical disorder, illness, or injury or when the continuation of the pregnancy will create a serious risk of substantial and irreversible physical impairment of a major bodily function of the pregnant woman.  Except in the case of a medical emergency, a physician must, prior to performing or inducing an abortion, determine the gestational age of the unborn child in a manner consistent with accepted obstetrical and neonatal practices and standards.

If a physician determines that the gestational age of the unborn child is 20 weeks or more, he or she must, prior to performing or inducing an abortion, determine if the unborn child is viable.

If a physician determines that the unborn child is viable, the physician cannot perform or induce an abortion except in the case of a medical emergency as specified in the bill.

A physician must certify in writing the medical threat posed to the life of the pregnant woman or the medical reasons that continuation of the pregnancy would cause a serious risk of substantial and irreversible physical impairment of a major bodily function of the pregnant woman before the physician can proceed with performing or inducing an abortion on a woman when it has been determined that the unborn child is viable. 

Before a physician may perform or induce an abortion on a woman carrying an unborn child that has been determined to be viable, he or she must comply with procedures specified in the act.
Any person who knowingly performs or induces an abortion of an unborn child in violation of these provisions will be guilty of a class C felony and subject to imprisonment for not less than one year and a fine of between $10,000 and $50,000.  Any physician licensed in this state who pleads guilty to or is found guilty of performing or inducing an abortion of an unborn child in violation of these provisions can have his or her license suspended or revoked by the State Board of Registration for the Healing Arts.  Any licensed hospital or ambulatory surgical center that knowingly allows an abortion to be performed or induced in violation of these provisions can be subject to the suspension or revocation of its license. (July 14, 2011 - Allowed to go into effect pursuant to Article 3, Section 31 of the Missouri Constitution)

HCS HB 223 & 231 – Higher education financial assistance programs (See Education & School Law)

SCS HB 270 – State employees' health insurance benefits  (See Labor & Employment Law)

SCS HCS HB 300, 334 & 387 – Interscholastic Youth Sports Brain Injury Prevention Act Establishes the Interscholastic Youth Sports Brain Injury Prevention Act to enact rules focused on the safety and protection against long-term injuries to youth athletes.

Every school district must annually distribute a concussion and brain injury information sheet to each youth athlete in the district’s athletic program which must be signed by the athlete’s parent or guardian and submitted to the school district prior to the youth athlete participating in any practice or competition.

A youth athlete suspected of sustaining a concussion or brain injury must be removed from competition at that time and for at least 24 hours.  He or she must not return to competition until being evaluated by a licensed health care provider trained in the evaluation and management of concussions under the guidelines developed by the department and receiving a written clearance from the provider to return to competition. (Signed 7/13/11)

SCS HB 388 – Patient information requirements regarding breast implantations Removes the current requirement that an attending physician provide a standardized written summary prepared by the Department of Health and Senior Services, regarding the risks and benefits of breast implantation to a patient undergoing breast implantation surgery and instead requires the attending physician to advise the patient of the advantages, disadvantages, and risks prior to an operation.

(Signed 6/30/11)

SCS HCS HB 412 – Pharmacies Changes the laws regarding pharmacies.

CHANGES PROVISIONS RELATING TO THE MISSOURI RX PLAN (Section 208.798, RSMo) AND VETERINARY LEGEND DRUGS (Sections 338.010, 338.140, 338.150, 338.220, and 338.240)

BOARD OF PHARMACY (Section 338.055) The Board of Pharmacy within the Department of Insurance, Financial Institutions and Professional Registration is authorized to refuse to issue a certificate of registration, permit, or license to an applicant for a pharmacy or drug distributor license if the designated pharmacist-in-charge, manager-in-charge, or any office owner, manager, or controlling shareholder of the applicant has committed an act which would be grounds for discipline.

WHOLESALE DRUG DISTRIBUTORS (Section 338.330) Defines “legend drug” as it relates to regulating wholesale drug distributors as any drug or biological product that is subject to Section 503(b) of the Federal Food, Drug and Cosmetic Act; is required under federal law to be labeled in certain ways; or is required by law or regulation to be dispensed by prescription only or that is restricted to use by practitioners only.  Any investigational new drug or a drug product being used for conducting a clinical trial or investigation under specified situations is exempt from this provision.

