SECOND REGULAR SESSION
SENATE COMMITTEE SUBSTITUTE FOR
SENATE BILL NO. 924
91ST GENERAL ASSEMBLY
TERRY L. SPIELER, Secretary.
3901S.02C
AN ACT
To repeal sections 332.051, 332.071, 332.081, 332.111 and 332.121, RSMo, relating to non-profit-corporations that provide dental services, and to enact in lieu thereof five new sections relating to the same subject, with penalty provisions.
Section A. Sections 332.051, 332.071, 332.081, 332.111 and 332.121, RSMo, are repealed and five new sections enacted in lieu thereof, to be known as sections 332.051, 332.071, 332.081, 332.111 and 332.121, to read as follows:
332.051. 1. The board shall establish and maintain an office at Jefferson City, Missouri, where its records and files shall be kept.
2. Investigators employed by the board shall, among other duties, have the power in the name of the board to investigate alleged violations of this chapter including the right to inspect, on order of the board, dental offices, including records, dental laboratories, dental equipment and instruments, and not-for-profit corporations licensed to practice dentistry in this state, including patient dental records, and locations where not-for-profit corporations practice dentistry, with respect to violations of the provisions of this chapter.
332.071. A person or other entity "practices dentistry" within the meaning of this chapter who:
(1) Undertakes to do or perform dental work or dental services or dental operations or oral surgery, by any means or methods, gratuitously or for a salary or fee or other reward, paid directly or indirectly to the person or to any other person or entity;
(2) Diagnoses or professes to diagnose, prescribes for or professes to prescribe for, treats or professes to treat, any disease, pain, deformity, deficiency, injury or physical condition of human teeth or adjacent structures or treats or professes to treat any disease or disorder or lesions of the oral regions;
(3) Attempts to or does replace or restore a part or portion of a human tooth;
(4) Attempts to or does extract human teeth or attempts to or does correct malformations of human teeth or jaws;
(5) Attempts to or does adjust an appliance or appliances for use in or used in connection with malposed teeth in the human mouth;
(6) Interprets or professes to interpret or read dental radiographs;
(7) Administers an anesthetic in connection with dental services or dental operations or dental surgery;
(8) Undertakes to or does remove hard and soft deposits from or polishes natural and restored surfaces of teeth;
(9) Uses or permits to be used for the person's benefit or for the benefit of any other person or other entity the following titles or words in connection with the person's name: "Doctor", "Dentist", "Dr.", "D.D.S.", or "D.M.D.", or any other letters, titles, degrees or descriptive matter which directly or indirectly indicate or imply that the person is willing or able to perform any type of dental service for any person or persons, or uses or permits the use of for the person's benefit or for the benefit of any other person or other entity any card, directory, poster, sign or any other means by which the person indicates or implies or represents that the person is willing or able to perform any type of dental services or operation for any person;
(10) Directly or indirectly owns, leases, operates, maintains, manages or conducts an office or establishment of any kind in which dental services or dental operations of any kind are performed for any purpose; but this section shall not be construed to prevent owners or lessees of real estate from lawfully leasing premises to those who are qualified to practice dentistry within the meaning of this chapter;
(11) Constructs, supplies, reproduces or repairs any prosthetic denture, bridge, artificial restoration, appliance or other structure to be used or worn as a substitute for natural teeth, except when one, not a registered and licensed dentist, does so pursuant to a written uniform laboratory work order, in the form to be prescribed by the board and copies of which shall be retained by the nondentist for two years, of a dentist registered and currently licensed in Missouri and which the substitute in this subdivision described is constructed upon or by use of casts or models made from an impression furnished by a dentist registered and currently licensed in Missouri;
(12) Attempts to or does place any substitute described in subdivision (11) of this section in a human mouth or attempts to or professes to adjust any substitute or delivers any substitute to any person other than the dentist upon whose order the work in producing the substitute was performed;
(13) Advertises, solicits, or offers to or does sell or deliver any substitute described in subdivision (11) of this section or offers to or does sell the person's services in constructing, reproducing, supplying or repairing the substitute to any person other than a registered and licensed dentist in Missouri;
(14) Undertakes to do or perform any physical evaluation of a patient in the person's office or in a hospital, clinic, or other medical or dental facility prior to or incident to the performance of any dental services, dental operations, or dental surgery;
(15) Reviews examination findings, x-rays, or other patient data to make judgements or decisions about the dental care of a patient in this state.
