HB 2226 Modifies the laws regarding the regulation of certain professions and the regulation of hospitals

     Handler: Scott

Current Bill Summary

- Prepared by Senate Research -


CCS/SCS/HB 2226 & HB 1824 & HB 1832 & HB 1990 - This act relates to the regulation of certain professions.

JOINT COMMITTEE ON LEGISLATIVE RESEARCH

(Section 23.156)

This act requires employees of the oversight division of the joint committee on legislative research to take an oath to support the constitution, faithfully demean themselves in office, to not disclose information to unauthorized persons, and to not accept gifts for the discharge of their duties. Any employee who violates these duties is guilty of a class a misdemeanor.

THIRD PARTY PAYER

(Section 208.215)

Under this amendment any third party payer, such as third party administrators, administrative service organizations, health benefit plans and pharmacy benefits managers, shall process and pay all properly submitted MO HealthNet subrogation claims using standard electronic transactions or paper claims forms for a period of three years from the date services were provided or rendered. However, such third party payers shall not:

(1) be required to reimburse for items or services which are not covered under MO HealthNet;

(2) deny a claim submitted by the state solely on the basis of the date of submission of the claim, the type or format of the claim form, failure to present proper documentation of coverage at the point of sale, or failure to obtain prior authorization;

(3) be required to reimburse for items or services for which a claim was previously submitted to the third party payer by the health care provider or the participant and the claim was properly denied by the third party payer for procedural reasons, except for timely filing, type or format failure to present proper documentation of coverage at the point of sale, or failure to obtain prior authorization;

(4) be required to reimburse for items or services which are not covered under or were not covered under the plan offered by the entity against which a claim form for subrogation has been filed.

Such third party payers shall reimburse for items or services to the extent that the entity would have been liable as if it had been properly billed at the point of sale, and the amount due is limited to what the entity would have paid as if it has been properly billed at the point of sale. The MO HealthNet division shall also enforce its rights within six years of a timely submission of a claim.

Certified computerized MO HealthNet records shall be prima facie evidence of proof of moneys expended and the amount due the state.

This provision is similar to a provision of CCS/HCS/SCS/SBs 842, 799, and 809 (2010), CCS/HCS/SS/SB 1007 (2010), and is similar to HB 2057 (2010) and SB 552 (2009).

CEMETERIES

(Sections 214.160, 214.270, 214.276, 214.277, 214.282, 214.283, 214.300, 214.310, 214.320, 214.325, 214.330, 214.335, 214.340, 214.345, 214.360, 214.363, 214.365, 214.367, 214.387, 214.389, 214.392, 214.400, 214.410, 214.500, 214.504, 214.508, 214.512, 214.516, 214.550)

This act modifies certain laws regarding cemeteries.

It allows county commissions that serve as trustees of funds for cemeteries to invest these funds in certificates of deposit.

Current law allows the division of professional registration to seek an injunction against certain unlicensed cemetery operators in the county in which the conduct occurred or in which the defendant resides. This act eliminates this specific venue provision.

Each contract sold by a cemetery operator for cemetery services and items such as grave lots, markers, and tombstones shall meet certain requirements. If these requirements are not met, the contract is voidable by the purchaser.

Except for family burial grounds, individuals and public and private entities are required to notify the Office of Endowed Care Cemeteries of the name, location, and address of real estate used for the burial of human bodies.

Cemetery operators are exempted from the prearranged contract requirements of chapter 436.

Currently, cemetery operators are required to correct deficiencies in the funding of endowed care trust funds. This act specifies that deficiencies do not include deficiencies caused by the fluctuating value of investments.

The requirements of endowed care trust funds and escrow accounts are modified in several ways. Among other changes, the requirement that a financial institution that serves as the trustee of an endowed care trust be located in Missouri is removed. Cemetery operators must maintain the name and address of the trustee and records custodian and supply the office with this information upon request. The trust records shall be maintained in Missouri, or electronically accessible. Missouri law shall control all endowed care trust funds and such funds will be administered in accordance with certain trust requirements. Endowed care cemetery funds may also be held in an escrow account in Missouri. However, if the funds in the escrow account are over 350,000 dollars, in most cases they must be in an endowed care trust fund. Trustees and escrow agents shall consent in writing to Missouri jurisdiction and the supervision of the Office of Endowed Care Cemeteries.

