WEEKLY OVERVIEW: This week the Senate continued to slog through legislation at a pace slower than a turtle’s race. The chamber spent an inordinate amount of time debating paycheck protection (annual affirmation by union members to withhold dues and fees) without any conclusion of the issue. Senators also thoroughly debated a tort reform piece relating to the qualifications of expert witnesses which culminated in passage of the bill. There are now 147 bills on the Senate Calendar – Senate Bills for Perfection and 38 bills on the Senate Calendar – House Bills on Second Reading.
Next week is spring break so there will be no report.
Senate Floor Action:
EXPERT WITNESSES: This week the Senate Truly Agreed to and Finally Passed HB 153 sponsored by Representative Kevin Corlew (R-Platte). This bill specifies that a witness who is qualified as an expert may testify in the form of an opinion or otherwise if the expert’s specialized knowledge will help the trier of fact to understand the evidence or to determine a fact in issue, the testimony is based on sufficient facts or data, the testimony is the product of reliable principles and methods, and the expert has reliably applied the principles and methods to the facts of the case.
This bill was Truly Agreed to and Finally Passed by a vote of 21 yeas and 11 noes. This bill has been sent to the Governor for final approval.
House Floor Action:
ACTION AGAINST HEALTH CARE PROVIDERS: This week the House took up HCS HB 452, sponsored by Rep. Kevin Austin (R-Springfield). This bill creates a definition for the term “employee” and repeals the definition for the term “physician employee” in provisions relating to causes of action for damages against a health care provider for personal injury or death.
During Perfection, an amendment was adopted which removes the provision within the definition of physician employee requiring the hospital to provide health insurance.
The bill was Third Read and Passed with 101 ayes and 52 noes.
SENIOR SERVICES PROTECTION: This week the House took up HCB 3, sponsored by Rep. Justin Alferman (R-Herman). This bill prohibits the issuance of the renter’s portion of the senior citizens property tax credit. The Department of Revenue is required to calculate how much of the renter’s portion of the tax credit was redeemed in fiscal year 2016. Beginning fiscal year 2018, such amount will be transferred into the newly created, Missouri Senior Services Protection Fund. Moneys in the fund will be used for services for low-income seniors and disabled persons.
During Perfection an amendment was adopted which changed the mechanism for how the money would be placed into the Senior Service Protection Fund.
The bill was Third Read and Passed with 85 ayes and 72 noes.
Committee Action of Interest:
SUICIDE PREVENTION TRAINING: This week the Senate Professional Registration Committee held a hearing on SB 490, sponsored by Senator Jill Schupp (St. Louis). This legislation requires psychologists, behavior analysts and professional counselors to complete two hours of suicide prevention training as a condition of initial licensure and license renewal. Provident, Inc., MO Coalition on Behavioral Healthcare, Missouri Nurses Association, American Foundation for Suicide Prevention, provided supporting testimony. No opposing testimony was provided. Immediately after the hearing the committee went into executive session to consider the bill. After no discussion, the bill was passed consent by a 7 to 0 vote.
PHYSICAL THERAPISTS: The Senate Professional Registration Committee also held a hearing on SB 317 sponsored by Sen. Sater (R). This bill modifies provisions relating to physician referral to physical therapists. The sponsor noted that this bill deals with physician referrals for physical therapy to facilities in which they have a financial interest. He said that there is a financial disclosure form to be signed. He believes that the current laws inhibits patients and said that this is a free market solution.
Testifying in support was Signature Medical Group, a private physician, Jefferson City Medical Group, Missouri State Orthopedic Association and Missouri Association of Osteopathic Physicians and Surgeons and the Missouri State Medical Association.
Supporters mentioned that there are two conflicting laws on the books currently regarding this issue. One says no provider can require any patient to receive treatment from any entity that they have financial control over. It was noted that another law essentially allows referrals if the disclosure requirement is meet. They noted that Missouri is only one of two states that have this prohibition on the books. They also stressed that hospitals currently have an exemption. They believe that the cost of health care will be brought down by this bill.
Testifying in opposition were the Missouri Physical Therapy Association, a private practice physical therapist and the Missouri Insurance Coalition.
Opponents noted that the prohibition was passed in 1992. They believed that if this bill is passed there will be less competition because people will go where they are directed by the physician and costs will increase. They noted that physical therapists like to work with the doctors and not for the doctors. They stated that it comes down to physicians trying to generate more revenue. It was noted that Missouri has limited direct access. They also believe that the bill would lead to over utilization.
The committee took no action on the bill.
HEALTH INSURANCE: On March 15, the House Health and Mental Health Policy Committee held a hearing on HB 994 sponsored by Rep. Eggleston (R). This bill establishes that an employee can receive either health insurance benefits or the premium paid by the employer, in form of compensation or a health savings account. The sponsor noted that he wants the bill to be revenue neutral to the employer. He noted that he would like to see the relationship with the doctor reinstated. He believed this would add personal responsibility to the process.
No one testified in support or opposition.
Testifying for information purposes was a representative of the St. Louis Area Business Health Coalition. He said that their members are under ERISA and the bill will not apply to them. Also testifying for informational purposes was the Missouri Hospital Association. They urged the committee to let the federal process play out before enacting these provisions. The Missouri Insurance Coalition also testified for informational purposes and noted that, in order to have an HSA, you need it tied to a health plan.
MAINTENANCE MEDICATIONS: On March 15, the House Health and Mental Health Policy Committee held an executive session on HB 657 sponsored by Rep. Rhoads (R). This bill changes the laws regarding dispensations of maintenance medications.
An amendment was adopted which allows the pharmacist to move maintenance medication dispensing to 180 days with insurance companies to cover no more than 90 days.
The committee voted the bill “do pass” by a vote of 10 to 0.
LONG TERM CARE INSURANCE: On March 14, the House Insurance Policy Committee held a hearing on HB 829 sponsored by Rep. Matthiesen (R). This bill specifies that any whole life insurance policies with long-term care riders shall meet the existing qualifications to join the Missouri Partnership. The sponsor noted that this bill will save the state money in the long term. He noted that these policies have the benefit of long-term care, a death benefit and a cash value. He said that use of this product will delay the time in which the state may have to pay through Medicaid. He stated that the Missouri Partnership is incentivizing persons to buy long-term care insurance.
No one testified in support or opposition and the committee took no action on the bill.