Legislative Updates

Legislative Update: Feb. 4, 2013

The Senate passed two bills in as many days, both of which had been debated for the past several sessions and never made progress.  The Senate has sent a signal that gridlock is a thing of the past.

The House continues to work on the budget now that the governor announced his budget, built on revenues that are not yet available, and need legislation to enact them.  The Republicans pushed back hard on a few of his initiatives including the expected Medicaid expansion.

Workers Compensation reform is the theme for the week for the Senate.  I look for a lot of debate on this issue, as there are multiple factions, and factions within factions attempting to resolve the bankrupt system.

Next week a nearly full slate of hearings begin, and below are bills and hearings that are of interest;

Below are bills and hearings that are of interest;

HB 99   White Requires a health carrier to provide Internet access of its standard fee schedules, prohibits a carrier from refusing to contract with any willing provider, and changes the requirements for provider referrals.

Bill History: 01-31-13 H Referred to House Committee on House-Health Care Policy

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HB 112   Burlison Creates a statutory cause of action for damages against a health care provider for personal injury arising out of the rendering of or failure to render health care services, replacing the common law action.

Bill History: 01-24-13 H Referred to House Committee on House-SC on Emerging Issues in Health Care

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HB 115  Davis Prohibits an employer from requesting or requiring an employee or applicant to disclose any user name, password, or other means for accessing a personal account or service through an electronic device.

Bill History: 01-10-13 H Read second time

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HB 218   Cox Changes the laws regarding the sale and possession of controlled substances.

Bill History: 01-31-13 H Referred to House Committee on House-Judiciary

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HB 317   Phillips Establishes Molly’s Law that requires a health care practitioner to provide the list of ingredients in a vaccination to the parent or guardian of specified children prior to the administration of the vaccination.

Bill History: 01-28-13 H Read second time

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HB 346   Molendorp Prohibits any contract between a health carrier or health benefit plan and a dentist from requiring a fee schedule established by the insurer if the services are not covered under the plan.

Bill History: 01-30-13 H Read second time

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HB 347   Engler Establishes the Prescription Drug Monitoring Program Act.

Bill History: 01-30-13 H Read second time

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HB 365   Roorda Changes the controlled substance classification of all methamphetamine precursor drugs from Schedule IV and Schedule V to Schedule III, requiring a physician’s prescription.

Bill History: 01-31-13 H Read second time

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HB 378   Kelley Prohibits any requirement that pharmacies carry a specific drug or device.

Bill History: 01-31-13 H Read second time

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HJR 6   White Proposes a constitutional amendment allowing the General Assembly to cap noneconomic damages in medical malpractice and other cases.

Bill History: 01-10-13 H Read second time

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SB 88   Schaaf Modifies provisions relating to fees health care professionals are allowed to charge for medical records.

Bill History: 01-17-13 S Referred to Senate Committee on Senate-Veterans Affairs and Health

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SB 111   Emery Prohibits any requirement that pharmacies carry a specific drug or device.

Bill History: 01-24-13 S Referred to Senate Committee on Senate-Judiciary Civil/Criminal Jurisprudence

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SB 126   Sater Relating to pharmacy inventories.

Bill History: 01-31-13 S Referred to Senate Committee on Senate-Judiciary Civil/Criminal Jurisprudence

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SB 131  Nasheed Relating to Mo HealthNet services.

Bill History: 01-31-13 S Read second time

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SB 146  Schaaf Establishes a Prescription Drug Monitoring Program. This version is substantively different that what the proponents advocated for in previous years.  Sen Schaaf was the main opponent to the bill last year. His version makes 3 big changes from what we anticipate Senator David Sater and Representative Engler will file in the next week.

The 3 changes are; (1) sends the entire proposal to a vote of the people, (2) the bill only requires cash transactions to be reported to the system, and (3) limits the bill to tracking schedule II and III drugs with dihydrocodone. I am not certain the preferred proposal being introduced by Sater and Engler can get by Senator Sater, but its chances are better than last year.

Bill History: 01-31-13 S Referred to Senate Committee on Senate-Veterans Affairs and Health

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SB 158  Sater Allows foreign health insurers from selected states to issue health insurance policies in Missouri.

Bill History: 01-31-13 S Referred to Senate Committee on Senate-Small Bus./Insurance/Industry

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SB 167   Sater Modifies the laws on the licensing requirements and services provided by nurses.

Bill History: 01-31-13 S Referred to Senate Committee on Senate-Financial/Gov. Org. and Elections

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SB 211   Rupp Requires the Department of Elementary and Secondary Education to develop guidelines for the training of school employees in the care needed for students with diabetes.

Bill History: 01-24-13 S Introduced and read first time

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SB 233   Sater Establishes a Prescription Drug Monitoring Program.

Bill History: 01-29-13 S Introduced and read first time – This is our preferred version of the bill.

This bill would establish a database to track schedule II – IV scripts.  The bill would allow physicians to review their patient’s information prior to issuing a prescription, which will assist in reducing over prescribing of these scheduled drugs.  Representative Engler has filed the same legislation.