Cemetery operators are required to notify the Division of Professional Registration at least thirty days prior to selling the business assets of the cemetery, or selling a majority of its stock. If the division does not disapprove, the cemetery operator can continue to take such action.

Sellers of prearranged burial merchandise and services are required to deposit a portion of the purchase price in an escrow or trust account. These funds are maintained in this account until delivery of the property, performance of the services, or the contract is cancelled. These escrow arrangements and trusts must each meet certain requirements. Cemetery prearranged contracts entered into after August 28, 2010 can be cancelled within thirty days of receiving the executed contract for a full refund, and at any time before the services or merchandise are provided, with exceptions, for 80% of the net amount of all payments made into the escrow account or trust.

The Division is allowed to direct a trustee, financial institution, or escrow agent to suspend distributions from endowed care trust funds or escrow accounts, if the cemetery operator is not licensed or does not meet certain other requirements, and after the cemetery operator is notified, and given sixty days to correct the violations. The cemetery operator may appeal this suspension.

Several provisions that previously applied to the city of st. Louis and allowed the sale of certain cemeteries owned by the city and applied to cemetery operators who purchased cemeteries from the city are now applied to all cities.

These provisions are identical to provisions of CCS#2/HCS/SCS/SB 754 (2010), SS/SCS/HCS#2/HB 1692, 1209, 1405, 1499, 1535, & 1811 (2010), HCS/HB 2388 (2010), and SB 753 (2010), and similar to HB 1845 (2010) and SB 416 (2009).

PRIVATE INVESTIGATORS

(Sections 324.1100, 324.1102, 324.1102, 324.1103, 324.1106, 324.1106, 324.1110, 324.1112, 324.1114, 324.1118, 324.1118, 324.1124, 324.1126, 324.1128, 324.1132, 324.1134, 324.1136, 324.1140, 324.1147)

This act requires that members of the Board of Private Investigator Examiners be Missouri residents for at least a year and registered voters. A board member's term shall be five years, instead of the current two year term.

The act also repeals a doubly-enacted section which limited the private investigator licensing exemption for employees of a not-for-profit organization, or its affiliate or subsidiary, to employees who make and process requests on behalf of health care providers and facilities for employee criminal background information. The section that remains exempts employees of an organization, whether for-profit or not-for profit, whose investigatory activities are limited to making and processing requests for criminal history records and other background information from state, federal, or local databases. The act also adds an exemption from private investigator licensing for certified public accountants and employees of the certified public accountant and of the accounting firm who assist in investigatory activities and modifies the exemption for individuals who contract with state and local government.

This act allows the Board of Private Investigator Examiners to deny a request for license to an applicant with a felony or misdemeanor conviction, even if the conviction occurred more than two years prior to the application date. The act also specifies that the board may deny a request for a license to an applicant who has received a suspended imposition of sentence following a plea of guilty to a misdemeanor offense and to an applicant who has been refused a license or had a license revoked in any other state. The board shall consider evidence of the applicant's rehabilitation when considering whether to grant a license to the applicant.

A private investigator agency is prohibited from hiring an employee if within two years prior to the application date the person has received a suspended imposition of sentence following a plea of guilty to a misdemeanor offense.

The division of professional registration, rather than the board of private investigator examiners, is required to determine the form of the license. The procedure for renewing a license is modified, to among other things provide for the payment of a delinquent renewal fee. The fee for additional licenses is no longer one-half the cost of the original license, but is a fee determined by the board.

Licensees are required to maintain information about their employees as required by the board.

If a licensee is required by contract or court order to destroy, seal, or return records related to their work to a party in a lawsuit, then the licensee is required to maintain a copy of the contract or court order.

The board is required to license, rather than certify, individuals who are qualified to train private investigators. These trainers are no longer required to be 21 years old, licensed as a private investigator, and have a year of supervisory experience with a private investigator agency.

These provisions are similar to SB 1003 (2010), HCS/SCS/SB 754 (2010), HCS/HB 2388 (2010), HB 1779 (2010), HB 1912 (2010), HB 2170 (2010).

