May 24th, 2016
What Passed and What Did Not
Telehealth Authorization (SB 579) – This bill gives statutory authority and provides parameters for the use of telehealth services. This includes the establishment of the physician-patient relationship, standard of care, and the use of store-and-forward technologies. It also allows a framework for the use of these technologies in the MO HealthNet program. This language was passed as an amendment to another bill a couple of weeks before the end of the session. The original bills became expendable after they were weighed down with other amendments.
Collateral Source Rule (SB 847) – This tort reform effort requires damages be calculated using the actual cost of healthcare services, rather than the value of those services. It will help suppress high verdicts based on the subjective value, and constrain damages awards to what the plaintiff actually paid for their care. We expect this bill to be vetoed, and an override to be attempted in September.
Naloxone (HB 1568) – This bill allows for the sale of naloxone by pharmacists under a physician protocol to individuals and organizations who have a standing order to store and dispense it. It also provides immunity to people who use naloxone on an individual they believe is suffering from an opioid-related overdose.
Pediatric Specialty Reimbursement Bump (HB 2011) – The state budget wonks found it permissible to earmark approximately $4.4 million in a MO HealthNet reimbursement bump for maternal-fetal medicine, neonatology, and pediatric cardiology.
Step Therapy (HB 2029) – Among other things, this language requires health plans to provide physicians with a convenient process to request step therapy overrides. Although not as robust as we would have liked, this bill does provide a good framework for future amendments.
Medication Synchronization (SB 865) – This bill forces health plans to offer services that allow patients to synchronize the fills of their medications without charging an amount in excess of the applicable co-payments.
CDB Oil Liability (HB 1682) – This language gives civil, criminal, and professional immunity to physicians who choose to prescribe CDB oil.-This would be a chemical found in marijuana. Of course, it is still schedule 1 by federal law.
Emergency Medicine CME (SB 988) – This bill gives sole authority to the Board of Healing Arts in establishing continuing medical education requirements for emergency medicine physicians practicing in STEMI, stroke, or trauma designated ERs.–This may be huge as may allow for us to ged rid of many of the onerous TCD CME requirements.
What Failed…Which Is Not Necessarily a Bad Thing
Helmet Repeal – The bill represented the annual attempt to repeal the state’s motorcycle helmet law. It received about 45 minutes of debate on the second to last day of the session, but never made it out of that chamber.
APRN Licensure and Scope – This bill would have established a licensure category for advanced practice registered nurses. It also contained a broad definition of their scope of practice. It was added as an amendment in a few places but never made it to the Governor.
Collaborative Practice -Attacks on the collaborative practice act were put in many bills at the end of session. There were efforts to completely eliminate the 50-mile proximity rule, change the familiarity rule and record review, and to increase the number of APRNs a physician can collaborate with from three to five. None made these across the finish line.
Drug Monitoring Program – Missouri will remain the only state without a much-needed prescription drug monitoring program. The House of Representatives sent a good bill over to the Senate, who waited until the last week to give it about twenty minutes of floor discussion before killing it.
Epipens – This bill would have allowed restaurants and theme parks to stock a supply of epipens under a physician protocol. This issue was the underlying bill in a conference committee report, but the Senate never took it up.
BNDD Funding – This amendment would have created a fund to provide the Bureau of Narcotics and Dangerous Drugs the ability to hire additional inspectors and provide more provider education opportunities. It was added to a few bills in the House but never had enough support to pass both chambers.
Concussions – This bill would have allowed a student with a suspected concussion to return to the game if they pass a sideline test. It received a hearing in the Senate, but made it no further.
Tobacco/Allocable Share – This bill would have required small tobacco companies who were not a party to the Master Settlement Agreement to contribute funds in order to pay off any future claims. This bill received a Senate hearing, but it got a late start and never gained any traction after that.
May 11th, 2016
Christine Sullivan, MD, FACEP, Receives MOCEP R.R. Hannas Physician of the Year Award
Christine Sullivan, MD, FACEP, was presented the Missouri College of Emergency Physician’s (MOCEP) R.R. Hannas Physician of the Year Award at the Annual Membership Meeting on May 5, 2016, in Springfield, Mo. She was nominated by Matthew Gratton, MD, of the UMKC School of Medicine and Truman Medical Center.