SB 29
Modifies various provisions of law regarding the licensing of certain professions
Sponsor:
LR Number:
0331L.03C
Last Action:
5/13/2011 - In Conference--SCS for SB 29-Brown, with HCS, as amended
Journal Page:
Title:
HCS SCS SB 29
Calendar Position:
2
Effective Date:
August 28, 2011
House Handler:

Current Bill Summary

HCS/SCS/SB 29 - This act modifies various provisions of law regarding the licensing of certain professions.

HEALTH CARE PROFESSIONAL IDENTIFICATION BADGES

(Section 197.705)

After August 28, 2011, all hospitals, ambulatory surgical centers and certain health care facilities shall require all newly hired personnel providing services in such facilities to wear identification badges prominently displaying the employee's photograph, first name, title and employer. The title of the employee shall include whether the employee is a physician, nurse, as specified under the act, or other titles as determined by the Department of Health and Senior Services. Nothing in this act shall prohibit a health care provider from placing the provider's additional specialty or designation on the badge. Personnel shall not be required to wear the badge while delivering direct care if not clinically feasible.

Compliance with this act for all current personnel may occur when any badges are issued or replaced within a reasonable time after August 28, 2011, but no later than by August 28, 2016. Nothing in this act requires the immediate replacement of identification badges worn by current personnel.

This act is substantially similar to HCS/HB 287 (2011) and SCS/SB 137 (2011).

DRIVER'S LICENSE COMPETENCY ASSESSMENT

(Section 302.291)

This act adds licensed professional counselors to the list of health care professionals who can report to the Department of Revenue a person diagnosed as having a disorder or condition that may prevent him or her from driving a motor vehicle in a safe manner. A report from a professional counselor shall provide the director with good cause to believe that the operator may be incompetent or unqualified to retain his or her driver's license and the director may require the person to submit to an examination in order to retain it.

This provision is identical to truly agreed to and finally passed HB 499 (2011).

NOTIFYING EMPLOYERS REGARDING THE LICENSURE STATUS OF EMPLOYEES

(Section 324.013)

This act requires any board, commission, committee, council, or office within the Division of Professional Registration to notify a licensee's current employer, if the employer is known, of a change in the licensee's license or disciplinary status. Employers may also provide a list of current licensed employees and make a written request to the appropriate board to be notified when there is a change in the licensure status of any of those employees.

This provision is substantially similar to SCS/HB 265 (2011) and SB 325 (2011).

ADMINISTRATIVE PROCEDURES AND POWERS OF THE BOARD OF REGISTRATION FOR THE HEALING ARTS

(Section 324.043, 324.045,334.001, 334.040, 334.070, 334.090, 334.099, 334.100, 334.102, 334.103, 334.108, 334.715, 536.063, 536.067, 536.070, 621.045, 621.100, 621.110)

This act modifies disciplinary and administrative procedure provisions that apply to professions and businesses licensed by the Division of Professional Registration or by any board committee, commission or office within the Division of Professional Registration. The act also modifies the licensing requirements and disciplinary powers of the Board of Registration for the Healing Arts.

If a person who is licensed by any board, committee, commission, or office under the Division of Professional Registration does not defend against a disciplinary proceeding, the appropriate board or the Administrative Hearing Commission is required to enter a default decision against the person. The board or the Administrative Hearing Commission may set aside the default decision for good cause if the person files a motion within thirty days after the default decision.

Evidence contesting the basis of a criminal conviction or disciplinary action from another state will not be admissible in an administrative hearing.

The Administrative Hearing Commission is required to deliver the findings of fact and conclusions of law in disciplinary cases to the appropriate agency within one hundred and twenty days of the date the case became ready for decision.

BOARD OF REGISTRATION FOR THE HEALING ARTS

The Board of Registration for the Healing Arts is authorized to list certain information about individuals who are licensed by the board and applicants for licenses from the board on its website. The board is also required to disclose confidential information to applicants for licenses and licensees without a fee, if the information is less than five years old.

The board is no longer authorized to require doctors licensed in other states to take certain examinations prior to waiving the Missouri examination requirement. The board is authorized to require another examination, more education, or further training before issuing a permanent medical license to applicants who have not actively practiced clinical medicine or held a teaching position for two of the three years before their application.

Doctors are no longer required to display their certificate of registration in the office.

The board is required to make individuals applying for a license or holding a license submit to an evaluation of their skills, a multi-disciplinary evaluation, or a substance abuse evaluation, after a hearing, if there is reasonable cause to believe that the individual is incompetent about the medical or osteopathic profession, mentally or physically incapacitated, or excessively uses or abuses alcohol or controlled substances.

