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WEEKLY OVERVIEW: This week, the House spent much of its floor debate time perfecting and third reading tort reform bills. In all, the House passed and sent to the Senate four tort reform measures dealing with venue, joinder, intervention in a tort action and torts involving insurance contracts. The Senate Calendar – Senate Bills for Perfected now has a backlog of 119 bills as senators continue to methodically debate on the floor.

Spring break for the legislature begins upon adjournment on March 16th and resumes on March 27th. You will receive a legislative report next Friday, but no report for the following week.

In the news…

* Governor Eric Greitens has come under fire for his role in the creation of a nonprofit policy organization that can accept unlimited donations without having to disclose the donors and amounts. Democrats are blasting the Governor for continuing to use “dark money” and point out the hypocrisy of his calling for cleaning up politics in Jefferson City while having his campaign manager lead the new nonprofit group.

* This week, the House passed legislation that would prohibit political subdivisions from passing their own minimum wage laws. The bill is a response to a recent Missouri Supreme Court decision that struck down a similar prohibition contained in a bill passed in 1998. The ruling paved the way for a St. Louis ordinance passed in 2015 that would increase the minimum wage to $10 per hour this year and $11 per hour in 2018.

* This week, Secretary of State Jay Ashcroft rolled out a voter educational program to inform voters about the photo ID requirements needed to vote that were passed by the voters last November (Constitutional Amendment 6). The program, entitled “Show It 2 Vote” is intended to educate voters on acceptable identification at the polls and alternative acceptable methods to cast a ballot.

* This week, the ACLU sued the state of Missouri in a class action suit for underfunding the state’s public defender’s office. The lawsuit alleges that the state has failed to meet the constitutional requirement of providing minimally adequate legal representation to indigent defendants.

* This week, the Missouri Public Service Commission approved a rate increase for Ameren Missouri totaling $92 million or approximately $3.70 per month per customer. The utility was seeking an increase of $206.4 million in this rate case which was filed in July, 2016.

Senate Floor Action:

RX PROGRAM: This week the Senate Perfected and then later in the week Third Read and Passed SCS B 139 sponsored by Senator David Sater (R-Barry) by a vote of 30 Yeas and 3 Noes.

This legislation creates the Rx Cares for Missouri Program to promote medication safety and prevent prescription drug abuse. After a brief explanation of the bill and no debate, the bill received Senate approval.

GLOBAL WAIVER FOR MO HEALTHNET: This week the Senate debated SCS SB 28 sponsored by Senator David Sater (R-Barry). This legislation requires the Department of Social Services to apply for a global waiver for MO HealthNet. During discussions, multiple Senators expressed their support for the bill and the importance of creating a program that works correctly for Missourians. After about an hour of discussions, the sponsor stated the bill still needs some work and laid it over on to the informal calendar.

House Floor Action:

PROFESSIONAL REGISTRATION: This week the House took up HCS HB 480, sponsored by Rep. Robert Ross (R-Yukon). This bill establishes guidelines for the regulation of occupations and professions not currently regulated by the Division of Professional Registration, within the Department of Insurance, Financial Institutions and Professional Registration, as well as guidelines for substantially increasing the scope of practice of currently regulated occupations and professions. The bill specifies that the state may not impose a substantial burden on an individual’s pursuit of his or her occupation or profession unless there is an important governmental interest for the state to protect the general welfare. If an interest exists, the regulation adopted by the state must be substantially related to the public interest to be protected. All bills introduced in the General Assembly to regulate an occupation or profession for the first time or to substantially increase the scope of practice must be reviewed according to specified criteria (Section 324.001, RSMo). For any new board or commission charged with regulating or licensing an occupation or profession, the bill specifies that those practitioners actively engaged in a newly regulated occupation or profession for at least one year prior to the effective date of the regulatory statute must have a property right in his or her continued legal ability to engage in his or her occupation or profession and specified due process rights. Any refusal of licensure by the board shall be in writing and any practitioner denied licensure shall then have the right to appeal the decision (Section 621.280).

The bill was Third Read and Passed with 107 ayes and 40 noes and has been reported to the Senate and First Read.

House Committee Action:

HEALTH CARE REFORM: On March 7, the House Insurance Policy Committee held an executive session on HB 780 sponsored by Rep. Hill (R). This bill establishes a state innovation waiver task force to develop a health care reform plan.

HCA 1 – Engler – Provides for a 13 person on the committee and other issues. Adopted and rolled into a substitute.

