“If we really want to pray, we have to give time to learning its lessons.” (Mother Mary Clare)

Gracious God, in the midst of this time called Lent, we are particularly mindful of the time in prayer we ought to spend with You. But, let us Lord, not only take the time to pray that is needed but let us discover ourselves as we truly are before You in our prayers and be able to mature and deepen our relationship with You. In Your Holy Name we pray. Amen.

Photographers from KMIZ-TV, the Associated Press and KRCG-TV were given permission to take pictures in the Senate Chamber today.

	Present—Senators
Bartle	Bray	Callahan	Cauthorn
Champion	Clemens	Coleman	Crowell
Days	Dolan	Dougherty	Engler
Gibbons	Graham	Green	Griesheimer
Gross	Kennedy	Klindt	Koster
Loudon	Mayer	Nodler	Purgason
Ridgeway	Scott	Shields	Stouffer
Taylor	Vogel	Wheeler	Wilson—32

	Absent with leave—Senators—None

	Vacancies—2

	The Lieutenant Governor was present.

Senator Vogel offered Senate Resolution No. 615, regarding Corrections Officer I Christopher Ryan “Chris” Adams, Jefferson City, which was adopted.

Senator Vogel offered Senate Resolution No. 616, regarding Corrections Officer I James Redden, Jefferson City, which was adopted.

Senator Vogel offered Senate Resolution No. 617, regarding Corrections Officer I Vaughn Morton, Jefferson City, which was adopted.

Senator Vogel offered Senate Resolution No. 618, regarding Corrections Officer I Jack McKee, Jefferson City, which was adopted.

Senator Vogel offered Senate Resolution No. 619, regarding Corrections Officer I Bobbie Culpepper, Jefferson City, which was adopted.

Senator Vogel offered Senate Resolution No. 620, regarding Corrections Officer I Steven Denton, Iberia, which was adopted.

Senator Vogel offered Senate Resolution No. 621, regarding Corrections Officer II Derek Weaver, Fulton, which was adopted.

Senator Vogel offered Senate Resolution No. 622, regarding Corrections Officer I Joseph Blevins, Jefferson City, which was adopted.

WHEREAS, more than two centuries ago, our founders envisioned a new nation, a land free from tyranny and filled with opportunity, prosperity, and liberty for all. Many Irish people, faced with severe hardship in their homeland, embraced the dream of a more promising future and left behind Ireland's shores, their families, and their friends for a new beginning in America. Each year during the month of March, we celebrate these courageous men and women of Ireland and remember with pride their many contributions to our nation; and

WHEREAS, with strength, courage, wit, and creativity, Irish Americans have flourished in our diverse nation of immigrants. Writers such as Flannery O'Connor and Eugene O'Neill have transformed our literature; entrepreneurs like Henry Ford helped revolutionize American industry; performers such as Gregory Peck and Helen Hayes have enriched the arts; patriots such as Audie Murphy, our most decorated soldier of World War II, redefined the meaning of courage; and social reformers such as suffragist Leonora Barry and labor organizer Mary Kenney O'Sullivan fought for the rights of others. Generations of Irish Americans have worked alongside their fellow Americans to build a more perfect union, and America is a stronger nation because of them; and

WHEREAS, during his visit to Ireland in 1963, President Kennedy reminded us that “our two nations, divided by distance, have been united by history”. Today, people on both sides of the Atlantic are united not only by history, but also once again by a dream of a better way of life. This month, as we celebrate Saint Patrick's Day and our shared heritage with Ireland, we remember as well our common love of liberty, commitment to progress, and quest for lasting peace, and we look toward a future as proud as our past; and

WHEREAS, 150 years ago, the blight that struck Ireland's potato crop (“the single root that changed the history of the world”), known as the Great Famine, caused 2,000,000 of Ireland's population to emigrate, mostly to America's shores, and in 1847 alone, 25,000 Irish immigrants arrived in Boston; by 1851, the end of the famine exodus, 1,712 emigrant ships had sailed up the Narrows into New York harbor, and during the “Great Hunger” (1845-1851) more people left Ireland than had emigrated in the previous 250 years; and