BOARD FOR ARCHITECTS, PROFESSIONAL ENGINEERS, PROFESSIONAL LAND SURVEYORS AND LANDSCAPE ARCHITECTS

(Sections 327.031, 327.041, 327.351, and 327.411)

This act adds another professional engineer member to the Board for Architects, Professional Engineers, Professional Land Surveyors and Landscape Architects. It also allows a landscape architect to be the chairperson of the board. It also gives each member of the landscape architectural division of the board a vote when voting on action pending before the board. Beginning August 28, 2010, the chairperson of the board will rotate sequentially among an architect, professional engineer, professional land surveyor, and landscape architect. The chairperson shall only serve one four year term as chairperson. The chairperson of the landscape architectural division will be a vice chairperson of the board and will be ranking vice chairperson when the chairperson of the board is a landscape architect.

Eight members of the board, including at least one from each division will be required for a quorum for board business. Two voting members of each division of the board will be required for a quorum for division business.

A faculty member at an accredited school with the rank of assistant professor or higher will be regarded as actively practicing landscape architecture, in order to eligible for board membership.

The board will no longer be required to have the advice of the attorney general to summon or subpoena witnesses and documents under hearing or investigation.

The act also specifies that licensees are personally responsible for the contents of all documents to which they affix their seal, whether they were prepared or drafted by another licensee, or not. Licensees are also specifically required to only perform those architectural, professional engineering, professional land surveying, and landscape architectural services as they are qualified by education, training, and experience to perform.

Also, professional land surveyors with inactive licenses may continue to use the title "professional land surveyor" or the initials "PLS" after their name.

This act is similar to SS/SCS/HCS#2/HB 1692, 1209, 1405, 1499, 1535, & 1811 (2010), HCS/SCS/SB 754 (2010), HB 1639 (2010), HCS/HB 2388 (2010), and SB 298 (2009).

DENTAL ASSISTANTS AND DENTAL HYGIENISTS

(Sections 332.011, 332.098)

This act requires dental assistants and dental hygienists to obtain a permit from the dental board in order to perform expanded-function duties. Expanded-function duties are reversible acts that would be considered the practice of dentistry that the board specifies by rule may be delegated to a dental assistant or dental hygienist with an expanded-functions permit. This permit must be renewed every five years.

This act is similar to provisions of HCS/SCS/SB 754 (2010), and HCS/HB 2388 (2010), and SB 953 (2010) and HB 2229 (2010).

PHYSICAL THERAPISTS

(Section 334.100, 334.506, 334.613)

This act authorizes physical therapists to accept prescriptions for treatment from advanced practice registered nurses licensed in Missouri.

This act is similar to HB 1449 (2010), SB 986 (2010), and provisions of HCS/HB 2388 (2010) and HCS/SCS/SB 754 (2010).

PHYSICIANS AND PHYSICIAN ASSISTANTS

(Section 334.735)

This act provides that doctors and physician assistants working in rural health clinics are not required to meet state law supervision requirements that exceed the minimum federal law requirements if the physician-physician assistant team has been granted a waiver of the state laws that require certain amounts of on-site supervision by a doctor and that require physician assistants to practice within a certain distance of the doctor. The board of healing arts is allowed to void a current waiver after conducting a hearing and issuing a finding of fact that the physician-physician assistant team has failed to comply with the federal act or that either member of the team has violated a provision of the licensing laws.

Currently, a physician assistant is not permitted to prescribe or dispense any drug, medicine, device or therapy without consulting the supervising physician. This act removes this requirement.

This act is similar to HB 1738 (2010), and a provision of HCS/HB 2388 (2010) and HCS/SCS/SB 754 (2010).

NURSES AND HEALTH CARE PROFESSIONALS

(Section 335.075, 383.130, 383.133)

This act requires employers to check the license status of registered nurses, licensed practical nurses, and advanced practice registered nurses.

The act also adds home health agencies, nursing homes, nursing facilities, and any entity that employs or contracts with licensed health care professionals to provide healthcare services to individuals to the list of entities that are required to report to professional licensing authorities when disciplinary action is taken against a health care professional, or when the health care professional resigns while there are pending complaints that might have led to disciplinary action.

These provisions are similar to SB 1022 (2010) and a provision of HB 1990 (2010), HCS/HB 2388 (2010), HCS/SCS/SB 754 (2010).