The disciplinary authority of the board is modified to allow the board to discipline licensees for municipal violations, prescribing drugs through the internet without a valid physician-patient relationship, for being listed on a sex offender registry, any conduct that is unethical of unprofessional involving a minor, for a single act of negligence, for knowingly making a false statement to the board, for violating a settlement agreement with the board, for failing to comply with a treatment program, and for violating any professional trust or confidence.

The board's authority to issue an emergency suspension or restriction of a licensee's license is modified to allow additional reasons for an emergency suspension or restriction, including: sexual conduct with a patient, sexual misconduct with a minor, possession or use of a controlled substance, a court finding that the licensee is incapacitated, habitual intoxication or dependence on alcohol or a controlled substance or failing to comply with a treatment program. The procedure for issuing emergency restrictions or suspensions is also modified. Emergency suspensions will take effect when the documents are served, rather than after a preliminary hearing before the Administrative Hearing Commission. The emergency restriction or suspension may be appealed to the circuit court.

The board is also authorized to initiate hearings before itself when disciplining a licensee's license for certain actions. The board's disciplinary decision is appealable to the circuit court.

Doctors who prescribe any drug, controlled substance, or other treatment through the internet are required to meet certain requirements to establish that there is a valid physician-patient relationship. These requirements do not apply to treatment provided in a hospital, hospice program, in accordance with a collaborative practice agreement, or in conjunction with a physician assistant.

The board's authority to discipline athletic trainers is also modified.

These provisions are similar to SCS/SB 303 (2011) and HCS/HB 732 (2011).

LIMITED TEACHING LICENSE FOR DENTAL INSTRUCTORS

(Section 332.425)

This act allows the Missouri Dental Board to issue a limited teaching license to an instructor at an accredited dental school. This limited teaching license only allows the licensee to practice within the accredited dental school programs. Individuals who receive a limited teaching license must meet specified requirements, including evidence of spoken written proficiency in the English language, but will not be required to have graduated from an accredited dental school.

This provision is similar to HB 591 (2011) and HCS/SB 325 (2011).

VETERINARY LEGEND DRUGS

(Sections 338.010, 338.140, 338.150, 338.220, and 338.240)

This act modifies the authority of the Board of Pharmacy with regard to certain drugs used in veterinary medicine.

This act also adds a veterinarian to the advisory committee appointed by the Board of Pharmacy to make recommendations to it about rules and regulations dealing with drug distribution and manufacturing. The advisory committee is also required to review and make recommendations to the Board of Pharmacy regarding rules and regulations about veterinary legend drugs.

Businesses that only hold a class L pharmacy permit will not be required to have a pharmacist on site, except for when noncontrolled drugs for use in animals are being compounded. A pharmacist is responsible for reviewing the activities and records of class L pharmacies.

These provisions are similar to HCS/SB 325 (2011) and HB 1814 (2010).

REAL ESTATE LICENSEES

(Section 339.190)

Currently, licensed real estate brokers and salespersons have immunity from liability for statements made by certain individuals, such as an inspector, unless the individual was employed by the real estate licensee, selected by and engaged by the licensee, or the licensee knew the statement was false or acted in reckless disregard as to whether the statement was true or false. This act specifies that if the real estate broker or salesperson only orders a report or inspection, that does not mean the licensee selected or engaged the individual, so the real estate licensee would still have immunity from liability for the statements the individual made.

This provision is identical to HCS/HB 220 (2011) and HCS/SB 325 (2011).

PEER REVIEW PROCESS FOR LICENSED ARCHITECTS, LANDSCAPE ARCHITECTS, PROFESSIONAL LAND SURVEYORS, OR PROFESSIONAL ENGINEERS

(Section 537.033)

This act authorizes the establishment of a peer review process for architects, landscape architects, professional land surveyors, or professional engineers.

Peer reviewers and each person who testifies before them, provides information to them, acts upon their recommendation, or participates in the peer review process are immune from civil liability for these actions, as long as the actions are performed in good faith, without malice and are reasonably related to the scope of inquiry of the peer review process.

Certain documents created during the peer review process are privileged and are prohibited from being released to any person. These documents are not admissible in any judicial or administrative action for failure to provide appropriate architectural, landscape architectural, land surveying, or engineering services. A person who participated in the peer review process shall not be permitted or required to disclose information they learned from the peer review process.

This act does not limit the authority of the Board for Architects, Professional Engineers, Professional Land Surveyors and Landscape Architects to obtain information from a peer reviewer or to require disclosure of otherwise confidential information developed outside of the peer review process.

This act is identical to HB 568 (2011) and similar to SB 326 (2011).