WHEREAS, within a few years of their arrival in the United States, these Irish immigrants took jobs as laborers, built railroads, canals, and schools, dedicated themselves to help build this nation, and this same legacy remains a part of today's American mainstream; and

WHEREAS, James Smith, George Taylor, Matthew Thornton, and Charles Thomson, four of the individuals who signed the Declaration of Independence, were Irish born and nine other signers were of Irish ancestry; more than 200 Irish-Americans have been awarded the Congressional Medal of Honor and 19 Presidents of the United States proudly claim Irish heritage, included among them, the first president, George Washington;

WHEREAS, the 44,000,000 Americans of Irish ancestry, like their forebearers, continue to enrich all aspects of life in the United States, in science, education, art, agriculture, business, industry, literature, music, athletics, military and governmental service.

NOW THEREFORE BE IT RESOLVED that the members of the Missouri Senate, Ninety-Third General Assembly, First Regular Session, the House of Representatives concurring therein, do hereby designate the month of March 2005 as Irish-American Heritage Month. The Governor is requested to issue a proclamation calling upon the people of the state of Missouri to observe this month with appropriate ceremonies, programs, and activities; and

BE IT FURTHER RESOLVED that the Secretary of the Missouri Senate be instructed to prepare properly inscribed a copy of this resolution for the Governor of the state of Missouri.

Senator Klindt moved that SB 237, with SCS, SS for SCS, SA 1 and SSA 1 for SA 1 (pending), be called from the Informal Calendar and again taken up for perfection, which motion prevailed.

At the request of Senator Griesheimer, the above substitute amendment was withdrawn.

Amend Senate Substitute for Senate Committee Substitute for Senate Bill No. 237, Page 29, Section 392.245, Line 3 of said page, by inserting after “service” the following: “;

(6) Notwithstanding any other provision of this subsection, any incumbent local exchange company may petition the commission for competitive classification within an exchange based on competition from any entity providing local voice service in whole or in part by using its own telecommunications facilities or other facilities or the telecommunications facilities or other facilities of a third party, including those of the incumbent local exchange company as well as providers that rely on an unaffiliated third-party Internet service. The commission shall approve such petition within sixty days unless it finds that such competitive classification is contrary to the public interest. The commission shall maintain records of regulated providers of local voice service, including those regulated providers who provide local voice service over their own facilities, or through the use of facilities of another provider of local voice service. In reviewing an incumbent local exchange telephone company's request for competitive status in an exchange, the commission shall consider their own records concerning ownership of facilities and shall make all inquiries as are necessary and appropriate from regulated providers of local voice service to determine the extent and presence of regulated local voice providers in an exchange”.

Senator Klindt moved that the above amendment be adopted, which motion prevailed.

Amend Senate Substitute for Senate Committee Substitute for Senate Bill No. 237, Page 22, Section 392.200, Lines 26-28 of said page, by striking said lines; and

Senator Klindt moved that the above amendment be adopted, which motion prevailed.

Amend Senate Substitute for Senate Committee Substitute for Senate Bill No. 237, Page 28, Section 392.245, Lines 18-22 of said page, by striking said lines and inserting in lieu thereof the following:

“(3) Regardless of the technology utilized, local voice service shall mean two-way voice service capable of receiving calls from a provider of basic local telecommunications services as defined by subdivision (4) of section 386.020, RSMo;”.

Senator Klindt moved that the above amendment be adopted, which motion prevailed.

Amend Senate Substitute for Senate Committee Substitute for Senate Bill No. 237, Page 22, Section 392.200, Line 12 of said page, by striking the word “existing,”; and further amend said line by striking the comma “,” after the word “new”.

Amend Senate Substitute for Senate Committee Substitute for Senate Bill No. 237, Page 8, Section 386.020, Line 24, by inserting after the word “service” as it appears the second time in said line, the following: “. Nonbasic telecommun-ication services shall include voice over internet protocol services”

Amend Senate Substitute for Senate Committee Substitute for Senate Bill No. 237, Page 21, Section 392.200, Lines 24-25 of said page, by striking the following: “or 392.361”.

