Health & Hospital Law

CCS/HCS/SS#2/SCS/SB 1 – Modifies the law relating to the Second Injury Fund and occupational disease within the workers’ compensation system. 

Requires medical providers to apply for reimbursement within 2 years from the date the first notice of dispute of the medical charge was received by a health care provider if services are rendered before July 1, 2013, and within one year if they are rendered after that date. The act shall become effective January 1, 2014. (See also Workers Compensation Law

CCS/SCS/SB 33 – Modifies provisions relating to individuals with mental disabilities. Designates December 4 as “PKS Day” in Missouri to encourage awareness of Pallister–Killian Syndrome 

Under this act an individual with mental disabilities is added to the list of people who must be afforded the same rights as those without disabilities to use streets, highways, sidewalks, public buildings, public facilities, and other public places. An individual with mental disabilities is also entitled to equal accommodation from common carriers, airlines, motor vehicles, trains, buses, taxis, and any other public conveyances or modes of transportation, as well as hotels, places of public accommodation, amusement or resort, and other places to which the general public is invited. (Signed 6/12/13) 

SB 35 – Sahara’s Law– Authorizes a check–off box on the Missouri individual and corporate income tax forms for contributions to the newly created Pediatric Cancer Research Trust Fund, to be distributed to the organization CureSearch for Children’s Cancer. The provisions of this new program expire December 31, 2019. (Signed 6/28/13) 

SB 80 – Requires the Missouri Board of Nursing Home Administrators to notify, rather than mail an application for license renewal to nursing home administrators, who require license renewal, that year. (Signed 5/16/13)

HCS/SCS/SB 89 – A health information organization shall not restrict the exchange of state agency data or standards– based clinical summaries for patients for HIPAA allowable uses. Charges for such service shall not exceed the cost of actual technology connection or recurring maintenance. 

Allows nursing home districts to establish and maintain senior housing in any third or fourth classification county. Provides for “the constitutionally required percentage” of the votes cast for a nursing home district local bond issue to pass rather than needing “two–thirds” of the votes cast. (Signed 7/8/13) 

HCS/SCS/SB 118 – Authorizes circuit courts or a combination of circuits to create veterans treatment courts. These courts will handle cases involving substance abuse or mental illness of current or former military personnel. (See Judicial Administration

SCS/SB 126 – States that Missouri licensed pharmacies cannot be required to carry or maintain an inventory of any specific drug or device. (Signed 6/27/13) 

CCS/HCS/SB 127 – Modifies provisions relating to public assistance benefits. Includes provisions relating to advanced practice registered nurses, the Mo Healthnet Dental Delivery System, referrals for home–and community–based services, new federal requirements for current Mo Healthnet participants, and provisions relating to the employment disqualification list for home care employees. (Signed 7/8/13) 

SS/SCS/SB 129 – Establishes the Volunteer Health Services Act which allows a licensed health care provider to provide volunteer professional health care services for a sponsoring organization. (See summary under Tort Law, infra). (Signed7/5/13) 

SS/SCS/SB 159 – Prohibits health carriers from imposing greater copayments or coinsurance percentages to insureds for prescribed covered services provided by a licensed physical therapist than those charged for the same covered services provided by licensed primary care physicians. Under the act, health carriers must clearly state the availability of physical therapy coverage under its plan and all related limitations, conditions, and exclusions. (Signed 6/25/13) 

CCS/HCS/SB 161 – Under this act, the Oversight Division of the Joint Committee on Legislative Research must conduct an actuarial analysis of the cost impact to consumers, health insurers, and other private and public payers if a state mandate was enacted to provide health benefit plan coverages for certain orally administered anticancer medications and diagnosis and treatment of certain eating disorders that include residential treatment and access to psychiatric and medical treatments. (Signed 7/8/13) 

HCS/SCS/SB 186 – Provides that if the person or entity who certifies the cause of death is not be part of, or does not use, the electronic death registration system then the funeral director or person acting as such may enter the required personal data into the electronic death registration system and then complete the filing by presenting the signed cause of death certification to the local registrar. 

Also provides that a funeral establishment or coroner in possession of cremated remains is authorized to release the required information to the Department of Veterans Affairs or a veterans’ service organization to obtain verification for eligibility of a military burial. 

A funeral establishment, coroner, or veterans’ service organization shall not be liable for actions stemming from final disposition of the remains when the establishment has followed proper notification procedures. 

Authorizes the State Treasurer to release certain information contained in the holder report of abandoned military medals to the public in order to facilitate the identification of the original owner or the owner’s heirs or beneficiaries. The Treasurer may designate a veterans’ organization to assist in the identification of the original owner of the medal. (Signed 7/10/13) 

SB 197 – Includes provisions relating to creation of Meningococcal Disease brochure for higher education. (See Labor and Employment Law

HCS/SCS/SB 229 – Under current law, an employee in a mental health facility is disqualified from holding a direct care position if such employee has been found guilty of or pleaded guilty to certain criminal offenses. This act adds to the list of criminal offenses that are included in the Mental Health Disqualification Registry. (Signed 6/25/13) 

SB 230 – Establishes “Chloe’s Law” which requires, effective January 1, 2014, every child born in this state to be screened for critical congenital heart disease with pulse oximetry or in another manner as prescribed by the Department of Health and Senior Services. 

