The Capitol Report | July 20th, 2017

Governor Issues ‘PDMP’ Executive Order

Governor Greitens recently issued an executive order to create a prescription drug monitoring program in Missouri. However, the system put in place by the governor is markedly different from the plan proposed by the legislature earlier this year and other drug monitoring programs across the country. Specifically, the governor’s plan calls for the Department of Health and Senior Services to create a database that will target “pill mills” that pump out prescription drugs at “dangerous and unlawful levels.” The department will work with private sector partners to obtain de-identified data that can be used to target abusers.

The plan adopted earlier this year by the House would have tracked when patients are prescribed opioids and allowed doctors to have access to data so they could look for signs of abuse. The governor’s plan does not put information in the hands of physicians, but rather focuses the data collection effort on those who prescribe and distribute addictive prescription medications. Some opponents have mentioned, as a result, the governor’s program does not prevent “doctor-shopping”, which is the practice of visiting multiple physicians to obtain more than an allotted amount of a medication or prescription. Moreover, opponents have pointed out that regardless of whether one is for or against the actual subject matter of the governor’s program, the executive order could be a form of legislating—a power reserved for the legislative branch not the governor’s office.

The differences in the original program and the governor’s program prompted the House sponsor of the original PDMP legislation to say, “It’s of the utmost importance, in order to treat addiction – which is at the core of this epidemic – for our medical professionals to be able to see this data.  We need to be able to catch addiction on the front end and that’s what the traditional PDMP does.”

Right now more than 26 counties and jurisdictions around the state have a more traditional PDMP system in place. The sponsor of the PDMP legislation says approximately 60 percent of Missourians are already living in an area with a monitoring program. The sponsor said she will also look at filing her PDMP bill again next session to supplement the governor’s plan in order to create a more substantive effort to fight the opioid crisis.

The governor’s program will now be put in place by the Department of Health and Senior Services at a startup cost of approximately $250,000. The department will enter into a contract with Express Scripts to establish the program, and will need to add additional staff to administer it. The money for the program will come from the Department of Social Services under Medicaid.

Also, as promised, below is a brief summary of more bills the legislature has passed this regular session. More passed bill summaries will follow in the weeks to come.

SB 8 (Signed by Governor 6/28) Modifies the law relating to flashing lights on motor vehicles and equipment

SB 16 (Signed by Governor 7/5) Exempts delivery charges from sales and use taxes

SB 19 (Signed by Governor 2/6) – Creates new provisions of law relating to labor organizations

SB 31 (Signed by Governor 7/5) Modifies provisions relating to the collateral source rule and provides that parties may introduce evidence of the actual cost, rather than the value, of the medical care rendered

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

 

Governor Issues ‘PDMP’ Executive Order

Governor Greitens recently issued an executive order to create a prescription drug monitoring program in Missouri. However, the system put in place by the governor is markedly different from the plan proposed by the legislature earlier this year and other drug monitoring programs across the country. The governor’s plan, though, still asserts to possess the same intent of preventing the over-prescribing and misuse of opioids such as Vicodin, OxyContin, and Percocet. Specifically, the governor’s plan calls for the Department of Health and Senior Services to create a database that will target “pill mills” that pump out prescription drugs at “dangerous and unlawful levels.” The department will work with private sector partners to obtain de-identified data that can be used to target abusers.

The plan adopted earlier this year by the House would have tracked when patients are prescribed opioids and allowed doctors to have access to data so they could look for signs of abuse. The governor’s plan does not put information in the hands of physicians, but rather focuses the data collection effort on those who prescribe and distribute addictive prescription medications. Some opponents have mentioned, as a result, the governor’s program does not prevent “doctor-shopping”, which is the practice of visiting multiple physicians to obtain more than an allotted amount of a medication or prescription. Moreover, opponents have pointed out that regardless of whether one is for or against the actual subject matter of the governor’s program, the executive order could be a form of legislating—a power reserved for the legislative branch not the governor’s office.

The differences in the original program and the governor’s program prompted the House sponsor of the original PDMP legislation to say, “It’s of the utmost importance, in order to treat addiction – which is at the core of this epidemic – for our medical professionals to be able to see this data.  We need to be able to catch addiction on the front end and that’s what the traditional PDMP does.”

Right now more than 26 counties and jurisdictions around the state have a more traditional PDMP system in place. The sponsor of the PDMP legislation says approximately 60 percent of Missourians are already living in an area with a monitoring program. The sponsor said she will also look at filing her PDMP bill again next session to supplement the governor’s plan in order to create a more substantive effort to fight the opioid crisis.

The governor’s program will now be put in place by the Department of Health and Senior Services at a startup cost of approximately $250,000. The department will enter into a contract with Express Scripts to establish the program, and will need to add additional staff to administer it. The money for the program will come from the Department of Social Services under Medicaid.

What Missourians Need to Know about REAL ID

Missourians can keep using state licenses at federal facilities and airports through October 10, but it could be up to two years before REAL ID compliant Missouri IDs are available under a law that goes into effect in August.