Senator Griesheimer moved that the above amendment be adopted, which motion prevailed.

Amend Senate Substitute for Senate Committee Substitute for Senate Bill No. 237, Page 22, Section 392.200, Line 18, by striking the word “any” and inserting in lieu thereof the following: “each”.

Amend Senate Substitute for Senate Committee Substitute for Senate Bill No. 237, Page 35, Section 392.500, Line 19, by inserting after all of said line the following:

“536.024. 1. When the general assembly authorizes any state agency to adopt administrative rules or regulations, the granting of such rulemaking authority and the validity of such rules and regulations is contingent upon the agency complying with the provisions of this section in promulgating such rules after June 3, 1994.

2. Upon filing any proposed rule with the secretary of state, the filing agency shall concurrently submit such proposed rule to the joint committee on administrative rules, which may hold hearings upon any proposed rule or portion thereof at any time.

3. A final order of rulemaking shall not be filed with the secretary of state until thirty days after such final order of rulemaking has been received by the committee. The committee may hold one or more hearings upon such final order of rulemaking during the thirty-day period.

4. The committee may file with the secretary of state any comments or recommendations that the committee has concerning a proposed or final order of rulemaking. Such comments shall be published in the Missouri Register.

5. The committee may refer comments or recommendations concerning such rule to the appropriations and budget committees of the house of representatives and the appropriations committee of the senate for further action.

6. The provisions of this section shall not apply to rules adopted by the [public service commission and the] labor and industrial relations commission.

536.037. 1. There is established a permanent joint committee of the general assembly to be known as the “Committee on Administrative Rules”, which shall be composed of five members of the senate and five members of the house of representatives. The senate members of the committee shall be appointed by the president pro tem of the senate and the house members by the speaker of the house. The appointment of each member shall continue during his term of office as a member of the general assembly unless sooner removed. No major party shall be represented by more than three appointed members from either house.

2. The committee on administrative rules shall meet within ten days after its creation and organize by selecting a chairman and a vice chairman, one of whom shall be a member of the senate and one of whom shall be a member of the house of representatives. A majority of the members constitutes a quorum. Meetings of the committee may be called at such time and place as the chairman designates.

3. The committee shall review all rules promulgated by any state agency after January 1, 1976, except rules promulgated by the [public service commission and the] labor and industrial labor relations commission. In its review the committee may take such action as it deems necessary which may include holding hearings.

4. The members of the committee shall receive no compensation in addition to their salary as members of the general assembly, but may receive their necessary expenses while attending the meetings of the committee, to be paid out of the joint contingent fund.

Section 1. Any rule or portion of a rule, as that term is defined in section 536.010, RSMo, that is created under authority delegated to the Public Service Commission shall become effective only if it complies with and is subject to all of the provisions of chapter 536, RSMo, and, if applicable, section 536.028, RSMo. This section and chapter 536, RSMo, are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536, RSMo, to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2005, shall be invalid and void.” and

Senator Ridgeway moved that the above amendment be adopted, which motion prevailed on a standing division vote.

Amend Senate Substitute for Senate Committee Substitute for Senate Bill No. 237, Page 29, Section 392.245, Line 7, by striking the word “thirty” and inserting in lieu thereof the following: “sixty”.

Amend Senate Substitute for Senate Committee Substitute for Senate Bill No. 237, Page 26, Section 392.245, Line 20, by striking the words “subsections 2 through 5 of”; and

Further amend said section, page 34, line 16 by striking the words “subsections 2 through 5 of”; and

Further amend section 392.500, page 34, line 28 by striking the words “subsections 2 through 5 of”.

Amend Senate Substitute for Senate Committee Substitute for Senate Bill No. 237, Page 32, Section 392.245, Line 7, by striking the opening bracket; and

Senator Klindt moved that SS for SCS for SB 237, as amended, be adopted, which motion prevailed.