EMILY KALMER

HA 2 - THIS AMENDMENT MAKES THE EXECUTIVE DIRECTOR OF THE MISSOURI HOUSING DEVELOPMENT COMMISSION, INCLUDING THE CURRENT EXECUTIVE DIRECTOR, SUBJECT TO THE ADVICE AND CONSENT OF THE SENATE. THE EXECUTIVE DIRECTOR WILL SERVE THREE YEAR TERMS AND BE SUBJECT TO THE ADVICE AND CONSENT OF THE SENATE FOR ANY ADDITIONAL TERM. THE EXECUTIVE DIRECTOR SHALL ONLY IMPLEMENT THOSE POLICIES APPROVED BY THE COMMISSION.

HA 3, AS AMENDED - THIS AMENDMENT MODIFIES DISCIPLINARY AND ADMINISTRATIVE PROCEDURE PROVISIONS THAT APPLY TO PROFESSIONS AND BUSINESSES LICENSED BY THE DIVISION OF PROFESSIONAL REGISTRATION OR BY ANY BOARD COMMITTEE, COMMISSION OR OFFICE WITHIN THE DIVISION OF PROFESSIONAL REGISTRATION. THE AMENDMENT ALSO MODIFIES THE LICENSING REQUIREMENTS AND DISCIPLINARY POWERS OF THE BOARD OF REGISTRATION FOR THE HEALING ARTS.

IF A PERSON WHO IS LICENSED BY ANY BOARD, COMMITTEE, COMMISSION, OR OFFICE UNDER THE DIVISION OF PROFESSIONAL REGISTRATION DOES NOT DEFEND AGAINST A DISCIPLINARY PROCEEDING, THE APPROPRIATE BOARD OR THE ADMINISTRATIVE HEARING COMMISSION IS REQUIRED TO ENTER A DEFAULT DECISION AGAINST THE PERSON. THE BOARD OR THE ADMINISTRATIVE HEARING COMMISSION MAY SET ASIDE THE DEFAULT DECISION FOR GOOD CAUSE IF THE PERSON FILES A MOTION WITHIN THIRTY DAYS AFTER THE DEFAULT DECISION.

THE ADMINISTRATIVE HEARING COMMISSION IS REQUIRED TO DELIVER THE FINDINGS OF FACT AND CONCLUSIONS OF LAW IN DISCIPLINARY CASES TO THE APPROPRIATE AGENCY WITHIN ONE HUNDRED AND TWENTY DAYS OF THE DATE THE CASE BECAME READY FOR DECISION.

BOARD OF REGISTRATION FOR THE HEALING ARTS

THE BOARD OF REGISTRATION FOR THE HEALING ARTS IS AUTHORIZED TO LIST CERTAIN INFORMATION ABOUT INDIVIDUALS WHO ARE LICENSED BY THE BOARD AND APPLICANTS FOR LICENSES FROM THE BOARD ON ITS WEBSITE. THE BOARD IS ALSO REQUIRED TO DISCLOSE CONFIDENTIAL INFORMATION TO APPLICANTS FOR LICENSES AND LICENSEES WITHOUT A FEE, IF THE INFORMATION IS LESS THAN FIVE YEARS OLD.

THE BOARD IS NO LONGER AUTHORIZED TO REQUIRE DOCTORS LICENSED IN OTHER STATES TO TAKE CERTAIN EXAMINATIONS PRIOR TO WAIVING THE MISSOURI EXAMINATION REQUIREMENT. THE BOARD IS AUTHORIZED TO REQUIRE ANOTHER EXAMINATION, MORE EDUCATION, OR FURTHER TRAINING BEFORE ISSUING A PERMANENT MEDICAL LICENSE TO APPLICANTS WHO HAVE NOT ACTIVELY PRACTICED CLINICAL MEDICINE OR HELD A TEACHING POSITION FOR TWO OF THE THREE YEARS BEFORE THEIR APPLICATION.

DOCTORS ARE NO LONGER REQUIRED TO DISPLAY THEIR CERTIFICATE OF REGISTRATION IN THE OFFICE.

THE BOARD IS REQUIRED TO MAKE INDIVIDUALS APPLYING FOR A LICENSE OR HOLDING A LICENSE SUBMIT TO AN EVALUATION OF THEIR SKILLS, A MULTI-DISCIPLINARY EVALUATION, OR A SUBSTANCE ABUSE EVALUATION, AFTER A CONTESTED HEARING, IF THERE IS REASONABLE CAUSE TO BELIEVE THAT THE INDIVIDUAL IS INCOMPETENT ABOUT THE MEDICAL OR OSTEOPATHIC PROFESSION, MENTALLY OR PHYSICALLY INCAPACITATED, OR EXCESSIVELY USES OR ABUSES ALCOHOL OR CONTROLLED SUBSTANCES. THE BOARD IS REQUIRED TO ISSUE RULES TO PROVIDE FOR THE PROCEDURES FOR IMPLEMENTING THESE PROCEDURES.