The federal REAL ID Act was passed after the September 11, 2001 terrorist attacks.Missouri in 2009 adopted a law barring compliance with that Act based on concerns about citizens’ privacy because the act required them to produce source documents to be stored electronically. Because Governor Greitens signed into law last month a bill that would give Missourians who want Real ID compliant licenses the option of getting one, the federal government granted an extension giving the state through October to comply with the REAL ID Act.

The bill’s sponsor said Missouri will continue seeking federal extensions until everything is in place to make compliant IDs available.said in considering further extensions the Department of Homeland Security will look for evidence that Missouri is moving toward compliance, and the implementation ofBill 151provide that. He said the state will be able to show DHS what the Department of Revenue is doing and the steps they are taking to move toward compliance.

Missouri will need to seek another waiver by January, or at that time current Missouri licenses would not be accepted to get through federal security. Eventually Missourians who want or need to be able to get through federal security will have to have Real ID compliant licenses.HB 151 lets those Missourians get such IDs.Those who don’t need them won’t have to go through the act’s more stringent proof-of-identity requirements if they don’t want to.

The sponsor said it’s not clear how soon compliant Missouri licenses will be available. He said the Department of Revenue has indicated it could take up to two years but he is hopeful the department will be able to implement the new IDs within a year. The REAL ID bill sponsor said there’s nothing Missourians need to do or be concerned about right now, but said those with further questions should contact the Department of Revenue.

Truly Agreed To & Finally Passed Bills

Now that both the regular and first special legislative sessions have come to an end, the legislature stands at a little over 75 bills that have been Truly Agreed to and Finally Passed (TAFP). These bills now await the Governor’s approval or veto. These TAFP bills span a variety of topics. Below is a brief summary of a few more TAFP bills. As promised, more TAFP bill summaries will follow in the weeks to come.

SB 8 (Signed by Governor 6/28) – Modifies the law relating to flashing lights on motor vehicles and equipment

This act establishes a five cent per gallon motor fuel tax on propane fuel used to propel motor vehicles, to be increased to seventeen cents per gallon by January 1, 2025. Owners and operators of propane-fueled vehicles may continue to apply for and use alternative fuel decals in lieu of paying the motor fuel tax. This act also changes what entity may designate the roads on which a 14-foot length limit applies; and who shall issue permits for the movement of sludge disposal units, pump trucks, well-driller’s equipment, and utility wires, poles, and equipment; from the chief engineer of MODOT to the Missouri Highways and Transportation Commission. Additionally, this act provides that agricultural machinery and implements may be operated on state highways between the hours of sunset and sunrise for agricultural purposes provided such vehicles are equipped with lighting meeting the requirements of RSMo 307.115.

Among other provisions, this act also changes lighting regulations for service vehicles. Under current law, motor vehicles and equipment owned by the State Highways and Transportation Commission or a contractor or subcontractor performing work for the Department of Transportation may use or display fixed, flashing, or rotating amber or white lights only when the vehicle is stationary in a work zone and while highway workers are present. This act permits use of such lights at any time. The act also permits such use of amber and white lights, as well as red and blue lights from dusk until dawn, by motor vehicles and equipment which are leased by the commission or a contractor or subcontractor.

SB 16 (Signed by Governor 7/5) – Exempts delivery charges from sales and use taxes

This act provides that usual and customary delivery charges that are stated separately from the sale price shall not be subject to sales and use taxes.

SB 19 (Signed by Governor 2/6) – Creates new provisions of law relating to labor organizations

Under this act, employers are barred from requiring employees to become, remain, or refrain from becoming a member of a labor organization or pay dues or other charges required of labor organization members as a condition of employment. Any person who violates or directs another to violate this act is guilty of a Class C misdemeanor. Moreover, any person injured as a result of violation or threatened violation of this act is entitled to injunctive relief and certain other damages.

SB 31 (Signed by Governor 7/5) – Modifies provisions relating to the collateral source rule and provides that parties may introduce evidence of the actual cost, rather than the value, of the medical care rendered

Under the act, special damages claimed by the plaintiff at trial that have been satisfied by a payment from a defendant, the defendant’s insurer, or authorized representative prior to trial are not recoverable. The defendant is entitled to deduct such payments towards special damages from any judgement as provided in current law.

Parties may introduce evidence of the actual cost, rather than the value, of the medical care or treatment to the plaintiff, and the act repeals a provision of law which provides that there is a rebuttable presumption that the value of the medical treatment provided is represented by the dollar amount necessary to satisfy the financial obligation to the health care provider. The actual cost of the medical care or treatment shall not exceed the dollar amounts paid by or on behalf of a patient whose care is at issue plus any remaining amount necessary to satisfy the financial obligation for medical care by a health care provider after adjustment for any contractual discounts or price reduction.

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 415-B, Jefferson City, MO 65101. If you wish to unsubscribe from this report, please email Dylan Bryant at dylan.bryant@house.mo.gov

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