HEALTH & HOSPITAL LAW
SS/SB 464 - Prohibits the establishment, creation, or operation of a state-based health insurance exchange unless the exchange is created by a legislative act, an initiative petition, or referendum. Specifically prohibits the establishment of a state-based health insurance exchange by an executive order issued by the Governor.
Further prohibits state agencies from establishing programs or promulgating any rules or policies to establish, create, administer or otherwise operate a state-based health insurance exchange unless the agency has received statutory authority to create it. Specifically prohibits agencies from performing responsibilities of a state-based health insurance exchange unless authorized by statute.
Under the terms of this act, no department, agency, instrumentality, or political subdivision of this state shall apply for, accept or expend federal moneys related to the creation, implementation or operation of a state-based health insurance exchange or a federally-facilitated health benefit exchange unless such acceptance or expenditure is authorized by statute or an appropriations hill.
Prohibits agencies from entering into agreements to establish or operate a federally-facilitated health benefit exchange unless the agency has received statutory authority to enter into such agreements. In addition, the act prohibits departments and agencies from providing assistance or resources of any kind to any federal agency or department relating to the creation of a federally-facilitated health benefit exchange unless the assistance or resources are authorized by state statute or the assistance is mandated by federal law.
Specifically provides any taxpayer of this state or any member of the general assembly with legal standing to bring suit against the state of Missouri or any official, department, division, agency, or political subdivision of this state which is in violation of the act in any court with jurisdiction to enforce the provisions of the act.
The act requires courts to grant attorney’s fees, court costs, and reasonable expenses to taxpayers or legislators who are successful in bringing a lawsuit against the state or one of its agencies. The act further provides that in no case shall the award of attorney’s fees, court costs, or reasonable expenses be paid from the legal defense fund, nor shall any department, division, agency, or political subdivision of this state request, or be granted, additional appropriations in order to satisfy an award made under this act. This act will be submitted to the voters for their approval in November of 20l2.
HCS/SS/SCS/SB 682 - Mandates that only licensed physicians may use certain techniques in diagnosing or treating chronic pain or pain occurring outside of a surgical, obstetrical, or post-operative course of care. Such techniques limited to licensed physicians are ablation of nerves, placement of drugs in the spinal column under fluoroscopic guidance, discectomy, and placement intrathecal infusion pumps or spinal cord stimulators. Certain expectations are specified.
The Board of Registration for the Healing Arts may promulgate rules to implement the provisions of this act. The provisions of this act will expire August 28, 2016, unless reauthorized by an act of the General Assembly. (Signed 6/18/12)
SS/SCS/SB 689 - Makes it an unlawful violation of the financial exploitation statute to fail to remit to a nursing facility in which a Medicaid eligible person resides all money owing the facility resident from any source.
If a person admits to or is found guilty of failing to remit money owed to a facility licensed under Chapter 198, the court can order the offender to make restitution to the facility as a condition of sentence and or probation. Any order or agreement for restitution must allow the prosecuting attorney to receive ten percent of each payment toward the restitution as reimbursement for the cost of enforcement. (See Elder Law for a more complete summary of this bill). (Signed 7/11/12)
CCS/HCS/SS/SB 749 -Modifies provisions relating to the protection of the religious beliefs and moral convictions of certain persons and health care entities.
No employee, self-employed person, or any other person shall be compelled to obtain coverage for, or be discriminated against or penalized for declining or refusing coverage for, abortion, contraception, or sterilization in a health plan if such items or procedures are contrary to the religious beliefs or moral convictions of such employee or person.
No employer, health plan provider, health plan sponsor, health care provider, or any other person or entity shall be compelled to provide coverage for, or be discriminated against or penalized for declining or refusing coverage for, abortion, contraception, or sterilization in a health plan if such items or procedures are contrary to the religious beliefs or moral convictions of such employer, health plan provider, health plan sponsor, health care provider, person, or entity.
No such employee, self-employed person, employer, health plan provider, health plan sponsor, health care provider, or any other person or entity shall be discriminated against by any governmental entity, public official, or entity acting in a governmental capacity for failing to obtain or provide coverage for, pay for, participate in, or refer for such coverage because of such religious beliefs or moral convictions.
Allows the Missouri Attorney General to bring a civil action in any appropriate state or federal court whenever there is reasonable cause to believe that the provisions of this act or other law that protects the religious beliefs or moral convictions of such entities or persons have been or is threatened to be violated.