THE DISCIPLINARY AUTHORITY OF THE BOARD IS MODIFIED TO ALLOW THE BOARD TO DISCIPLINE LICENSEES FOR PRESCRIBING DRUGS THROUGH THE INTERNET WITHOUT A VALID PHYSICIAN-PATIENT RELATIONSHIP, FOR BEING LISTED ON A SEX OFFENDER REGISTRY, ANY CONDUCT THAT IS UNETHICAL OR UNPROFESSIONAL INVOLVING A MINOR, FOR KNOWINGLY MAKING A FALSE STATEMENT TO THE BOARD, FOR VIOLATING A SETTLEMENT AGREEMENT WITH THE BOARD, AND FOR FAILING TO COMPLY WITH A TREATMENT PROGRAM.

THE BOARD'S AUTHORITY TO ISSUE AN EMERGENCY SUSPENSION OR RESTRICTION OF A LICENSEE'S LICENSE IS MODIFIED TO CHANGE THE REASONS FOR AN EMERGENCY SUSPENSION OR RESTRICTION, INCLUDING: SEXUAL CONDUCT WITH A PATIENT, SEXUAL MISCONDUCT WITH A MINOR, POSSESSION OF A CONTROLLED SUBSTANCE, EXCEPT FOR RECORD KEEPING VIOLATIONS, USE OF A CONTROLLED SUBSTANCE WITHOUT A PRESCRIPTION, A COURT FINDING THAT THE LICENSEE IS INCAPACITATED, HABITUAL INTOXICATION OR DEPENDENCE ON ALCOHOL OR A CONTROLLED SUBSTANCE OR FAILING TO COMPLY WITH A TREATMENT PROGRAM, A REPORT FROM A FACILITY OR PROFESSIONAL HEALTH PROGRAM THAT THE LICENSEE IS NOT FIT TO PRACTICE, OR CONDUCT WHICH VIOLATES THE DISCIPLINARY PROVISIONS AND IS A SERIOUS DANGER TO A PATIENT OR THE PUBLIC. THE PROCEDURE FOR ISSUING EMERGENCY RESTRICTIONS OR SUSPENSIONS IS ALSO MODIFIED. EMERGENCY SUSPENSIONS WILL TAKE EFFECT UPON SERVICE TO THE LICENSEE AFTER THE ADMINISTRATIVE HEARING COMMISSION FINDS THAT THERE IS PROBABLE CAUSE, RATHER THAN AFTER A PRELIMINARY HEARING BEFORE THE ADMINISTRATIVE HEARING COMMISSION. THE ADMINISTRATIVE HEARING COMMISSION IS THEN REQUIRED TO HOLD A HEARING WITHIN FORTY-FIVE DAYS OF THE BOARD'S FILING OF A COMPLAINT TO DETERMINE IF CAUSE FOR DISCIPLINE EXISTS.

THE BOARD IS ALSO AUTHORIZED TO INITIATE HEARINGS BEFORE ITSELF WHEN DISCIPLINING A LICENSEE'S LICENSE FOR CERTAIN ACTIONS. THE BOARD'S DISCIPLINARY DECISION IS APPEALABLE TO THE CIRCUIT COURT.

DOCTORS WHO PRESCRIBE ANY DRUG, CONTROLLED SUBSTANCE, OR OTHER TREATMENT THROUGH THE INTERNET ARE REQUIRED TO MEET CERTAIN REQUIREMENTS TO ESTABLISH THAT THERE IS A VALID PHYSICIAN-PATIENT RELATIONSHIP. THESE REQUIREMENTS MAY BE MET BY THE PRESCRIBING PHYSICIAN'S DESIGNEE WHEN TREATMENT IS PROVIDED IN A HOSPITAL, IN A HOSPICE PROGRAM, IN HOME HEALTH SERVICES PROVIDED BY A HOME HEALTH AGENCY, IN ACCORDANCE WITH A COLLABORATIVE PRACTICE AGREEMENT, IN CONJUNCTION WITH A PHYSICIAN ASSISTANT, IN CONSULTATION WITH ANOTHER PHYSICIAN WHO HAS AN ONGOING PHYSICIAN-PATIENT RELATIONSHIP WITH THE PATIENT, OR IN ON-CALL OR CROSS-COVERAGE SITUATIONS.

THE BOARD'S AUTHORITY TO DISCIPLINE ATHLETIC TRAINERS IS ALSO MODIFIED.

THIS AMENDMENT IS SIMILAR TO HCS/HB 732 (2011) AND SB 303 (2011).

HA 4 - UNDER CURRENT LAW, THE CHILDREN'S VISION EXAMINATION PROGRAM IS SET TO SUNSET ON JUNE 30, 2012. THIS AMENDMENT REPEALS THE SUNSET PROVISION.

