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WEEKLY OVERVIEW:  Last week, the Senate rolled the Senate Perfection Calendar, allowing leadership to pick and choose from the hundred-plus Senate bills on the Senate Calendar – Senate Bills for Perfection.  The word is that Senate Majority Leader Mike Kehoe has promised all thirty-three senators that they will be able to have floor debate on their number one priority bill on that calendar.  Given the acrimony in the Senate, this could prove to be a very cumbersome promise.  There are 149 bills on the Senate Informal Calendar – Bills for Perfection. This week, the Senate did perfect and third read a number of bills.  However, hours of floor debate centered on two abortion-related bills that were not voted on.

PDMP: On Thursday, the Senate Committee on Transportation, Infrastructure, and Public Safety conducted a public hearing on HCS HB 90, sponsored by Rep. Holly Rehder (R-Sikeston).  This bill establishes the “Narcotics Control Act.” In its main provisions, the bill: (1) Requires the Department of Health and Senior Services to establish and maintain a program to monitor the prescribing and dispensing of all Schedule II through Schedule IV controlled substances; (2) Requires each dispenser to electronically submit specified information to the department within 24 hours of dispensation. Beginning January 1, 2019 the department shall begin phasing in a requirement that dispensers report data in real time with full implementation by January 1, 2020; (3) Allows the department to issue a waiver to a dispenser who is unable to submit the required information electronically and allows a dispenser to submit the required information by paper form or other means; (4) Requires all submitted prescription information to be confidential and not subject to public disclosure, with specified exceptions; (5) Requires the department to notify appropriate law enforcement or agencies if it has reasonable cause to believe that there may have been a violation in the law or a breach of professional standards; (6) Prohibits dispensation information submitted to the department from being used to prevent an individual from obtaining a concealed carry permit; (7) Allows the department to release non-personal, general information for statistical, educational, or research purposes; (8) Authorizes the department to contract with any other agency of this state or any other state with a private vendor or any state government that currently runs a narcotics control program; (9) Specifies that a dispenser who knowingly fails to submit required dispensation information to the department or knowingly submits incorrect dispensation information will be subject to an administrative penalty in the amount of $1,000 for each violation; and (10) Specifies that any person who unlawfully and knowingly accesses or discloses, or a person authorized to have prescription or dispensation information under these provisions or knowingly uses the information in a manner and for a purpose in violation of these provisions is guilty of a class E felony.

Testifying in support was St. Louis County, Walgreens, Missouri Pharmacy Association, College of Emergency Physicians, Missouri Association of Osteopathic Physicians , Missouri Rural Health Clinics,  BJC, Cox, Mo State Medical Association, Missouri Insurance Coalition, American Insurance Association, State Farm Insurance, Missouri Nurses Association, Missouri Retailers Association, Community Mental Health Centers, Johnson and Johnson, Missouri Grocers Association, Associated Industries of Missouri, Kansas City Fraternal Order of Police, St. Louis Fraternal Order of Police, Anheuser Busch and the Missouri Coalition for Behavioral Healthcare.

Testifying in opposition to the measure were three private citizens who raised concerns about privacy.

The committee then went into executive session and voted HCS HB 90 & 68 “do pass” 7-0.

This bill is currently on the Senate Calendar – House Bills for Third Reading.

MANAGED CARE:   On April 5, the House Health and Mental Health Committee held an executive session on SB 194 sponsored by Sen. Wallingford (R) and voted the bill “do pass” consent.  This bill provides that a managed care plan’s network is adequate if the health carrier is accredited by the Accreditation Association for Ambulatory Health Care. The committee then reconsidered that vote, added an amendment on dental provider directories that contained penalty provisions and also added an amendment regarding managed care plans and prosthetic devices.  The committee then again voted the bill “do pass” consent.  

STATE EMPLOYEES RIGHT TO SHOP: On Wednesday, the House Committee on Health and Mental Health Policy met in executive session to vote “do pass” HB 125, sponsored by Rep. Keith Frederick (R-Rolla).  This bill creates the “Right to Shop Act.” The bill defines a “patient” as any person employed full time by the state or a participating member agency or a person eligible for coverage by a state-sponsored retirement system or a retirement system sponsored by a participating state agency. The bill requires a health care provider to disclose the allowable amount, if subject to insurance, or amount that will be charged for a nonemergency admission, procedure, or service if requested by a patient or prospective patient. If a health care provider is unable to quote a specific amount due to an inability to predict the specific treatment or diagnostic code, the provider must disclose what is known for the estimated amount, the incomplete nature of the estimate, and the ability of the patient or perspective patient to obtain an updated estimate once additional information is determined. If a patient or perspective patient is covered by insurance and the health care provider is in-network, upon request the provider must provide sufficient information regarding the proposed admission, procedure, or service for the patient to obtain a cost estimate of out-of-pocket expenses from his or her insurance carrier.

The full bill summary may be found here: 

DENTAL PROFESSIONALS IN HOSPITALS: On Wednesday, the House Committee on Health and Mental Health Policy met in executive session to vote HB 762 sponsored by Rep. Jay Barnes (R-Jefferson City) “do pass”.  This bill allows licensed hospitals to employ a dentist, an oral and maxillofacial surgeon, and a maxillofacial prosthodontist to treat conditions specified in the bill.

MANDATORY REPORTING FOR LONG-TERM CARE: On Thursday, the House Committee on General Laws met in executive session to vote “do pass” 13-0 HCS HB 551, sponsored by Rep. Mike Bernskoetter (R-Jefferson City). 

This bill amends provisions relating to reporting of suspected abuse and neglect of a resident of a long-term care facility who is 60 years of age or older or an eligible adult. Currently, a report is required to be made to the Department of Health and Senior Services in the event of suspected abuse or neglect. Under this bill, in the event of suspected sexual assault of the resident, specified mandated reporters shall also report to local law enforcement under the procedures of the federal Elder Justice Act of 2009. 

The bill has been referred to the House Committee on Rules-Legislative Oversight. 

BUDGET UPDATE: This week the House finished crafting their version of the $27.8 billion FY 2018 budget before the full House.  There were very few surprising changes made during debate.  Money for DUI checkpoints was stripped of all funding but for $1 as the House appropriations committee believes that saturation patrols are more effective.  The Foundation Formula is fully funded but is expected to trigger serious negotiations with the Senate who have already expressed concerns.  The $6 million given to fund the State Public Defenders Office was returned to the Office of Attorney General. An additional $1.5 million was given to the Secretary of State to aid in educating voters regarding Voter ID laws. Language was added which would prohibit the use or study of toll-roads, the expansion of Medicaid, and lower tuition for DACA students. 

It is expected the Senate Committee on Appropriations will begin working on crafting their version of the budget early next week.  The constitutional deadline to deliver a Truly Agreed to version of the budget is May 5th.

In the news…

  • This week, Governor Eric Greitens announced his initiative to bring broadband internet access to Missouri’s rural school districts. Greitens said that $45 million would be invested in the program, comprised of $6 million in General Revenue funds matched by $39 million by the Federal Communication Commission’s E-Rate Program. It remains to be seen whether the General Assembly will approve this GR funding.
  • Attorney General Josh Hawley this week took aim at the issue of human trafficking in a press conference at a St. Louis safe house for human trafficking victims. Hawley said that “If traffickers attempt to use a business to mask their criminal enterprise, we will shut them down and we will hold them personally liable with civil and criminal penalties.” According to Missourinet press reports, these initiatives are the first of their kind in the nation and involve using the states consumer protection laws to target human traffickers. Hawley says many human traffickers use a business, such as a nail salon or a bar as a front for human trafficking.