The provisions of this act shall not apply if a parent or guardian of the newborn object to such testing on the grounds that such tests conflict with his or her religious tenets and practices. The parent or guardian of any child who refuses to have the critical congenital heart disease screening test administered after notice of the requirement for such test shall have such refusal documented in writing. (Signed 7/9/13) 

SB 234 – Provides that, for the purposes of licensure, a marital and family therapist applicant must present evidence of a master’s or doctoral degree in marital and family therapy from a program accredited by the Commission on Accreditation for Marriage and Family Therapy Education, or from an equivalent institution accredited by a body recognized by the United States Department of Education. (Signed 5/17/13) 

CCS/HCS/SS/SB 262 – Modifies various provisions relating to health insurance. (See also Insurance Law

SB 306 – Allows for the testing of drugs maintained by licensees by authorized personnel of the Board of Pharmacy. The Board shall pay for the cost of testing. (Signed 5/16/13) 

CCS#2/HCS/SB 330 – Modifies various provisions relating to professional licenses, including chiropractors, dental assistants, licensed professional counselors, psychologists, collaborative practice arrangements and hearing instrument specialists. (See Licensing Law

SCS/SB 376 – Allows hospital districts to lease to or allow for any institution of higher education to use or occupy the hospital, any real estate or facility owned or leased by the district, or any part of the hospital for the purpose of health care related and general education or training. (Signed 5/16/13) 

HB 68 – Designated the month of November as “Pancreatic Cancer Awareness Month” in Missouri. Also designates the last full week in October as “Respiratory Syncytial Virus (RSV) Awareness Week” in the state of Missouri. (Signed 5/31/13) 

SS#2/SCS/HB 116 – The Auditor may audit any public employee retirement or health care system. Currently, at least once every three years, the Auditor examines audits of the Missouri consolidated healthcare plan. Under the act, the Auditor may audit this system at any time. 

Creates the Missouri Senior Services Protection Fund in the state treasury. The State Treasurer is required under the act to make four scheduled deposits from July 15, 2013 to March 15, 2014 that total $55,100,000 into the fund. Moneys in the fund must be allocated for services for low–income seniors and people with disabilities. (See also State Government & Election Law

HB 163 – Modifies provisions regarding elections in third class cities, procedures to transfer a local city hospital, emergency services board elections, and the St. Louis public administrator. (Signed 5/15/13) 

– Allows the Department of Health and Senior Services to certify community paramedics. An ambulance service must enter into a written contract to provide community paramedic services in another ambulance service area. (See also Local Government Law

SS/HCS/HB 315 – Modifies various provisions relating to health care services. 

Includes provisions relating to early refills of prescription eye drops fee capping on dental services, emergency prescriptions, the scope of practice for physician assistants and the definition of “physician assistant supervision agreement” is modified. 

Allows the Missouri Board of Healing Arts to restrict or limit a person’s athletic trainer’s license for an indefinite period of time, as well as revoke a person’s license. 

Additional provisions affect physician license examinations, testing of pharmaceuticals, utilization of telehealth by nurses and board of nursing disciplinary actions. Currently, the State Board of Nursing may file a complaint against a licensee for certain causes with the Administrative Hearing Commission. This act adds additional causes to the list. 

Provides that for certain causes the Board may request an emergency suspension or restriction of a person’s license with the Commission. The act describes the process for the proceedings that the Board and the Commission must follow. If the Commission does not find probable cause and does not grant the emergency suspension then the Board must remove all references to the proceedings from public record. 

The Board may also initiate before the Board a hearing for discipline of a licensee’s license when certain causes exist. 

Changes the laws regarding advanced practice registered nurses (APRNs). (Signed 6/12/13) 

CCS/SS/HB 336 – Political subdivisions cannot prohibit first responders from engaging in political activity while off duty and not in uniform or being a candidate for or holding a public office unless the activity or candidacy is otherwise prohibited by law. 

Allows the Department of Health and Senior Services to certify community paramedics under certain circumstances. 

An ambulance service must enter into a written contract to provide community paramedic services in another ambulance service area. The contract may be for an indefinite period of time as long as it includes at least a 60–day cancellation notice by either ambulance service. (See also Local Government

SCS/HCS/HB 351 –Modifies provisions relating to hospitals and the furnishing of medical records. 

Sets out the procedures with respect to the sale, lease, or other transfer of all or substantially all of a local city hospital organized and operated under Chapter 96. If approved by the voters, the act prescribes the procedures for the sale of such property as well as the sufficient amount of proceeds required to be applied for any outstanding valid indebtedness or for operation of the hospital. This provision contains an emergency clause. 