On motion of Senator Klindt, SS for SCS for SB 237, as amended, was declared perfected and ordered printed.

President Pro Tem Gibbons referred HCS for HB 393, with SCS, to the Committee on Governmental Accountability and Fiscal Oversight.

The following message was received from the House of Representatives through its Chief Clerk:

Mr. President: I am instructed by the House of Representatives to inform the Senate that the House has taken up and passed HCS for HB 135, entitled:

An Act to repeal sections 100.710, 135.284, RSMo, section 100.840, as enacted by senate committee substitute for senate bill no. 620, ninety-second general assembly, first regular session, section 100.850, as enacted by conference committee substitute for senate substitute for senate committee substitute for house committee substitute for house bill no. 1182, ninety-second general assembly, second regular session, section 100.850, as enacted by house substitute for senate committee substitute for senate bill no. 1155, ninety-second general assembly, first regular session, and section 100.850, as enacted by conference committee substitute for house substitute for house committee substitute for senate bill no. 1394, ninety-second general assembly, second regular session and to enact in lieu thereof three new sections relating to business use incentives.

Senator Green offered Senate Resolution No. 623, regarding Rodney Jones, St. Louis, which was adopted.

Senator Engler offered Senate Resolution No. 624, regarding Corrections Officer I William Dennis, Park Hills, which was adopted.

Senator Engler offered Senate Resolution No. 625, regarding Corrections Officer I Dan Conway, Park Hills, which was adopted.

Senator Engler offered Senate Resolution No. 626, regarding Corrections Officer I Shawn Peery, Park Hills, which was adopted.

Senator Engler offered Senate Resolution No. 627, regarding Corrections Officer II John Hagerty, Park Hills, which was adopted.

Senator Engler offered Senate Resolution No. 628, regarding Corrections Officer II Scott McFarland, Bismark, which was adopted.

Senator Engler offered Senate Resolution No. 629, regarding Corrections Officer I Rodney St. Gemme, Bonne Terre, which was adopted.

Senator Engler offered Senate Resolution No. 630, regarding Corrections Officer II Jack Feller, Bismark, which was adopted.

Senator Engler offered Senate Resolution No. 631, regarding Corrections Officer I Ben Cosgrove, Bismark, which was adopted.

Senator Engler offered Senate Resolution No. 632, regarding Corrections Officer I Clifford Moulton, Park Hills, which was adopted.

Senator Engler offered Senate Resolution No. 633, regarding Corrections Officer I Janelle Caples, Bismark, which was adopted.

Senator Cauthorn offered Senate Resolution No. 634, regarding Corrections Classification Assistant Brook Kurth, New London, which was adopted.

Senator Cauthorn offered Senate Resolution No. 635, regarding Corrections Officer I Kristen Langley, Bowling Green, which was adopted.

Senator Scott offered Senate Resolution No. 636, regarding Brian Daniel Poppe, Lincoln, which was adopted.

The time of recess having expired, the Senate was called to order by President Kinder.

Senator Engler offered Senate Resolution No. 637, regarding Corrections Officer I Thomas D. Sanders, Farmington, which was adopted.

Senator Engler offered Senate Resolution No. 638, regarding Laundry Manager Terrance L. Cole, Desloge, which was adopted.

Senator Engler offered Senate Resolution No. 639, regarding Corrections Officer I John S. Moore, Irondale, which was adopted.

Senator Engler offered Senate Resolution No. 640, regarding Corrections Officer I Ronald L. Fryman, Potosi, which was adopted.

Senator Engler offered Senate Resolution No. 641, regarding Corrections Officer I Joseph J. Whitter, Potosi, which was adopted.

Senator Engler offered Senate Resolution No. 642, regarding Corrections Officer I Roger L. Faulkner, Des Arc, which was adopted.

Senator Crowell offered Senate Resolution No. 643, regarding Marie Chronister, which was adopted.