The committee voted the bill “do pass” by a vote of 11 to 0.

FREEDOM TO CHOOSE HEALTHCARE ACT: On March 7, the House Insurance Policy Committee held a hearing on HB 388 sponsored by Rep. Messenger (R). This bill establishes the Missouri Freedom to Choose Health Care Act. The sponsor noted that this is an any willing provider bill and also includes provisions that mandate payments for services that are pre-authorized. The sponsor noted that prosthetics providers have been added as providers.

Testifying in support was Ambulatory Surgery Centers Association, Signature Medical Group, Missouri Academy of Family Physicians, Missouri State Chiropractors Association and the Missouri State Medical Association. Supporters said that this bill will allow more providers to be included in networks that currently are narrow. They believe that physicians should have the freedom to participate in any network.

Testifying in opposition was the Missouri Insurance Coalition, Blue Cross Blue Shield of Kansas City, Anthem Blue Cross Blue Shield and United Health Care. Opponents noted that legislation like this increases the cost of providing health care. It negatively impacts the ability for a carrier to negotiate rates and quality. Any willing provider language raises premiums and lessens any negotiation position on price and utilization. It was also noted that consumers do choose between networks when buying health insurance. A narrow network is a lower cost option. It was noted that any willing provider is in the statute today if they are willing to take 85% of the lowest provider cost. Opponents said that the health care market is going through a transformation. It was noted that prior authorization has to be expedited because a treatment plan sometimes cannot be delayed. So if there is a situation where some treatments are in question there is an extensive appeal process. Opponents said that mandated legislation like this has a direct negative impact on premiums.

MAINTENANCE MEDICATIONS: This week the House Health and Mental Health Policy Committee held a hearing on HB 657, sponsored by Representative Shawn Rhoads (R-West Plains). Currently, if a patient has been on a prescribed medication for a least three months, a pharmacy is able to dispense refills limited to a 90-day supply. This bill increases the medication supply limit to 180 days and removes the requirement that the medication be prescribed to the patient for a three-month period.

The sponsor stated that the intention of the bill is to provide prescriptions to low income individuals who are not covered by insurance policies and has agreed to amend the language to clarify that these provisions do not apply to third party payers.

A representative from RX Outreach provided supporting testimony and a representative from the MO Insurance Coalition provided informational testimony. The committee took no further action.

SUICIDE AWARENESS: This week the House Health and Mental Health Policy Committee met in executive session and voted SB 52 sponsored by Senator Jamilah Nasheed (D-St. Louis) “do pass consent” 10-0.

This act requires each public institution of higher education to develop and implement a policy to advise students and staff on suicide prevention programs available on and off campus that includes, but is not limited to crisis intervention access, mental health program access, multimedia application access, student communication plans, and post intervention plans. Such policy shall also advise students, faculty, and staff of the proper procedures for identifying and addressing the needs of students exhibiting suicidal tendencies or behavior, and shall require training where appropriate.

Senate Committee Action:

INTERNAL AUDITS: On March 7, the Senate Insurance and Banking Committee held a hearing on SB 427 sponsored by Sen. Wasson (R). This bill requires certain insurers and insurance groups to establish an internal audit function. The sponsor noted that this bill provides a snapshot to the director of what the company looks like at a particular moment.

Testifying in support was RGA, Blue Cross Blue Shield of Kansas City, the Missouri Insurance Coalition and the Department of Insurance.

No one testified in opposition.

CORPORATE GOVERNANCE AND INTERNAL AUDITS: On March 7, the Senate Insurance and Banking Committee held a hearing on HCS HBs 337, 259, & 575 sponsored by Rep. Shull (R). This bill establishes procedures relating to financial accreditation standards for insurance companies.

Testifying in support were representatives of Reinsurance Group of America, Missouri Insurance Coalition, State Farm, AIA, PCI and the Department of Insurance. Supporters noted that the provisions of these bills are NAIC approved provisions dealing with internal audits and corporate governance annual disclosure reports.

No one testified in opposition.

SUICIDE EXCLUSIONS: On March 7, the Senate Insurance and Banking Committee held a hearing on HB 336 sponsored by Rep. Shull (R). This bill provides that riders, endorsements, and amendments to life insurance policies may contain suicide exclusions or limitations.

The sponsor noted that the bill

Testifying in support was American Family Insurance, AIA, PCI, State Farm, Prudential, American Council of Life Insurers, Missouri Association of Insurance and Financial Advisors and the Missouri Insurance Coalition.

No one testified in opposition.