THIS AMENDMENT IS SIMILAR TO SB 311 (2011) AND HB 677 (2011).

HA 5 - THIS AMENDMENT CREATES THE NURSING EDUCATION INCENTIVE PROGRAM WITHIN THE DEPARTMENT OF HIGHER EDUCATION FOR THE AWARDING OF GRANTS. THIS PROGRAM WILL ALLOW GRANTS NOT TO EXCEED $150,000 TO BE AWARDED TO MISSOURI INSTITUTIONS OF HIGHER EDUCATION ACCREDITED BY THE HIGHER LEARNING COMMISSION OF THE NORTH CENTRAL ASSOCIATION THAT OFFER A NURSING EDUCATION PROGRAM. NO CAMPUS MAY RECEIVE MORE THAN ONE GRANT PER YEAR.

TO BE CONSIDERED FOR A GRANT, AN INSTITUTION MUST OFFER A NURSING PROGRAM THAT MEETS A PREDETERMINED CATEGORY AND AREA OF NEED AS ESTABLISHED BY THE DEPARTMENT OF HIGHER EDUCATION AND THE STATE BOARD OF NURSING. WHEN ESTABLISHING CATEGORIES AND AREAS OF NEED, THE DEPARTMENT AND BOARD MAY CONSIDER: DATA FROM LICENSURE RENEWAL AND FROM THE DEPARTMENT OF HEALTH AND SENIOR SERVICES AND NATIONAL NURSING STATISTICAL DATA AND TRENDS FOR NURSING SHORTAGES.

THE STATE BOARD OF NURSING IS AUTHORIZED TO PROVIDE FUNDING TO THE PROGRAM.

THIS AMENDMENT ALSO REPEALS THE OBSOLETE NURSE TRAINING INCENTIVE FUND.

THESE PROVISIONS ARE SIMILAR TO SB 191 (2011) AND PROVISIONS OF HCS/HB 223 & 231 (2011).

HA 6 - THIS AMENDMENT MODIFIES LANGUAGE SO THAT AN APPLICANT FOR A LIMITED DENTAL TEACHING LICENSE SUBMIT TO THE BOARD EVIDENCE OF SUCCESSFUL PASSAGE OF AN EXAMINATION OF SPOKEN AND WRITTEN PROFICIENCY IN THE ENGLISH LANGUAGE.

HA 7 - THIS AMENDMENT MODIFIES THE LANGUAGE REGARDING BADGES IN HOSPITALS, AMBULATORY SURGICAL CENTERS, AND HEALTH CARE FACILITIES TO ELIMINATE THE REQUIREMENT THAT THE TITLE OF THE EMPLOYEE BE IN A SINGLE LINE AND OCCUPY A ONE-HALF INCH TALL STRIP. THE AMENDMENT ALLOWS THE TITLE OF THE EMPLOYEE TO BE AT TOP AND BOTTOM OF THE BADGE. THE AMENDMENT ALSO REMOVES THE "AT THE BOTTOM ONE-HALF MARGIN" REQUIREMENT AS TO PHYSICIAN BADGES AND PROVIDES THAT COMPLIANCE WITH THIS ACT FOR ALL CURRENT PERSONNEL MAY OCCUR WHEN ANY BADGES ARE ISSUED OR REPLACED WITHIN A REASONABLE TIME AFTER AUGUST 28, 2011, BUT NO LATER THAN TEN YEARS FROM AUGUST 28, 2011.

HA 8 - THIS AMENDMENT REQUIRES THE DEPARTMENT OF HEALTH AND SENIOR SERVICES TO REVIEW AND REVISE ITS REGULATIONS GOVERNING HOSPITAL LICENSURE AND ENFORCEMENT TO PROMOTE EFFICIENCY AND ELIMINATE DUPLICATE REGULATIONS AND INSPECTIONS BY OR ON BEHALF OF THE STATE AND FEDERAL AGENCIES.

THE DEPARTMENT IS ALSO REQUIRED TO ADOPT REGULATIONS THAT REQUIRE AMONG OTHER THINGS: (1) SPECIFIC FINDINGS OF DEFICIENCIES TO REFER TO THE SPECIFIC WRITTEN AND PUBLICLY AVAILABLE STANDARD THAT IS THE BASIS OF THE FINDING; (2) CONSISTENCY WITH THE FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES' (CMS) CONDITIONS OF PARTICIPATION FOR HOSPITALS; (3) A PROCESS AND STANDARDS TO DETERMINE IF A COMPLAINT WARRANTS AN ONSITE INVESTIGATION; (4) LIMITS TO A COMPLAINT INVESTIGATION PERFORMED BY THE DEPARTMENT TO THE SPECIFIC REGULATORY STANDARD RAISED BY THE COMPLAINT, UNLESS THERE IS AN IMMEDIATE SAFETY THREAT; AND (5) A PROCESS TO PROVIDE A HOSPITAL WITH A REPORT OF ALL COMPLAINTS MADE AGAINST IT.