332.081. 1. No person, corporation, or entity shall practice dentistry in Missouri as defined in section 332.071 unless and until the board has issued to the person a certificate certifying that the person has been duly registered as a dentist in Missouri and unless and until the board has issued to the person a license, to be renewed each period as provided in this chapter, to practice dentistry in Missouri; but nothing in this chapter shall be so construed as to make it unlawful for a legally qualified and licensed physician or surgeon, who does not practice dentistry as a specialty, from extracting teeth, or to make it unlawful for a dentist licensed in a state other than Missouri from making a clinical demonstration before a meeting of dentists in Missouri, or to make it unlawful for dental students in any accredited dental school to practice dentistry under the personal direction of instructors, or to make it unlawful for any duly registered and licensed dental hygienist in Missouri to practice as a dental hygienist as defined in section 332.091, or to make it unlawful for dental assistants, certified dental assistants or expanded functions dental assistants to be delegated duties as defined in section 332.093, or to make it unlawful for persons to practice dentistry in the United States armed services or in or for the United States Public Health Service, or in or for the United States Veterans Bureau, or to make it unlawful to teach in an accredited dental school, or to make it unlawful for a duly qualified anesthesiologist or anesthetist to administer an anesthetic in connection with dental services or dental surgery.
2. No corporation shall practice dentistry as defined in section 332.071 unless that corporation is organized as a not-for-profit corporation pursuant to the provisions of chapter 355, RSMo, and has the status of an organization under 26 U.S.C. Section 501(c)(3), or is organized under the provisions of chapter 356, RSMo.
3. A not-for-profit corporation organized under the provisions of chapter 355, RSMo, and qualifying as an organization under 26 U.S.C. Section 501(c)(3) shall:
(1) Only provide dental services to Medicaid recipients and individuals who have income below three hundred percent of the federal poverty level unless mandated by federal law;
(2) Only provide dental services in this state so long as at least ninety percent of the corporation's patient census consists of Medicaid recipients or patients with an income below three hundred percent of the federal poverty level unless mandated by federal law;
(3) Only employ dentists and dental hygienists licensed in this state and dental assistants to render dental services; and
(4) Be organized for health purposes only.
4. No not-for-profit corporation organized under the provisions of chapter 355, RSMo, and qualifying as an organization under 26 U.S.C. Section 501(c)(3) or any other person may direct or interfere or attempt to direct or interfere with a licensed dentist's professional judgment and competent practice of dentistry.
5. A not-for-profit corporation organized under the provisions of chapter 355, RSMo, and qualifying as an organization under 26 U.S.C. Section 501(c)(3) may apply for a license to practice dentistry in this state so long as the corporation applies for licensure in writing on forms provided by the Missouri dental board.
6. Any not-for-profit corporation that obtains a license to practice dentistry in this state is subject to discipline pursuant to section 332.321.
7. The board shall promulgate rules and regulations to ensure not-for-profit corporations are rendering care to the patient population as set forth herein, including requirements for not-for-profit corporations to report patient census data to the board.
8. All not-for-profit corporations organized and operated as migrant, community, or homeless health centers pursuant to 42 U.S.C. Section 254(b) or 254(c), or federally qualified health centers pursuant to 42 U.S.C. Section 13996(d), or as otherwise authorized herein, shall practice dentistry in accordance with the law of this state, except as specifically preempted by federal law.
332.111. Any person [who], corporation, or entity that practices dentistry as defined in section 332.071 [who] that is not a duly registered and currently licensed dentist in Missouri as hereinafter provided, or any person who practices as a dental hygienist as defined in section 332.091 who is not a duly registered and currently licensed dental hygienist in Missouri as hereinafter provided is guilty of a class A misdemeanor.
332.121. 1. Upon application by the board and the necessary burden having been met, a court of general jurisdiction may grant an injunction, restraining order or other order as may be appropriate to enjoin a person, corporation, or firm or other entity from:
(1) Offering to engage or engaging in the performance of any acts or practices for which a certificate of registration or authority, permit or license is required by this chapter upon a showing that such acts or practices were performed or offered to be performed without a certificate of registration or authority, permit or license; [or]
(2) Engaging in any practice or business authorized by a certificate of registration or authority, permit or license issued pursuant to this chapter upon a showing that the holder presents a substantial probability of serious danger to the health, safety or welfare of any resident of this state or client or patient of the licensee; or
(3) Directing, interfering with, or attempting to direct or interfere with licensed dentist's professional judgement or competent practice of dentistry.
2. Any such action shall be commenced either in the county in which the defendant resides or in the county in which such conduct occurred.
3. Any action brought under this section shall be in addition to and not in lieu of any penalty provided by this chapter and may be brought concurrently with other actions to enforce this chapter.