Current law allows a health care provider to condition the furnishing of medical records on the payment of a fee to cover costs of copying, off–site records storage, postage and notary services. This act allows for a search and retrieval amount not to exceed $22.82 plus copying in the amount of 53 cents for supplies and labor per page as well as for $21.36 for off–site record storage. The fee amounts shall be adjusted annually per the Consumer Price Index. 

This act also allows for the records to be furnished electronically upon payment of the search, retrieval, and copying fees set under this act at the time of the request or $100 total, whichever is less, under specified circumstances. 

Requires the Department of Health and Senior Services to review and revise its regulations governing hospital licensure and enforcement to promote efficiency and eliminate duplicate regulations and inspections by or on behalf of the state and federal agencies. 

The Department shall also accept a hospital inspection report from Joint Commission and the American Osteopathic Association Healthcare Facilities Accreditation Program under certain conditions. 

The Department shall post on its website information regarding investigations of complaints made against hospitals. The act details the requirements of such postings, including the required time lines for posting. (Signed 7/2/13) 

HB 400 – Requires that when RU–486 or any drug or chemical is used for the purpose of inducing an abortion, the initial dose of the drug or chemical shall be administered in the same room and in the physical presence of the physician who prescribed, dispensed, or otherwise provided the drug or chemical to the patient. (Effective pursuant to Article 3, Section 31 of the Missouri Constitution, 7/14/13) 

HB 436 – No licensed health care professional may be required by law to ask a patient whether he or she owns a firearm, document firearm ownership in a patient’s medical records or notify any governmental entity of the identity of a patient based solely on the patient’s status as a firearm owner. (See also State Government & Elections Law

CS/HCS/HB 505 – Current law requires that certain personnel must report, or cause a report to be made, to the Children’s Division when child abuse or neglect is suspected. This act requires that an individual must immediately report to the Children’s Division when child abuse or neglect is suspected. This act prohibits an internal investigation from being initiated until a report has been made. 

If two or more members of a medical institution are required to report jointly, a single report may be made by a designated member of that medical team. If the designated team member fails to report, any other member must immediately make the report. Supervisors and administrators are prohibited from impeding and inhibiting reporting. Employers are prohibited from sanctioning or imposing any adverse employment action on any mandatory reporter for making a report. Every employer must ensure that any employee who is required to report has immediate and un-restricted access to communications technology necessary to make and immediate report and is temporarily relieved of work duties to make any required report. 

Requires the Department of Public Safety to establish rules regarding the reimbursement of the costs of forensic examinations for children younger than 14 years of age, including establishing conditions and definitions for emergency and non–emergency forensic exams and specific qualifications for appropriate medical providers performing non–emergency forensic exams. The Department must provide reimbursements regardless of whether or not the findings indicate the child was abused. 

Also allows the department to establish additional qualifications for appropriate medical providers performing non–emergency forensic evaluations for children younger than 14 years of age. (See also Family & Juvenile Law

HCS/HB 675 – Modifies provisions relating to student health in elementary and secondary schools. 

Includes rules relating to physical fitness programs, diabetes management, and DARE (Drug Abuse Resistance Education). (See also Education & School Law

Diabetes care functions described in the act do not constitute the practice of nursing and will be exempt from all statutory and regulatory provisions restricting activities that can be delegated to or performed by a person who is not a licensed health care professional. A licensed health care professional may provide training to and supervise school employees with diabetes care functions. 

Students with diabetes will be permitted to perform certain diabetes care functions themselves at school, with written permission by a parent or guardian, as described in the act. 

No physician, nurse, school employee, charter school or school district will be liable for civil damages or subject to disciplinary action when acts are committed as an ordinarily reasonably prudent person would have acted under the same or similar circumstances. (Signed 7/3/13) 

SCS/HCS/HB 986 – Extends the sunset date for the Hand–Up Program, reauthorizes the Ticket–to–Work program until 2019 and creates the Missouri Senior Services Protection Fund. 

Also includes provisions relating to health information organizations, creation of a joint committee on Medicaid transformation, the Missouri senior services protection fund and telehealth health insurance coverage. 

Under the act, a health carrier may not exclude an otherwise covered health care service from coverage solely because the service is provided through telehealth rather than face–to–face consultation or contact between a health care provider and a patient. 

Allows a health carrier or health benefit plan to limit coverage for health care services that are provided through telehealth to health care providers that are in a network approved by the plan or the health carrier. 

The provisions of the act do not apply to certain types of supplemental insurance policies such as accident–only policies or Medicare supplement policies. 

The telehealth mandate portion of the act has an effective date of January 1, 2014. (Signed 7/8/13) 

CCS#2/SCS/HCS/HB 1035 – Modifies provisions relating to political subdivisions. (See summary under Local Government Law, infra)