Other bills not yet filed

The Nurses will introduce a bill expanding their scope of practice.  It will likely be opposed by the physician’s organizations. The nurses did however reach out to MPA inquiring about our stance on one section of their bill, which would allow them to dispense medications. I suspect the association will oppose that provision of their bill.

Rep Koenig wants to expand pharmacist’s scope of practice to allow them to administer any vaccination as long as certain training and protocols are met.  I am not sure the physician groups will appreciate this too much, but I will meet with them.  I did meet briefly with MSMA lobbyist regarding lowering the age from 12 to 9 on whom you can administer currently allowed vaccinations.

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Medicaid Expansion Excerpt from the 2013 Missouri State of the State Address

(1/29/13)
The following is an excerpt on Medicaid Expansion from Missouri Governor Jay Nixon’s 2013 State of the State Address:

This isn’t the time to re-open the debate or reargue the merits of the President’s health care plan. I had some problems with it, and I know many of you did as well.  But Congress passed it – the President signed it – and the Supreme Court upheld it.

It’s the law of the land. And it’s not within our power to rewrite federal laws, even if we wanted to.

It is within our power – it’s our responsibility – to now do what’s right for Missouri.

And the question before us is a narrow one. Will we bring the tax-dollars that Missourians send to Washington back home to strengthen our Medicaid system here in Missouri?

Or will we let the tax dollars that Missourians send to Washington be spent in other states instead? Other states would get the benefits, and we’d get the bill.

The answer is clear: the people of Missouri deserve to see their tax-dollars come back to their communities.

Friends, let’s put the politics of health care aside for just a moment and look at this as a business decision for the state of Missouri.

The Missouri Chamber of Commerce supports the Medicaid expansion – not because they’re big supporters of this President and his agenda – but because it’s the smart thing to do. They know that bringing billions of dollars back to Missouri is good for our state’s economy.

The Kansas City Chamber of Commerce has endorsed the Medicaid expansion. So have the chambers in Independence, Springfield, Lee’s Summit and St. Louis. So have the Civic Council of Greater Kansas City, Kirksville REDI, and our friends at the Associated Industries of Missouri.

Would the leaders from these business organizations who have joined us tonight because of the importance of this issue please stand? Thank you for your leadership on this critical issue.

For these business leaders, this is not a political decision. It’s an economic one. And we shouldn’t let last year’s politics get in the way of next year’s economic growth.

Moving forward with this plan will bring a total of $5.7 billion to Missouri for the first three calendar years – at no additional cost to the state.

The University of Missouri estimates this will generate an additional 24,000 jobs – and that’s just in 2014. We’re talking about good jobs – for nurses, doctors, pharmacists, therapists and medical technicians.

Strengthening Medicaid will strengthen our economy. Without question, it’s the smart thing to do.

Now I know there are some who have voiced concern that Washington will not live up to its commitment. Let me address that directly: I support including a provision that rolls back the Medicaid expansion if Washington doesn’t honor its financial commitment.

If Washington drops the ball, we’ll do what’s right for Missouri. We’ll always do what’s right for Missouri.

And there’s a human element to this that can’t be ignored.

A stronger Medicaid system will make health care available to 300,000 of our friends and neighbors.

Let’s be clear about who these people are. They’re working Missourians – folks who work day and night, but simply can’t afford health coverage.

These are not people who aren’t trying, or hoping to game the system. They’re folks we see every day – some holding down two jobs just to make ends meet.

We’re talking about a family of four, with a household income of roughly $32,000 a year. They wait tables and clean office buildings. They cut hair and trim trees. They work in factories, and repair cars and trucks.

Making it easier for these hardworking Missourians to get basic health insurance is the right thing to do. And because these folks can’t afford doctors’ bills or insurance, they often end up in our hospital emergency rooms, because it’s the only option for their family. In their shoes, you’d probably do the same thing.

It’s a terrible way to deliver health care. It drives up premiums for people who do have health insurance. That must change.

I’m well aware this is a tough issue politically. But across the country, we’re seeing Governors and state legislators put politics aside to do what’s undeniably best for their states.

Republican Governors in places like Arizona, North Dakota, New Mexico and Nevada are using federal funds to strengthen their Medicaid systems. Not because it’s the easy thing for them to do politically, but because it’s the right thing to do.

Here in Missouri, we must make the smart business decision. The right human decision. And bring the tax dollars we send to Washington back to work here in Missouri.

On another health care front, in recent years we have seen the tragic consequences when people with serious mental illness don’t get the help they need.

Right now, many people with severe mental illness only get treatment when they reach a crisis point. That’s too late.

My budget includes $10 million to help those with mental illness get timely, effective treatment in their own communities. That money will be used to:

  • Provide more services in our community mental health centers;
  • Increase mental health first-aid training for professionals so they can recognize the early warning signs of mental illness.
  • Train law enforcement in mental health crisis-intervention;
  • And teach families how to care for loved ones who suffer from severe mental illness.
  • We must do everything in our power to get folks the treatment they need, before it’s too late.

To read the 2013 State of the State address in its entirety, click here.

Other items of interest:
Budget and Legislative Priorities Year 2014

Executive Budget Fiscal Year 2014

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