SUBJECT TO APPROPRIATIONS, THE DEPARTMENT SHALL ALSO DESIGNATE ADEQUATE AND SUFFICIENT CONSULTATION AND STAFFING RESOURCES TO FACILITATE THE REQUIRED ANNUAL INSPECTION OF HOSPITALS FOR LICENSURE. THE DEPARTMENT SHALL ALSO ACCEPT A HOSPITAL INSPECTION REPORT FROM THE CMS-APPROVED ORGANIZATIONS IN LIEU OF THE DEPARTMENT'S OR OTHER GOVERNMENTAL ORGANIZATION'S ANNUAL INSPECTION REPORT AND ALSO SHALL ACCEPT SUCH HOSPITAL INSPECTION REPORT FOR LICENSURE PURPOSES IF THE ACCREDITATION INSPECTION WAS CONDUCTED WITHIN 3 YEARS, RATHER THAN 1 YEAR, OF THE MOST RECENT LICENSE RENEWAL. THIS ACT ALSO LIMITS THE SCOPE OF A GOOD CAUSE DEPARTMENTAL INSPECTION TO THE SPECIFIC REGULATORY STANDARD RAISED BY THE COMPLAINT.

A HOSPITAL AND ITS STAFF SHALL HAVE THE OPPORTUNITY TO PARTICIPATE AT LEAST ANNUALLY IN TRAINING SESSIONS PROVIDED TO STATE LICENSURE SURVEYORS AND IN THE TRAINING OF SURVEYORS ASSIGNED TO THE INSPECTION OF HOSPITALS TO THE FULLEST EXTENT POSSIBLE.

THIS ACT ALSO ESTABLISHES SPECIFIC TIMELINES IDENTICAL TO THOSE IN CMS'S STATE OPERATIONS MANUAL FOR STATE HOSPITAL OFFICIALS TO RESPOND TO A HOSPITAL REGARDING THE STATUS AND OUTCOME OF PENDING INVESTIGATIONS AND POSSIBLE REGULATORY ACTION.

HA 9 - THIS AMENDMENT MODIFIES LICENSING REQUIREMENTS FOR FUNERAL DIRECTORS, EMBALMERS, AND FUNERAL ESTABLISHMENTS AND CERTAIN REQUIREMENTS FOR PRENEED FUNERAL CONTRACTS.

THE AMENDMENT MODIFIES THE REQUIREMENTS FOR APPLICANTS FOR FUNERAL DIRECTOR AND EMBALMER LICENSES. A GENERAL EQUIVALENCY DIPLOMA, OR EQUIVALENT EDUCATION, AS DETERMINED BY THE BOARD OF EMBALMERS AND FUNERAL DIRECTORS, WILL SATISFY THE REQUIREMENT THAT A PERSON SEEKING A FUNERAL DIRECTOR OR EMBALMER LICENSE HAVE A HIGH SCHOOL DIPLOMA. AN APPLICANT FOR A LICENSE TO PRACTICE FUNERAL DIRECTING OR EMBALMING IS NO LONGER REQUIRED TO BE A MISSOURI CITIZEN OR A RESIDENT OF A COUNTY BORDERING MISSOURI. AN APPLICANT FOR AN EMBALMER'S LICENSE IS REQUIRED TO COMPLETE A FUNERAL SERVICE EDUCATION PROGRAM, RATHER THAN GRADUATE FROM AN INSTITUTE OF MORTUARY SCIENCE EDUCATION. AN APPLICANT FOR A FUNERAL DIRECTOR'S LICENSE IS REQUIRED TO COMPLETE THE APPRENTICESHIP IN TWELVE CONSECUTIVE MONTHS, RATHER THAN TWELVE MONTHS.

ALSO, FUNERAL ESTABLISHMENTS WILL NO LONGER BE REQUIRED TO KEEP THEIR REGISTER BOOK OR LOG IN THE PREPARATION OR EMBALMING ROOM. THE LOG BOOK MUST CONTAIN THE NAME OF EACH BODY THAT HAS BEEN IN THE ESTABLISHMENT, THE DATE THE BODY ARRIVED, IF APPLICABLE, THE PLACE THE BODY WAS EMBALMED, AND IF THE BODY WAS EMBALMED AT THE ESTABLISHMENT, THE DATE AND TIME OF THE EMBALMING AND THE NAME, SIGNATURE, AND LICENSE NUMBER OF THE EMBALMER.