Nothing in this act shall preclude a private cause of action by any person or entity aggrieved by a violation of this act or other law that protect the religious beliefs or moral convictions of such entities or persons, or be considered a limitation on any other remedy permitted by law. A court may order any appropriate relief, including recovery of damages, payment of reasonable attorney’s fees, costs, and expenses.
“Sterilization” for purposes of the act is defined to mean any elective medical procedure for which the sale purpose is to make an individual incapable of reproduction.
Also requires health carriers to offer and issue to any person or entity purchasing a health benefit plan that excludes coverage for contraceptives based on religious beliefs or moral convictions. Any health benefit plan issued under the exception in Section 376.1199 is required to provide clear and conspicuous written notice on the employee’s health benefit plan application and contract about optional riders for elective abortions and that the employee has the right to exclude and pay for coverage of elective abortions if such procedures are contrary to his or her religious beliefs and moral convictions.
This act contains an emergency clause for Section 191.724 of the act. (Vetoed 7/12/12)
HEALTH INFORMATION ORGANIZATIONS - Prohibits any state law from imposing a fine or penalty on a healthcare provider, hospital, or health care system for failure to participate in a health information organization. Laws in effect as of January 1, 2010 are not affected by the act. (Signed 7/10/12)
HB 1172 - Allow residential treatment agencies to apply for certain tax credits. (See Taxation Law for a more complete summary of this bill). (Signed 6/25/12)
HB 1188 -Allows school boards to authorize a school nurse to maintain a supply of asthma-related rescue medications at the school. (See Education & School Law for a more complete summary of this bill). (Signed 7/5/12)
SS/HB 1318 -Modifies provisions relating to mental health facilities and social security numbers used to identify employees.
DEPARTMENT OF CORRECTIONS MENTAL HEALTH PILOT PROGRAM - This act allows the Department of Corrections to establish a three-year pilot program in which judges in participating counties may send a criminal offender, upon a motion by a prosecutor, to the Department of Corrections for 120 days for mental health assessment and treatment. The victim must be given notice and an opportunity to be heard before the judge rules on the motion.
At the end of the 120 days, the department must send an assessment report to the sentencing court, which may release the offender on probation. The state probation and parole officer for the offender must work with the Department of Mental Health to enroll eligible offenders into Community Psychiatric Rehabilitation programs.
Offenders are not eligible for the pilot program who have been found guilty of, or plead guilty to, second-degree murder, forcible or first-degree statutory rape, forcible or first-degree statutory sodomy, first degree child molestation that is classified as a class A felony, or any other offense that does not allow probation or parole. Those found to be predatory sexual offenders are also ineligible.
The directors of the Departments of Corrections and Mental Health are to report to the Governor and the General Assembly by December 31, 2015 on whether the program should be statewide.
DEPARTMENT OF MENTAL HEALTH EMPLOYMENT DISQUALIFICATION REGISTRY - Modifies provisions relating to the Department of Mental Health Employment Disqualification Registry (EDR).
Current law requires an applicant for a direct care position in any of the named mental health facilities to sign certain consent forms for a criminal record review and to disclose previous employment disqualifications. This act no longer restricts the requirement to just direct care positions.
Mental health facilities or mental health programs in which people are admitted on a voluntary basis or are civilly detained are included amongst the list of other Department of Mental Health facilities who are required to request a criminal background check and to check the employee disqualification registries for new employees who will have contact with clients, residents or patients. Any of these facilities that decline to employ or discharge a person who is disqualified under the provisions of this act shall be immune from suit by that person for the failure to employ or for the discharge of the person due to disqualification.
A provider is guilty of a class A misdemeanor if the provider hires a person to hold any position knowing that such person has been disqualified under the provisions of this act.
Any employer who is required to discharge an employee because the employee was placed on the EDR after the date of hire shall not be charged for unemployment insurance benefits based on wages paid to the employee for work prior to the date of discharge.
Under current law, the Department of Mental Health is allowed to maintain the EDR. This act requires the department to do so. This act specifies the procedures for appealing a decision to have an employee placed on the EDR as well as delineating how the department determines the length of time the person’s name shall appear on the EDR.
The department shall provide the EDR to other state and federal agencies upon request. The department may also provide the EDR to any of the mental health facilities falling under this act. The department may also provide the EDR to a recognized school of nursing, medicine, or other health profession for the purpose of determining whether students scheduled to participate in clinical rotations are included in the EDR.
