PRESCRIPTION EYE DROPS - This act requires a health carrier that offers or issues plans which are issued or renewed on or after January 1, 2014, that provide coverage for prescription eye drops, to provide coverage for refilling the eye drop prescription prior to the last day of the insured's dosage period without regard to a restriction for an early refill as long as the prescribing health care provider authorizes the early refill and the health carrier or health benefit plan is notified. The coverage must not be subject to any greater deductible or co-payment than other similar health care services provided by the health plan. The act exempts certain supplemental insurance policies from its provisions. This portion of the act terminates on January 1, 2017. This portion of the act is identical to SCS/SB 147 (2013) and similar to SB 622 (2012) and HB 1081 (2012) (Section 376.1237).

FEE CAPPING ON DENTAL SERVICES - This act prohibits a contract between a health carrier and a dentist from requiring the dentist to provide dental services to an insured at a fee established by the health carrier if the dental services are not covered under the plan. This portion of the act is similar to SB 281 (2013), HB 346 (2013) and HB 1050 (2012) (Section 376.1226).

EMERGENCY PRESCRIPTIONS - This act allows a pharmacist to dispense an emergency supply of medication without prior authorization from the prescriber in certain situations. The act provides that the pharmacist is to promptly notify the prescriber of the emergency dispensing. This portion of the act is also contained in SB 302 (2013) (Section 338.200).

PHYSICIAN ASSISTANTS - This act modifies the scope of practice for physician assistants. The act changes the definition of the term "supervision" by repealing the requirement that a physician assistant must work in the same facility of a supervising physician 66% of the time that the physician assistant provides care. The act states that the physician assistant is to only practice where the supervising physician routinely provides care. Supervising physicians and physician assistants also shall sign an attestation which states that the physician assistant will not practice beyond the physician assistant's training and experience. In addition, the definition of supervision provides that the physician assistant and the supervising physician shall work in the same facility for at least four hours every fourteen days of patient care.

The requirement that a physician assistant must only practice at locations within thirty miles of the supervising physician is repealed. The act provides that under a supervision agreement a physician assistant may practice at locations which are fifty miles from the supervising physician.

In the case of physician-physician assistant teams, no supervision requirements beyond federal law requirements are necessary for the teams to practice in a rural health clinic.

The act rescinds the requirement that prescriptions shall have the supervising physician's name, address, and telephone number when the controlled substance is prescribed by a physician assistant.

The act modifies the definition of "physician assistant supervision agreement" by adding that the agreement must contain certain elements defined in the act including complete contact information of both the supervising physician and physician assistant, list of locations where the physician assistant is authorized to practice, and the manner of supervision provided.

This portion of the act is also contained in SB 219 (2013) (Section 334.735).

PHARMACY PERMITS - This act adds four classes of pharmacy permits: Class M specialty, Class N Automated dispensing system for a health care facility, Class O automated dispensing system for ambulatory care, and Class P practitioner office/clinic. This portion of the act is also contained in SB 303 (2013) (Section 338.220).

ATHLETIC TRAINER'S LICENSE - This act allows the Missouri Board of Healing Arts to restrict or limit a persons athletic trainer's license for an indefinite period of time, as well as revoke a person's license. This portion of the act is also contained in SB 304 (2013) (Section 334.715).

PHYSICIAN LICENSE EXAMINATIONS - This act provides that applicants for a physician's license who graduated from an approved medical college prior to January 1, 1994, must provide proof of successfully completing specified exams. Applicants who graduated on or after January 1, 1994, must provide proof of completing the United States Medical Licensing Examination (USMLE), an exam administered by the National Board of Osteopathic Medical Examiners, or compliance with certain certifying boards specified in the act. This portion of the act is also contained in SB 305 (2013)(Section 334.040).

TESTING OF PHARMACEUTICALS - Currently, authorized personnel of the Board of Pharmacy may enter and inspect premises selling drugs or chemicals. This act allows for the testing of drugs maintained by licensees of the Board. The Board shall pay for the cost of testing. This portion of the act is also contained in SB 306 (2013) (Section 338.150)

BOARD OF NURSING DISCIPLINARY ACTIONS - Currently, the State Board of Nursing may file a complaint against a licensee for certain causes with the Administrative Hearing Commission. This act adds additional causes to the list.

This act provides that for certain causes the Board may request an emergency suspension or restriction of a person's license with the Commission. The act describes the process for the proceedings that the Board and the Commission must follow, and how many days the Commission has to answer the complaint and render a decision. If the Commission does not find probable cause and does not grant the emergency suspension then the Board must remove all references to the proceedings from public record.

The Board may also initiate before the Board a hearing for discipline of a licensee's license when certain causes exists.

This portion of the act is also contained in SB 370 (2013) (Section 335.066).

UTILIZATION OF TELEHEALTH BY NURSES - This act changes the laws regarding advanced practice registered nurses (APRNs). By January 1, 2014, the Board of Registration for the Healing Arts in the Division of Professional Registration within the Department of Insurance, Financial Institutions and Professional Registration and the State Board of Nursing in the division must establish the Utilization of Telehealth by Nurses. An APRN who provides nursing services under a collaborative practice arrangement is permitted to provide the services using telehealth if the geographic proximity requirements of the collaboration arrangement prevents the nurse from providing services in a rural area located in a health professional shortage area in Missouri. All telehealth providers are required to obtain patient consent before telehealth services are initiated and ensure confidentiality of medical information. This provision is also contained in HB 936 (2013) (Section 335.175).

STEPHEN WITTE