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Last May concluded the 98th General Assembly’s regular legislative session. Unlike last year, both chambers continued to truly agree and finally pass legislation during the final week and days.

Several omnibus health care policy bills are now on their way to Governor Nixon’s desk. SB 607 was passed which includes language requiring the Department of Social Services to contract with a third party to determine public assistance eligibility by January of 2017, a provision that subject to appropriations MO HealthNet providers of behavioral, social, and psychophysiological services, including psychologists, shall be reimbursed for the prevention, treatment, or management of physical health problems, changes to the Joint Committee on MO HealthNet which will have the committee study, monitor and review efficacy of public assistance programs and make recommendations to the General Assembly.

SB 608 also by Senator Sater was sent to the Governor. This bill contained provisions around meningococcal vaccinations, the “Health Care Cost Reduction and Transparency Act” which requires health care providers to provide, upon a patient’s written request, including a medical treatment plan from the patient’s health care provider, an estimate of cost of a particular health care service within 3 business days. This bills also contained the language that would establish the Missouri Palliative Care and Quality of Life Interdisciplinary Council and the Palliative Care Consumer and Professional Information and Education Program. Furthermore this bill contained language on missed appointment fees for MO HealthNet participants, changes to the administrative rules regulating the construction of hospitals and a provision that would require state owned hospitals, expect for psychiatric hospitals to obtain a certificate of need, language that would create a physical therapist compact, a new nurse licensure compact, insurance coverage for occupational therapy services and the authorization of co-payments from providers to  MO HealthNet participants.

Senator Hegeman’s SB 635, carried by Representative Robert Cornejo in the House which included the palliative care language from SB 608, language on investment of funds by municipal hospitals, dyslexia screening, CPR curriculum, the prohibition of rules that would require hospitals to place fences around their helipads and a provision that would require the state to contract for a health care workforce data analysis.

Also passed was SB 988 sponsored by Senator Kraus. This bill started out with just the language that any rules and regulations promulgated by the Department of Health and Senior Services, or any interpretation of such rules, shall not require hospitals to have a fence or other barriers around a hospital helipad. Additionally, the Department shall not promulgate any rules and regulations with respect to the operation or construction of a helipad located at a hospital. Finally, hospitals shall ensure that helipads are free of obstruction and safe for use by a helicopter while on the ground, during approach, and takeoff. This legislation grew to include the language on invest of funds by hospitals, background checks for ambulance district employees, the CON language for state owned hospitals and also provisions around alternative stroke center designations.

The only other “must pass” piece of legislation outside of the budget, finally crossed the finish line on the last day of session. This was HB 1534 sponsored by Representative Tom Flanigan which would extend the Ground Ambulance, Nursing Facility, Medicaid Managed Care Organization, Hospital, Pharmacy, and Intermediate Care Facility for the Intellectually Disabled federal reimbursement allowance taxes. This self-imposed taxes are used to draw more federal dollars into Missouri’s Medicaid budget. Without this extension, there would be a very large hole the budget. While the Senate Ways and Means Committee reduced the extension to only one year, during debate on the Senate floor, the Senate Committee Substitute was defeated and taken back to a two year extension which was then sent on to Governor Nixon.

There is also a fairly big laundry list of issues that failed to cross the finish line this year. Representative Holly Rehder’s PDMP legislation again failed in the Senate after no agreement could be made on what language to include if it went to a vote on the ballot. Representative Joe Don McGaugh was successful in amending the Adult Health Care Decision Maker Act onto several pieces of legislation during the final weeks, but we were successful in stripping the language in conference on every bill it was amended to. Representative Kidd’s “Simon’s Law” also never gained traction.

Long term care certificate of need reform language failed to make it to the Governor’s desk even as it attached to two house bills late in session.  One of the two bills was brought up for discussion and presented by Senator Pearce.  Senator Schaaf expressed concern over the length of the moratorium and the purpose of the task force. There was some discussion of taking the moratorium provision out and simply having a task force but the healthcare association seemed to have some senators keyed up to require both or nothing.  Senator Onder expressed great concern over the moratorium as well and the bill was laid over.  The second bill that contained the language was brought up, however, a sub was offered that stripped it out.  It was likely done as a result of the previous debate on the issue.

The legislature will return in September for their annual veto session. Governor’s Nixon’s office is already conducting bill review with a close eye on the fiscal notes of each bill if the budget where needed to be brought in line if certain bills were enacted over a veto. Speaker Richardson has already said that a ban on lobbyist gifts will be the first bill out of the House come 2017.