Senator Crowell offered Senate Resolution No. 644, regarding Corporal Ryan Worthington, Perryville, which was adopted.

Senator Mayer offered Senate Resolution No. 645, regarding Joel Barbour, Poplar Bluff, which was adopted.

Senator Mayer offered Senate Resolution No. 646, regarding Corrections Training Officer Allen L. Hughes, Bernie, which was adopted.

Senator Mayer offered Senate Resolution No. 647, regarding Cole David Allen, Poplar Bluff, which was adopted.

Senator Cauthorn, Chairman of the Committee on Governmental Accountability and Fiscal Oversight, submitted the following report:

Mr. President: Your Committee on Govern-mental Accountability and Fiscal Oversight, to which was referred HCS for HB 393, with SCS, begs leave to report that it has considered the same and recommends that the bill do pass.

An Act to repeal sections 355.176, 408.040, 490.715, 508.010, 508.040, 508.070, 508.120, 510.263, 510.340, 514.060, 516.105, 537.035, 537.067, 537.090, 538.205, 538.210, 538.220, 538.225, 538.230, and 538.300, RSMo, and to enact in lieu thereof twenty-three new sections relating to claims for damages and the payment thereof.

An Act to repeal sections 355.176, 408.040, 508.010, 508.040, 508.070, 508.120, 510.263, 516.105, 537.035, 537.067, 537.090, 538.205, 538.210, and 538.225, RSMo, and to enact in lieu thereof seventeen new sections relating to claims for damages and the payment thereof.

An Act to repeal sections 355.176, 408.040, 490.715, 508.010, 508.040, 508.070, 508.120, 510.263, 516.105, 537.035, 537.067, 537.090, 538.205, 538.210, 538.220, 538.225, 538.230, and 538.300, RSMo, and to enact in lieu thereof twenty-one new sections relating to claims for damages and the payment thereof.

Amend Senate Substitute for Senate Committee Substitute for House Committee Substitute for House Bill No. 393, Page 18, Section 537.067, Line 16 of said page, by striking “1.”; and

Further amend said bill and section, Page 20, Lines 2 to 4 of said page, by striking all of the underlined language on said lines and inserting in lieu thereof the following: “if the plaintiff is found to bear sixty percent or more of the fault, then the court shall enter a directed verdict for the defendant and such plaintiff shall recover no damages. If the plaintiff is found to bear less than sixty percent of the fault, then a defendant shall be jointly and severally liable for the amount of the compensatory damages and noneconomic damages portion of the judgment rendered against defendants if such defendant is found to bear fifteen percent or more of fault. A defendant may not be jointly and severally liable for more than the percentage of punitive damages for which fault is attributed to such defendant by the trier of fact.”; and

Further amend said bill, Page 30, Section 538.229, Line 4 of said page, by inserting after all of said line the following:

“538.230. 1. In any action against a health care provider for damages for personal injury or death on account of the rendering of or failure to render health care services where fault is apportioned among the parties and persons released pursuant to subsection 3 of this section, the court, unless otherwise agreed by all the parties, shall instruct the jury to apportion fault among such persons and parties, or the court, if there is no jury, shall make findings, indicating the percentage of total fault of all the parties to each claim that is allocated to each party and person who has been released from liability under subsection 3 of this section.

2. The court shall determine the award of damages to each plaintiff in accordance with the findings, subject to any reduction under subsection 3 of this section and enter judgment against each party liable on the basis of the rules of joint and several liability. However, notwithstanding the provisions of this subsection, any defendant against whom an award of damages is made shall be jointly liable only with those defendants whose apportioned percentage of fault is [equal to or] less than such defendant.

