Missouri Senate

House Committee Substitute

This act provides that every state administrative rule shall be subject to a periodic review by the appropriate state agency every five years. The act creates a schedule for the periodic review of rules by their title in the Code of State Regulations. The Joint Committee on Administrative Rules (JCAR) shall cause notice to be published in the Missouri Register indicating the rules to be reviewed and also notice of the 60 day comment period. Each agency with rules under review shall prepare a report with the results of the periodic rule review. The report shall consider whether the rule: continues to be necessary or is obsolete; duplicates, overlaps or conflicts with other state, federal or local rules; needs changes or should be rescinded in order to reduce regulatory burdens on businesses, individuals or political subdivisions, or to eliminate unnecessary paperwork; and whether a less restrictive, more narrowly tailored rule could adequately protect the public or accomplish the same statutory purpose. For rules that affect small business, the agency must consider the specific public purpose or interest for adopting the rules and other reasons to justify its continued existence.

The subject agency must file its report with JCAR and the Small Business Regulatory Fairness Board within one year of notice being filed by JCAR in the Missouri Register. If the agency does not file the report, and does not receive an extension for good cause, then JCAR must notify the Secretary of State to publish notice in the Register as to the rules that are delinquent. The rules shall be void after the first sixty legislative days of the General Assembly's next regular session unless the agency cures the delinquency by providing the required report within 90 days after publication in the Register.

If a petition is filed with an agency requesting the adoption, amendment or rescission of a rule, the agency shall respond within 60 days with its determination as to whether a rule should be adopted, amended, or removed. Copies of the agency response shall be sent to JCAR and the Commissioner of Administration. A written petition shall constitute the required notice for purposes of current law provisions authorizing attorney fees and expenses in cases where an agency's actions were based on a statement of general applicability that should have been promulgated as a rule.

The act removes the requirement in current law that every agency with rules that affect small business must submit a list of such rules and a report to the General Assembly the and Small Business Regulatory Fairness Board every two years. This report contains the same information required in bill as part of the periodic review of all administrative rules.

This act 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; (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 a documented immediate and serious threat, as defined directly and through interpretive guidelines included in hospital licensure regulations; and (5) A process to provide a hospital with a report of all complaints made against it.

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 three years, rather than one 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.

These provisions are identical to SS/SCS/SB 621 (2012) and substantially similar to HB 1123 (2012) and HCS/HB 579 (2011).

This act is similar to SB 350 (2011) and HCS/HB 697 (2011).

JIM ERTLE