Newsletters

POSTED: June 26th, 2020
POSTED IN: EM Pulse - The Official Newsletter of MOCEP, May/June 2020,

The Missouri Legislature adjourned for the year in mid-May.  While the constitution dictated the 6:00 p.m. stop time on May 15, the Governor has indicated that he MAY use his power to bring the legislature back into session for a few key items. First, he wants to better assess the economic conditions of the state in early summer and then he wants to determine if the federal government will pass round four stimulus package.

If both indicators lead him to call a special session, then two issues, possibly three, will be included in “The Call”, a document outlining what may be debated during the special session. First, a supplemental budget bill to back fill cuts made during the regular appropriation process in early May; second, enact an online sales tax, to help state revenues and alleviate some of the price gap between the local retailers and on-line merchants; and third, possibly a COVID-19 liability reduction act, to convey additional protections to businesses/health care providers for COVID-19 related actions or inactions. This bill was discussed at the end of session, and we pushed the bill hard, but the trial bar said that since the legislature had already passed a tort bill this session, they would not allow the COVID-19 liability reform bill to progress unless they received concessions on the larger tort reform package.

That was a trade no one in the tort coalition entertained. The business and health care groups met again shortly after session to discuss a plan, both language and strategy, to enact reasonable reforms related to anticipated COVID-19 litigation.

Here is a rundown of the issues MOCEP was following:

MOCEP Priorities

• Overpayments(passed) – HB1682 was sponsored by Rep Mike Henderson and Senator Wayne Wallingford. Both Sen Wallingford and Rep Mike Henderson have been great supporters of the health care community.  This bill received some opposition late in session from insurance companies. The bill, which requires the health carrier to inform the provider which service and for which patient the recoupment is being made in addition to prohibiting recoupments being made from providers other than the one that was overpaid. 
• Credentialing (passed)– HB1682 –  During the COVID-19 break we met with the insurance lobbyists and reached a deal.  The insurers were attempting to get to a middle ground on a prompt pay issue, and in exchange were willing to give providers changes to their clunky credentialing process.  The bill was nearly derailed by the KC Blues, however their opposition was not enough to block the bill. There was one final concession on the locum tenens provision, which limited the 60 day credentialing exemption for only instances when the ordinary provider had an illness/condition/situation recognized by the Family Medical Leave Act. The bill also required providers who applied for credentialing with a health carrier to be reimbursed for care they delivered to the insurers patient during the credentialing process.
• Prompt Pay – The second half to the “credentialing” deal, also in HB182, was to revise the prompt pay law. This is very useful to us being able to collect downcoded claims, as interest and penalties are now specifically assessed on claims or “portions of claims” not paid, but subsequently paid due to an appeal with the carrier. The current law references filing your appeal in court, however most claims are dealt with in the health carrier appeal process.
• Rep Grier’slicensing reciprocity bill This bill requires boards to issue licenses to practitioners if they are licensed in another state with the same or higher educational requirements and have no disqualifying disciplinary issues.
• PDMPsat on the calendar for too long and opposition mounted, that was simply too great to overcome.  The democrats pulled several of their votes due to an issue that became a non-issue, which sent the bill back to the Senate where it never recovered.
• The legislaturedrafted a competing ballot measure to the health care coalition’s Medicaid Expansion, but the six-week break in session doomed this proposal.   
• SB689 (passed) – Under this act, no board, commission, or committee within the Division of Professional Registration shall utilize occupational fees, or any other fees associated with licensing requirements, or the purpose of offering continuing education classes.
• Rep Steve Helms presentedHB2379, which allows a child to remain on Medicaid for a full 12 months once enrolled, so their care is not disrupted by quarterly means tests. We testified in support, but the bill did not have enough support to be placed on the short list when the legislature returned for their last three weeks of session.
• Helmet Repeal was passed in a last day deal to move a transportation bill forward, after the House sent over another version that required the Senate to use a procedure to “unpass” a bill. I had not seen this done before.  The helmet bill requires $1M insurance coverage and applies the rule to those 26 and older.
• The Assistant Physician bill was heard in committee allowing for an alternative path to physician licensure.  MOCEP testified in opposition and the bill failed in committee.
• Several Nurse bills were filed and Rep Eric Burlison’s version, which would have essentially detached the nurse from the physician if the APRN takes that path. The bill ended its journey for the year as once again, the entire nurse and physician community could not get to an agreement.
• HB 2086 was the forensic evidence collection legislation that Dr. Sampson testified against. The bill would have required any entity that operates an emergency room to provide three hours of annual training on collection of forensic evidence; possess and maintain a secure storage unit capable of storing forensic evidence collected during the course of treatment of a gunshot wound patient or a stab wound patient; require a physician, surgeon, nurse, or other specified health care professional who treats a person for a stabbing wound that is at least one inch deep to report the wound to local law enforcement; and more. Luckily this bill did not pass.