3. Any release, covenant not to sue, or similar agreement entered into by a claimant and a person or entity against which a claim is asserted arising out of the alleged transaction which is the basis for plaintiff's cause of action, whether actually made a party to the action or not, discharges that person or entity from all liability for contribution or indemnity but it does not discharge other persons or entities liable upon such claim unless it so provides. However, the claim of the releasing person against other persons or entities is reduced by the amount of the released persons' or entities' equitable share of the total obligation imposed by the court pursuant to a full apportionment of fault under this section as though there had been no release.”; and

Further amend said bill, Page 30, Section 538.300, Line 13 of said page, by striking said line and inserting in lieu thereof the following: “[490.715, RSMo,] 509.050, RSMo, [510.263, RSMo,] 537.067,”; and

Further amend said bill, Page 33, Section 538.230, Lines 10 to 47 of said page, by striking said section from the bill; and

Senator Bartle renewed his motion on the adoption of SA 1 and requested a roll call vote be taken. He was joined in his request by Senators Crowell, Dolan, Days and Taylor.

	YEAS—Senators
Bartle	Bray	Callahan	Coleman
Days	Dougherty	Engler	Gibbons
Graham	Green	Kennedy	Koster
Mayer	Taylor	Wheeler	Wilson—16

	NAYS—Senators
Cauthorn	Champion	Clemens	Crowell
Dolan	Griesheimer	Gross	Klindt
Loudon	Nodler	Purgason	Ridgeway
Scott	Shields	Stouffer	Vogel—16

	Absent—Senators—None

	Absent with leave—Senators—None

	Vacancies—2

Amend Senate Substitute for Senate Committee Substitute for House Committee Substitute for House Bill No. 393, Page 1, Section A, Line 8 of said page, by inserting after all of said line the following:

“135.163. 1. For all tax years beginning on or after January 1, 2006, in order to encourage the retention of physicians and other health care providers in this state, an eligible taxpayer shall be allowed a credit not to exceed fifteen thousand dollars per eligible taxpayer against the tax otherwise due pursuant to chapter 143, RSMo, not including sections 143.191 to 143.265, RSMo, in an amount equal to fifteen percent of the increase in amount paid by an eligible taxpayer for medical malpractice insurance premiums in the aggregate from one policy period to the next immediate policy period. For purposes of this section, the base policy period for calculation of the credit shall be the medical malpractice insurance policy in effect on August 28, 2005.

2. The tax credit allowed by this section shall be claimed by the taxpayer at the time such taxpayer files a return. Any amount of tax credit which exceeds the tax due shall be carried over to any of the next five subsequent taxable years, but shall not be refunded and shall not be transferable.

3. The director of the department of insurance and the director of the department of revenue shall jointly administer the tax credit authorized by this section. The director of the department of insurance shall enact procedures to verify the amount of the allowable credit and shall issue a certificate to each eligible taxpayer that certifies the amount of the allowable credit. Both the director of the department of insurance and the director of the department of revenue are authorized to promulgate rules and regulations necessary to administer the provisions of this section. Any rule or portion of a rule, as that term is defined in section 536.010, RSMo, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536, RSMo, and, if applicable, section 536.028, RSMo. This section and chapter 536, RSMo, are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536, RSMo, to review, to delay the effective date or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2005, shall be invalid and void.

4. The tax credits issued pursuant to this section shall not exceed a total for all tax credits issued of fifteen million dollars per fiscal year.”; and

Further amend said bill, Page 2, Section 355.176, Line 14 of said page, by inserting after all of said line the following:

“379.316. 1. Section 379.017 and sections 379.316 to 379.361 apply to insurance companies incorporated pursuant to sections 379.035 to 379.355, section 379.080, sections 379.060 to 379.075, sections 379.085 to 379.095, sections 379.205 to 379.310, and to insurance companies of a similar type incorporated pursuant to the laws of any other state of the United States, and alien insurers licensed to do business in this state, which transact fire and allied lines, marine and inland marine insurance, to any and all combinations of the foregoing or parts thereof, and to the combination of fire insurance with other types of insurance within one policy form at a single premium, on risks or operations in this state, except:

(1) Reinsurance, other than joint reinsurance to the extent stated in section 379.331;

(2) Insurance of vessels or craft, their cargoes, marine builders' risks, marine protection and indemnity, or other risks commonly insured pursuant to marine, as distinguished from inland marine, insurance policies;

(5) All forms of life, accident and health, [and] workers' compensation insurance, and medical malpractice liability insurance.