Contains an emergency clause for the provisions regarding wholesale drug distributors. (Signed 6/10/11)

HB 423 – Health care compact. Authorizes Missouri to adopt the provisions of the Health Care Compact to improve health care policy within the states by securing consent from the United States Congress to return the authority to regulate health care to the states that have adopted the compact by specifying that the state legislatures have the primary responsibility to regulate health care in their respective states.  Missouri and other states that join the compact may suspend federal laws, rules, regulations, and orders regarding health care that are inconsistent with the laws and regulations adopted by the member state pursuant to the compact.  The compact will become effective upon adoption by at least two member states and the consent of Congress unless Congress, in consenting to the compact, alters its fundamental purposes. The compact can be amended by the unanimous agreement of the member states; and any amendment will be effective unless, within one year of its adoption, Congress disapproves the amendment. Any member state may withdraw from the compact by adopting a law to that effect but no withdrawal can take effect until six months after the governor of the withdrawing member state gives notice of the withdrawal to the other member states.  The compact must be dissolved upon the withdrawal of all but one of the member states. (July 14, 2011 - Allowed to go into effect pursuant to Article 3, Section 31 of the Missouri Constitution)

SCS HCS HB 552 – Bleeding disorder therapies Requires the State Board of Pharmacy within the Department of Insurance, Financial Institutions and Professional Registration to establish rules governing the standard of care for pharmacies dispensing blood clotting therapies.  The rules must include specified safeguards.
Blood clotting product-related services including home delivery of products, equipment, and supplies; medically necessary ancillary infusion equipment and supplies; and assessments that are deemed necessary by the treating physician which are conducted in the participant’s home are added to the list of services which are to be paid under MO HealthNet benefits. (Signed 7/7/11)

SS SCS HCS HB 555 – Health care Changes the laws regarding health care.

DISABILITY HISTORY AND AWARENESS MONTH  Designates October of each year as “Disability History and Awareness Month” and allows a school board to require schools within the district to provide instruction on the topic during the month that expands students’ knowledge, understanding, and awareness of individuals with disabilities, the history of disability, and the disability rights movement. 

INTELLECTUALLY DISABLED  Certain references of “mentally retarded,” “mental retardation,” or “handicapped” in current state law are changed to “intellectually disabled” or “developmentally disabled,” “intellectual disability” or “developmental disability,” or “disabled” respectively including renaming the Missouri Advisory Council on Mental Retardation and Developmental Disabilities as the Missouri Developmental Disabilities Council and the Division of Mental Retardation and Developmental Disabilities within the Department of Mental Health as the Division of Developmental Disabilities.

MO HEALTHNET OVERSIGHT COMMITTEE
Changes the composition of the membership of the MO HealthNet Oversight Committee.

PARENTAL RIGHTS OF INDIVIDUALS WITH DISABILITIES  The disability or disease of an individual cannot be the basis for a determination to refuse to issue, suspend, or revoke a foster care license; to remove a child from a parent’s custody or that a child is in need of care; to terminate parental rights; or to rule that an individual is unfit or not suitable to be an adoptive parent or a foster parent without a specific showing that there is a causal relationship between the disability or disease and harm to the child.

Also includes provisions relating to the mental health earnings fund; Department of Mental Health investigation reports; membership of the Missouri Children's Services Commission and duties; and creation of a Missouri Task Force on Prematurity and Infant Mortality; makes changes in provisions relating to appointments to the Missouri Dental Board and the State Board of Registration for the Healing Arts.

ACCESSIBLE PARKING AND PARKING LOTS  Requires any political subdivision or the owner of a private parking lot, when restriping an existing lot or constructing a new parking lot, to designate one in every four spaces as accessible, with at least one having an access aisle which is a minimum of 96 inches wide and designated “lift van accessible only” with signs that comply with the federal Americans with Disabilities Act and any rules or regulations established pursuant to the act.

