Capitol Report | August 25th, 2016

Health Care Changes in Missouri

As promised, over the next few weeks I will continue to provide brief overviews of some of the issues likely to take center stage during the upcoming Veto Session this September.

Last month, Governor Nixon vetoed SB 608, sponsored by Sen. Sater, which contained several significant proposed changes to health care in Missouri.

Under current law, the Department of Health and Senior Services must develop an informational brochure, available to students at institutions of higher education, relating to meningococcal disease. This act requires such brochures to state that immunizations against the disease are available and to include information on all vaccines receiving Category A or B recommendations from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention. Under current law, every public institution of higher education in Missouri must require all students residing in on-campus housing to have received the meningococcal vaccine, unless an exemption applies. This act would require all such students to have received the vaccine not more than 5 years prior to enrollment and in accordance with the latest recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.

SB 608 also establishes 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 estimate shall be accompanied by specified language. If health care providers provide the patient with a link to the estimated costs or post such costs on a publicly available website, such entity shall not be required to provide cost estimates to patients upon written request.

The bill also states, among other provisions, that beginning October 1, 2016, the Department of Social Services shall require MO HealthNet participants to pay an eight dollar co-payment fee for use of a hospital emergency department for the treatment of a condition that is not an emergency medical condition. The Department shall promulgate rules for the implementation of this provision.

Time will tell whether these provisions will become law when the General Assembly reconvenes on Sept. 14th for the annual veto session.

You may read in more detail about what is happening at your State Capitol below.

As always, I will work diligently for you as your State Representative.

-Jason

 

As promised, over the next few weeks I will continue to provide brief overviews of some of the issues likely to take center stage during the upcoming Veto Session this September. Last month, Governor Nixon vetoed SB 608, sponsored by Sen. Sater, which contained several significant proposed changes to health care in Missouri. The following topics are several of those provisions.

Vaccinations

Under current law, the Department of Health and Senior Services must develop an informational brochure, available to students at institutions of higher education, relating to meningococcal disease. This act requires such brochures to state that immunizations against the disease are available and to include information on all vaccines receiving Category A or B recommendations from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention. Under current law, every public institution of higher education in Missouri must require all students residing in on-campus housing to have received the meningococcal vaccine, unless an exemption applies. This act would require all such students to have received the vaccine not more than 5 years prior to enrollment and in accordance with the latest recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.

Additionally, this act defines “on-campus” housing as including any fraternity or sorority residence, privately owned or not, on or near the campus of a public institution of higher education. Under this act, each year between October 1 and March 1, all licensed long-term care facilities shall assist their health care workers, volunteers, and other employees who have direct contact with residents in obtaining a vaccination for the influenza virus by either offering a vaccination in the facility or providing information as to how they may independently obtain a vaccination.

Health Care Cost & Transparency Act

This provision, known as the “Health Care Cost Reduction and Transparency Act,” 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 estimate shall be accompanied by specified language. If health care providers provide the patient with a link to the estimated costs or post such costs on a publicly available website, such entity shall not be required to provide cost estimates to patients upon written request.

Beginning July 1, 2017, hospitals shall make available to the public the amount that would be charged without discounts for each of the 100 most prevalent diagnosis-related groups. No health care provider shall be required to report information under this provision if such reporting could reasonably lead to the identification of a person receiving health care services in violation of the Health Insurance Portability and Accountability Act of 1996 or other federal law. These provisions shall not apply to emergency departments that are required to comply with the Emergency Medical Treatment and Active Labor Act. Finally, this act requires health care providers located in certain Kansas border counties to comply with these provisions in order to become a MO HealthNet provider.

MO HealthNet Co-Payments

Beginning October 1, 2016, the Department of Social Services shall require MO HealthNet participants to pay an eight dollar co-payment fee for use of a hospital emergency department for the treatment of a condition that is not an emergency medical condition. The Department shall promulgate rules for the implementation of this provision.

MO HealthNet Missed Appointment Fees

This provision permits fee-for-service MO HealthNet health care providers, to the extent permitted by laws pertaining to the termination of patient care, to charge a missed appointment fee to MO HealthNet participants that such participants must pay before scheduling another appointment with that provider. The fee may be charged for missed appointments or for failing to cancel an appointment within 24 hours prior to the appointment. The permissible fees are as follows: No charge for the first missed appointment in a three-year period, $5 for the second missed appointment in a three-year period, $10 for the third missed appointment in a three-year period, and $20 for the fourth and each subsequent missed appointment in a three-year period. Health care providers shall waive the fee in cases of inclement weather. The health care provider shall not charge to nor shall the MO HealthNet participant be reimbursed by the MO HealthNet program for the missed appointment fee.

Joint Committee on Public Assistance

This act modifies the Joint Committee on MO HealthNet to create a permanent Joint Committee on Public Assistance. The committee shall have the following purposes: (1) studying, monitoring, and reviewing the efficacy of public assistance programs within the state, (2) determining the level and adequacy of resources needed for the programs, and (3) developing recommendations on the public assistance programs and on promoting independence from safety-net programs among participants as may be appropriate. The committee shall receive and obtain information from the departments of Social Services, Mental Health, Health and Senior Services, Elementary and Secondary Education, and any other department as applicable, regarding projected enrollment growth, budgetary matters, trends in childhood poverty and hunger, and any other information deemed relevant to the committee’s purpose. The directors of the departments of Social Services, Mental Health, and Health and Senior Services shall each submit an annual written report providing data and statistical information regarding the caseloads of the Department’s employees involved in the administration of public assistance programs.

Emergency Supplies of Medication

This act provides that only a licensed pharmacist can make the determination to dispense an emergency supply of medication without the authorization from the prescriber.

Maintenance Medication

This act provides that a pharmacist may dispense varying quantities of maintenance medication per fill up to the total number of dosage units as authorized by the prescriber, unless the prescriber has specified that dispensing a prescription for maintenance medication in an initial amount is medically necessary. When the dispensing of the maintenance medication is based on refills then the pharmacist shall dispense no more than a 90 day supply and the patient must have already been prescribed the medication for 3 months.

Health Care Price Transparency

Under this provision, no contract provision between a health carrier and a health care provider shall be enforceable if such provision prohibits, conditions, or in any way restricts any party to such contract from disclosing to an enrollee the contractual payment amount for a health care service if such payment amount is less than the health care provider’s usual charge for the health care service, and if such contractual provision prevents the determination of the potential out-of-pocket cost for the health care service by the enrollee.

I am committed to serve the constituents of the 120th District, so please feel free to contact my office anytime at 573-751-1688. Your District 120 Capitol Office is 201 W Capitol Ave, Rm 115-H, Jefferson City, MO 65101.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s