THE AMENDMENT CHANGES THE REQUIREMENTS FOR MEMBERSHIP ON THE BOARD OF EMBALMERS AND FUNERAL DIRECTORS AND ALLOWS A MAJORITY OF THE MEMBERS OF THE BOARD TO CONSTITUTE A QUORUM AT MEETINGS.

THE AMENDMENT ALSO MODIFIES PROVISIONS THAT REGULATE PRENEED FUNERAL CONTRACTS. AMONG OTHER CHANGES, THE ACT MODIFIES REQUIREMENTS FOR INSURANCE-FUNDED PRENEED CONTRACTS, SO THAT THESE PROVISIONS APPLY TO PRENEED CONTRACTS DESIGNATED TO BE FUNDED BY DEFERRED ANNUITY CONTRACTS THAT ARE NOT CLASSIFIED AS VARIABLE ANNUITIES AND HAVE DEATH BENEFIT PROCEEDS THAT ARE NEVER LESS THAN THE SUM OF PREMIUMS PAID. THE AMENDMENT SPECIFIES THAT A TRUSTEE OF A PRENEED TRUST IS ALLOWED TO INVEST TRUST FUNDS WITH AUTHORIZED EXTERNAL INVESTMENT ADVISORS OF A TRUSTEE, SELLER, OR PROVIDER AND ALLOWS PRENEED SELLERS AND PURCHASERS TO AGREE TO PUT THE FUNDS FOR THE PRENEED CONTRACT IN AN ACCOUNT TITLED IN THE BENEFICIARY'S NAME AND PAYABLE ON THE BENEFICIARY'S DEATH TO THE SELLER. THE AMENDMENT ALSO CHANGES THE PROCEDURE FOR A FUNERAL PROVIDER TO RECEIVE FUNDS AFTER PROVIDING FUNERAL SERVICES AND MERCHANDISE AND THE PROCEDURE FOR A PURCHASER WHO WANT TO CANCEL A PRENEED CONTRACT FUNDED BY A JOINT ACCOUNT.

THIS AMENDMENT IS SIMILAR TO PROVISIONS OF HCS/SB 325 (2011), SCS/SB 340 (2011), SS/SCS/HCS/HB 265 (2011), AND HB 668 (2011).

HA 10 - THIS AMENDMENT CREATES AN INTERIM COMMITTEE ON E-PRESCRIBE TECHNOLOGY BEGINNING SEPTEMBER 1, 2011. THE COMMITTEE IS ESTABLISHED FOR THE PURPOSE OF ASSESSING THE FEASIBILITY OF IMPLEMENTING AN ELECTRONIC PRESCRIBING SYSTEM IN MISSOURI. THE COMMITTEE SHALL EVALUATE THE FEASIBILITY OF AN ELECTRONIC PRESCRIBING SYSTEM THAT CREATES TRANSPARENCY, IMPROVES HEALTH CARE-OUTCOMES AND INCREASES HEALTH-CARE DELIVERY EFFICIENCY. THE COMMITTEE SHALL INVESTIGATE THE TECHNOLOGY UTILIZED BY MO HEALTHNET DIVISION IN THEIR STATEWIDE SYSTEM. THE AMENDMENT LISTS THE COMPONENTS THAT SHOULD BE LOOKED INTO BY THE COMMITTEE.

THE INTERIM COMMITTEE ON E-PRESCRIBE TECHNOLOGY SHALL CONSIST OF THE FOLLOWING MEMBERS:

(1) FIVE MEMBERS OF THE SENATE, APPOINTED BY THE PRESIDENT PRO TEM OF THE SENATE. THREE SUCH MEMBERS SHALL BE OF THE MAJORITY PARTY AND TWO SHALL BE OF THE MINORITY PARTY;

(2) FIVE MEMBERS OF THE HOUSE OF REPRESENTATIVES, APPOINTED BY THE SPEAKER OF THE HOUSE OF REPRESENTATIVES. THREE SUCH MEMBERS SHALL BE OF THE MAJORITY PARTY AND TWO SHALL BE OF THE MINORITY PARTY.

THE DIRECTORS OF THE MO HEALTHNET DIVISION AND DEPARTMENT OF INSURANCE, FINANCIAL INSTITUTIONS AND PROFESSIONAL REGISTRATION SHALL PROVIDE TECHNICAL ASSISTANCE TO THE COMMITTEE.

THE INTERIM COMMITTEE ON E-PRESCRIBE TECHNOLOGY SHALL REPORT BACK TO THE SENATE PRESIDENT PRO TEM AND SPEAKER OF THE HOUSE OF REPRESENTATIVES THEIR FINDINGS WITH SPECIFIC RECOMMENDATIONS NO LATER THAN DECEMBER 31, 2011. THE COMMITTEE SHALL EXPIRE ON DECEMBER 31, 2011.