NURSES

(Section 335.081)

This act exempts nurses who are legally qualified and licensed in another state, territory, or foreign country from having to be licensed in Missouri if the nurse is transporting patients into, out of, or through Missouri and the transport does not exceed forty-eight hours.

This provision is similar to a provision of HB 1990 (2010), HCS/HB 2388 (2010) and HCS/SCS/SB 754 (2010).

PROFESSIONAL COUNSELORS

(Section 337.528)

This act requires the committee for professional counselors to destroy documentation of complaints made by sexually violent predators against licensed professional counselors, if the complaint does not result in discipline. Past unsubstantiated complaints by sexually violent predators against a licensed professional counselor shall be destroyed upon request.

This provision is similar to HB 1832 (2010), and a provision of HCS/HB 2388 (2010) and CCS/HCS/SCS/SB 754 (2010).

SOCIAL WORKERS

(Sections 337.600, 337.603, 337.615, 337.618, 337.643)

The act eliminates the option of receiving a provisional license as a clinical social worker for applicants who have not yet completed their supervised clinical experience.

Currently, for a social worker to qualify as a qualified advanced macro supervisor, qualified baccalaureate supervisor, or qualified clinical supervisor, the social worker must have practiced in the field he or she will be supervising for at least five uninterrupted years. This act modifies this requirement so that these supervisors must have practiced in the field of social work as a licensed social worker and so their five years of practice may have been interrupted.

Currently, if supervised, a practitioner of master social work may engage in practices reserved to clinical social workers or advanced macro social workers. This act limits this practice to no more than four years for the purpose of obtaining a license as a clinical social worker or an advanced macro social worker.

These provisions are similar to HB 1824 (2010) and provisions of HCS/HB 2388 (2010) and HCS/SCS/SB 754 (2010).

MARITAL AND FAMILY THERAPISTS

(Sections 337.700, 337.703, 337.705, 337.706, 337.715, 337.718, 337.727, 337.739)

This act creates a provisional license for a marital and family therapist. A provisional licensed marital and family therapist will be required to have at least a master's degree, be supervised by a qualified supervisor as defined by rule, and meet all the licensing requirements, except for the required twenty-four months of supervised clinical experience.

This act also requires that state officials, employees, commissions, agencies, counties, municipalities, school districts, and political subdivisions not discriminate between persons licensed under the marital and family therapy statutes when promulgating rules or when requiring or recommending services that these individuals may legally perform.

These provisions are similar to HCS/HB 2388 (2010) and HCS/SCS/SB 754 (2010).

WHOLESALE DRUG DISTRIBUTORS

(Sections 338.333, 338.335, 338.337)

If wholesale drug distributors who distribute drug-related devices in Missouri meet certain conditions, this act exempts them from having to obtain a license from the board of pharmacy for out-of-state distribution sites. A Missouri wholesale drug distributor who receives shipments from these out-of-state sites is responsible for all shipments received.

These provisions are similar to SCS/SB 914 (2010), HB 1997 (2010), and provisions of HCS/HB 2388 (2010) and HCS/SCS/SB 754 (2010).

BOARD OF NURSING HOME ADMINISTRATORS

(Section 344.010, 344.020)

This act adds residential care facilities to the definition of "nursing home" in the chapter regarding nursing home administrators. This act also provides that the Board of Nursing Home Administrators may issue separate licenses to administrators of residential care facilities that were licensed as a residential care facility II on or before August 27, 2006, that continue to meet the licensure standards for a residential care facility II in effect on August 27, 2006. Any individual who receives a license to operate a residential care facility or an assisted living facility is not authorized to operate any skilled nursing or intermediate care facility.

These provisions are similar to provisions of CCS/HCS/SCS/SB 754 (2010) and HCS/HB 2388 (2010).

HOSPITAL LICENSES

(Section 1)

This act requires an applicant for hospital licensure to identify the premises of its hospital base in the application. Any other buildings or facilities located within one thousand yards of the hospital base and operated or maintained by the applicant to support the hospital base or to provide hospital-based inpatient, outpatient, or ancillary services shall be included in the hospital's license, provided the remote location meets the Department of Health and Senior Services regulations applicable to hospital construction and operational standards.

This provision is similar to SB 1023 (2010).

EMILY KALMER


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