Makes changes in maximum hours of employment in any 24 hour period in any maximum and intermediate security mental health facilities.
Requires notice regarding the release of sexually violent predators to be served upon the prosecutor of the jurisdiction into which the committed person is to be released. (See Labor Law for a more complete summary of additional provisions of this bill). (Signed 7/5/12)
SS/SCS/HCS/HB 1563 - Modifies provisions relating to healthcare services. Includes provisions relating to:
SCHOOL SOCIAL WORKERS
PRESCRIPTION DRUGS - A pharmacist, in good faith, may sell and dispense controlled substances to any person upon a prescription of a practitioner located in another state, under specified circumstances.
PHARMACIES AND PRESCRIPTION DRUGS - Allows a pharmacy to sell, purchase, or trade prescription drugs to pharmacies not licensed in Missouri under certain circumstances. This information must be readily available upon request by the Board of Pharmacy. The Board is authorized to promulgate rules regarding these provisions.
The Board of Pharmacy is authorized to promulgate rules allowing the distribution of drugs by out-of-state pharmacies in the event of an emergency or to alleviate a supply shortage.
COLLABORATIVE PRACTICE ARRANGEMENTS - Currently, a collaborating physician must review a certain percentage of an advanced practice registered nurses charts. This act allows the collaborative practice arrangements to specify alternative doctors to review the charts.
BEHAVIOR ANALYSTS - Modifies provisions relating to temporary behavior analysts, temporary assistant behavior analysts, provisional behavior analysts, provisional assistant behavior analysts, and the Behavior Analyst Advisory Board.
ELECTRONIC PRIOR AUTHORIZATION COMMITTEE - Establishes the Missouri Electronic Prior Authorization Committee in order to facilitate, monitor, and report to the General Assembly on Missouri-based efforts to contribute to the establishment of national electronic prior authorization standards. Prior authorization generally relates to the process of obtaining prior approval from an insurer for certain services or medications.
Such Missouri-based efforts to be analyzed by the committee include the Missouri-based electronic prior authorization pilot program established under this act and the study and dissemination of information by the committee of the efforts of the National Council on Prescription Drug Programs (NCPDP) to develop national electronic prior authorization standards. The committee shall advise the General Assembly as to whether there is a need for administrative rules to be promulgated by the Department of Insurance, Financial Institutions and Professional Registration (Department of Insurance) as soon as practically possible.
Upon the adoption of national electronic prior authorization standards by the NCPDP, the committee shall prepare a final report to be distributed to the General Assembly and Governor that identifies the appropriate Missouri administrative regulations, if any, that will need to be promulgated in order to make those standards effective as soon as practically possible, and advise the General Assembly and Governor if there are any legislative actions necessary to the furtherance of that end.
The Department of Insurance and the Missouri electronic prior authorization committee shall recruit a Missouri-based pharmacy benefits manager (PBM) doing business nationally to volunteer to conduct an electronic prior authorization pilot program in Missouri. Such pilot program established under this act shall be operational by January 1, 2014. The department and the committee may provide advice or assistance to the PBM conducting the pilot program but shall not maintain control or lead with the direction of the pilot program. This act contains a six-year sunset provision. (See also SCS/HCS/HB 1827)
EMPLOYEE DISQUALIFICATION LIST - Allows consumer reporting agencies that conduct background checks for certain healthcare providing entities to have access to the employee disqualification list maintained by the Department of Social Services. Consumer reporting agencies may only check the employee disqualification list when requested by healthcare providing entities. Persons with access to the list are not to disclose information on the list to any person not entitled to access the list. Persons violating this provision will be guilty of an infraction. (Signed 7/12/12)
SS/HCS/HB 1576 - Allows any specialized licensed foster parent of foster children with special needs due to a history of sexual abuse, serious physical abuse, or severe chronic neglect to purchase the same health insurance as state employees for himself or herself and his or her dependents from the Missouri Consolidated Health Care Plan at his or her own expense. A foster parent who is seeking to adopt a foster child or who is related to the foster child shall not be eligible to purchase the plan. (See Family & Juvenile Law for a more complete summary of this bill). (Signed 6/25/12)
SS/HCS/HB 1647 - Allows employers that routinely use medical needles to use safety protection devices to protect employees and customers from needle stick injuries. (See Local Government for a more complete summary of this omnibus bill). (Signed 7/10/12)