All new signs erected on or after August 28, 2011, relating to disabled parking must contain the words “Accessible Parking” and must not contain “Handicap Parking” or “Handicapped Parking.” (Signed 7/12/11)

HCS HB 557 – Mental health earnings fund (See State Government)

SCS HB 591 – Limited dental teaching licenses (See Licensing Law)

SS#2 HB 648 – Individuals with disabilities (See SS SCS HCS HB 555)

HB 667 – Prostate cancer pilot programs (See also SB 38)  Subject to securing a cooperative agreement with a non-profit entity for funding, this bill establishes two prostate cancer pilot programs within the Department of Health and Senior Services to fund prostate cancer screening and treatment services and to provide education to men residing in the state.  One program must be located in St. Louis City and one in Pemiscot, New Madrid, or Dunklin County.  The department can contract with the Missouri Foundation for Health to implement the pilot programs. The provisions of the bill will expire six years from the effective date. (Signed 6/17/11)

HB 675 – County coroner training Requires every elected or appointed county coroner, deputy coroner, and assistant to the coroner to complete the annually required educational training within six months of his or her election or appointment. (Signed 7/5/11)

SB 38 – Prostate cancer pilot program (See HB 667)

HCS SS#2 SCS SB 62 – Health care providers Changes the laws regarding health care providers.  Includes provisions relating to:

FEDERAL REIMBURSEMENT ALLOWANCES (Sections 190.839, 198.439, 208.437, 208.480, 338.550, and 633.401, RSMo)

MEDICAL RECORDS FEES (Section 191.227) Currently, a health care provider can charge a patient a fee of not more than $17.05 for copying his or her medical records plus 40 cents per page for supplies and labor.  The bill increases the fee to $21.36 plus 50 cents per page for supplies and labor adjusted annually for inflation.  A health care provider will also be allowed to include in that fee a retrieval or handling fee, not to exceed $20, charged by an outsourced records storage service with which the provider has contracted for off-site records storage and management.  If a health care provider stores records in an electronic or digital format and provides records and affidavits, if requested, in an electronic or digital format, the maximum copying amount cannot exceed $5 plus 50 cents per page or $25 total, whichever is less.

HEALTH CARE TRANSPARENCY AND PROPOSED MANDATES (Section 376.1190) Beginning January 1, 2014, health insurance carriers must allow a policyholder, upon request, to obtain specific cost-sharing information for a health service or item within the policyholder’s health benefit plan including the deductible, copayment, and co-insurance.  Certain supplemental insurance policies are exempt from this provision.

Beginning August 28, 2011, any health care benefit mandate proposed by the General Assembly after August 28, 2011, will be subject to an actuarial review to determine the cost impact on private and public payers.  These provisions will become effective January 1, 2014.

This bill contains a nonseverability clause.

(Signed 6/10/11)

SS SCS SB 65 – Late-term abortions (See HB 213)

HCS SS SB 118 – Sprinkler system requirements for long-term care facilities Currently, certain long-term care facilities are required to install and maintain an approved sprinkler system by December 31, 2012.  This bill extends the required implementation date to December 31, 2014. (Vetoed 7/6/11)

CCS HCS SS SB 226 – Emergency services (See Taxation Law)

SS SB 238 – Benefits for a firefighter incurring an infectious disease in the line of duty (See Labor & Employment Law)

CCS HCS SB 284 – Pharmacies Changes the laws regarding pharmacies.

Authorizes a sales tax exemption for certain drugs and medical equipment (Section 144.030, RSMo).

BOARD OF PHARMACY (Section 338.055) Allows The Board of Pharmacy within the Department of  Insurance, Financial Institutions and Professional Registration to refuse to issue a certificate of registration, permit, or license to an applicant for a pharmacy or drug distributor license if the designated pharmacist-in-charge, manager-in-charge, or any office owner, manager, or controlling shareholder of the applicant has committed an act which would be grounds for discipline.

WHOLESALE DRUG DISTRIBUTORS (Sections 338.330)
The bill defines “legend drug” as it relates to regulating wholesale drug distributors as any drug or biological product that is subject to certain federal laws and required to be labeled in certain ways, dispensed by prescription only or used or dispensed by practitioners only excluding any drug being used for conducting a clinical trial or investigation under specified situations.

The bill contains an emergency clause for the provisions regarding wholesale drug distributors. (Signed 7/11/11)