HSA 1 for HA 11 - UNDER THIS AMENDMENT, ANY HEALTH BENEFIT PLAN THAT PROVIDES COVERAGE AND BENEFITS FOR CANCER CHEMOTHERAPY TREATMENT SHALL NOT REQUIRE A HIGHER COPAYMENT, DEDUCTIBLE, OR COINSURANCE AMOUNT FOR A PRESCRIBED, ORALLY ADMINISTERED ANTICANCER MEDICATION THAT IS USED TO KILL OR SLOW THE GROWTH OF CANCEROUS CELLS THAN WHAT THE PLAN REQUIRES FOR AN INTRAVENOUSLY ADMINISTERED OR INJECTED CANCER MEDICATION THAT IS PROVIDED, REGARDLESS OF FORMULATION OR BENEFIT CATEGORY DETERMINATION BY THE HEALTH CARRIER ADMINISTERING THE HEALTH BENEFIT PLAN. A HEALTH CARRIER SHALL NOT ACHIEVE COMPLIANCE WITH THE PROVISIONS OF THE ACT BY IMPOSING AN INCREASE IN COPAYMENT, DEDUCTIBLE, OR COINSURANCE AMOUNT FOR AN INTRAVENOUSLY ADMINISTERED OR INJECTED CANCER CHEMOTHERAPY AGENT COVERED UNDER THE HEALTH BENEFIT PLAN. COVERAGE UNDER THIS AMENDMENT IS LIMITED TO FEDERAL DRUG ADMINISTRATION APPROVED INDICATIONS AND NATIONAL COMPREHENSIVE CANCER NETWORK RECOMMENDATIONS AND MAY BE ADMINISTERED BY A SPECIALTY PHARMACY NETWORK.

HA 12 - THIS AMENDMENT ALLOWS PHARMACISTS TO SELL AND DISPENSE CONTROLLED SUBSTANCES TO ANY PERSON UPON THE PRESCRIPTION OF A PRACTITIONER IN ANOTHER STATE.

THIS AMENDMENT ALSO REQUIRES THE DEPARTMENT OF HEALTH AND SENIOR SERVICES TO ESTABLISH AND MAINTAIN A PROGRAM FOR THE MONITORING OF PRESCRIPTIONS OF CONTROLLED SUBSTANCES.

HA 13 - THIS AMENDMENT ADDS ANOTHER REFERENCE TO AMBULATORY SURGICAL CENTERS IN THE LANGUAGE REGARDING IDENTIFICATION BADGES.

HA 14 - THIS AMENDMENT PROHIBITS POLITICAL SUBDIVISIONS FROM IMPOSING RESTRICTIONS OR ENFORCING LOCAL LICENSING OR REGISTRATION ORDINANCES WITH RESPECT TO AN INSURER'S CLAIMS HANDLING OPERATIONS AT THE TIME OF ANY EMERGENCY, CATASTROPHE, OR OTHER LIFE OR PROPERTY THREATENING EVENT.

HA 15 - CURRENT LAW ALLOWS A HEALTH CARE PROVIDER TO CONDITION THE FURNISHING OF MEDICAL RECORDS ON THE PAYMENT OF A FEE TO COVER COSTS OF COPYING, POSTAGE AND NOTARY SERVICES. THIS AMENDMENT PROVIDES THAT THE COPYING AMOUNT SHALL NOT EXCEED $21.36 PLUS 50 CENTS FOR SUPPLIES AND LABOR PER PAGE PLUS, IF THE HEALTH CARE PROVIDER HAS CONTRACTED FOR OFF-SITE RECORDS STORAGE AND MANAGEMENT, ANY ADDITIONAL LABOR COSTS OF OUTSIDE STORAGE RETRIEVAL, NOT TO EXCEED $20, AS ADJUSTED ANNUALLY PER THE CONSUMER PRICE INDEX.

IN INSTANCES WHERE THE HEALTH CARE PROVIDER STORES RECORDS IN AN ELECTRONIC OR DIGITAL FORMAT, AND PROVIDES THE REQUESTED RECORDS, INCLUDING ANY REQUESTED AFFIDAVITS, IN AN ELECTRONIC OR DIGITAL FORMAT, THE MAXIMUM COPYING AMOUNT SHALL NOT EXCEED $5 PLUS 50 CENTS PER PAGE, OR $25 TOTAL, WHICHEVER IS LESS.

THIS PROVISION IS IDENTICAL TO PROVISIONS CONTAINED IN HCS/SCS/SB 177 (2011), HCS/HB 579 (2011), HCS/HB 669 (2011).

Amendments