Missouri Senate

House Committee Substitute

IMPOSITION OF ABORTION, CONTRACEPTION OR STERILIZATION SERVICES (Sections 191.724 and 376.1199)

This act provides that notwithstanding any other provision of law to the contrary, no employee, self-employed person, or any other person shall be compelled to obtain coverage for, or be discriminated against or penalized for declining or refusing coverage for, abortion, contraception, or sterilization in a health plan if such items or procedures are contrary to the religious beliefs or moral convictions of such employee or person.

No employer, health plan provider, health plan sponsor, health care provider, or any other person or entity shall be compelled to provide coverage for, or be discriminated against or penalized for declining or refusing coverage for, abortion, contraception, or sterilization in a health plan if such items or procedures are contrary to the religious beliefs or moral convictions of such employer, health plan provider, health plan sponsor, health care provider, person, or entity.

No such employee, self-employed person, employer, health plan provider, health plan sponsor, health care provider, or any other person or entity shall be discriminated against by any governmental entity, public official, or entity acting in a governmental capacity for failing to obtain or provide coverage for, pay for, participate in, or refer for such coverage because of such religious beliefs or moral convictions.

CONSCIENCE PROTECTION FOR MEDICAL PROFESSIONALS AND HEALTH CARE INSTITUTIONS (Sections 191.1150 to 191.1168)

This act provides medical freedom of conscience protection for medical professionals and health care institutions with respect to the provision and participation of specified medical procedures or research. "Specified medical procedures or research" is defined as "abortion, abortion-inducing drugs, contraception, sterilization which is not medically necessary, assisted reproduction, human cloning, human embryonic stem-cell research, human somatic cell nuclear transfer, fetal tissue research, and non-therapeutic fetal experimentation and no longer includes any phase of patient medical care." Medical professional is defined as a physician, physician's assistant, registered nurse, licensed practical nurse, advanced practice registered nurse, certified nurse practitioner, medical assistant, medical researcher, medical or nursing school faculty, student or applicant for studies or training in any program in the health care professions. The definition for health care institution is in the act as well.

No medical professional or health care institution shall be civilly, criminally, or administratively liable for declining to participate in or provide specified medical procedures or research that violates the professional's or institution's conscience. However, a health care institution shall provide a consent form to be signed by a patient before admission to the institution stating that it reserves the right to decline to provide such specified medical procedures or research.

"Conscience" is defined as religious, moral or ethical principles. For purposes of this act, a health care institution's conscience shall be determined by reference to its existing or proposed religious, moral, or ethical guidelines, mission statement, constitution, bylaws, articles of incorporation, regulations, or other relevant documents. A medical professional's conscience means a sincere and meaningful belief in God or in relation to a supreme being, or a belief which, though not so derived, occupies in the life of its possessor a place parallel to that filled by God among adherents to religious faiths.

It shall be unlawful for a medical professional or health care institution to be discriminated against based on the professional or institution declining to participate in specified medical procedures or research that violate the professional's or institution's conscience. The act prescribes the list of prohibited discrimination against a medical professional or institution. An employee asserting a right not to participate in specified medical procedures or research shall provide reasonable notice under the circumstances of his or her intent not to participate.

A cause of action for damages or injunctive relief, or both, may be brought for the violation of any provision of this act. It shall not be a defense to any claim arising out of the violation of this act that such violation was necessary to prevent additional burden or expense on any other medical professional, health care institution, individual or patient. It shall be an affirmative defense for an employer that the specified medical procedure or research was so integral to the duties of the employee's position and to the central business purpose of the business or enterprise that a reasonable person would understood that participating in the specified medical procedure or research at issue was a requirement of the employee's position.

Upon a finding of a violation of this act, the aggrieved party shall be entitled to treble damages, including pain and suffering, the costs of the action and reasonable attorney's fees. In no case shall recovery be less than five thousand dollars for each violation in addition to the costs of the action and reasonable attorney's fees.

Nothing in the act shall be construed to authorize any medical professional or health care institution to withhold emergency medical treatment or services imminently necessary to save the life of a patient under the professional's or institution's care. Nor shall the act be construed to relieve a medical professional from any duty which may exist under current law to inform a patient of the risks, prognosis, medical options and resources available to the patient, including information required to be given under the abortion regulation chapter.

The General Assembly may, by concurrent resolution, appoint one or more of its members who sponsored or co-sponsored this act in his or her official capacity, to intervene as a matter of right in any case in which the constitutionality of this law is challenged. This act contains a severability clause.

These provisions are substantially similar to SCS/HCS/HB 1541 (2012) and to SCS/SB 657 (2012).

PHARMACY INVENTORY REQUIREMENTS (Section 338.255)

This act states that Missouri licensed pharmacies cannot be required to carry or maintain an inventory of any specific drug or device.

This provision is identical to HB 1075 (2012) and to a provision in HCS/SS/SB 742 (2012).

ADRIANE CROUSE