2. Inland marine insurance shall be deemed to include insurance now or hereafter defined by statute, or by interpretation thereof, or if not so defined or interpreted, by ruling of the director, or as established by general custom of the business, as inland marine insurance.

3. Commercial property and commercial casualty insurance policies are subject to rate and form filing requirements as provided in section 379.321.

383.112. Any insurer or self-insured health care provider that fails to timely report claims information as required by sections 383.100 to 383.125 shall be subject to the provisions of section 374.215, RSMo.

383.150. As used in sections 383.150 to 383.195, the following terms shall mean:

(1) “Association” [means], the joint underwriting association established pursuant to the provisions of sections 383.150 to 383.195;

(2) “Competitive bidding process”, a process under which the director seeks, and insurers may submit, rates at which insurers guarantee to provide medical malpractice liability insurance to any health care provider unable to obtain such insurance in the voluntary market;

[(3)] (4) “Health care provider” includes physicians, dentists, clinical psychologists, pharmacists, optometrists, podiatrists, registered nurses, physicians' assistants, chiropractors, physical therapists, nurse anesthetists, anesthetists, emergency medical technicians, hospitals, nursing homes and extended care facilities; but shall not include any nursing service or nursing facility conducted by and for those who rely upon treatment by spiritual means alone in accordance with the creed or tenets of any well-recognized church or religious denomination;

[(4)] (5) “Medical malpractice insurance” [means], insurance coverage against the legal liability of the insured and against loss, damage, or expense incident to a claim arising out of the death or injury of any person as a result of the negligence or malpractice in rendering professional service by any health care provider;

[(5)] (6) “Net direct premiums” [means], gross direct premiums written on casualty insurance in the state of Missouri by companies authorized to write casualty insurance under chapter 379, RSMo 1969, in the state of Missouri, less return premiums thereon and dividends paid or credited to policyholders on such direct business.

383.151. When the department determines after a public hearing that medical malpractice liability insurance is not reasonably available for health care providers in the voluntary market, the director shall establish a method for providing such insurance to such health care providers. The director may:

(1) Establish a competitive bidding process under which insurers may submit rates at which they agree to insure such health care providers; or

(2) Establish any other method reasonably designed to provide insurance to such health care providers.

(1) “Director”, the same meaning as such term is defined in section 383.100;

(2) “Health care provider”, the same meaning as such term is defined in section 383.100;

(3) “Insurer”, an insurance company licensed in this state to write liability insurance, as described in section 379.010, RSMo;

(4) “Medical malpractice insurance”, the same meaning as such term is defined in section 383.200.

2. The following standards and procedures shall apply to the making and use of rates pertaining to all classes of medical malpractice insurance:

(1) Rates shall not be excessive, inadequate, or unfairly discriminatory. A rate is excessive if it is unreasonably high for the insurance provided. A rate is inadequate if it is unreasonably low for the insurance provided and continued use of it would endanger the solvency of the company. A rate is unfairly discriminatory if it does not reflect equitably differences in reasonably expected losses and expenses;

(2) (a) Every insurer that desires to increase a rate by less than fifteen percent shall file such rate, along with data supporting the rate change as prescribed by the director, no later than thirty days after such rate becomes effective. Filings under this paragraph shall not be subject to approval or disapproval by the director.

(b) Every insurer that desires to increase a rate by fifteen percent or more shall submit a complete rate application to the director. A complete rate application shall include all data supporting the proposed rate and such other information as the director may require. The applicant shall have the burden of proving that the requested rate change is justified and meets the requirements of this act.

(c) Every insurer that has filed a rate increase under paragraph (a) of this subdivision for two consecutive years and in the third year desires to file a rate increase which in the aggregate over the three-year period will equal or exceed a total rate increase of forty percent or more shall be required to submit a complete rate application under paragraph (b) of this subdivision.

(d) Every insurer that has not filed or had a rate increase approved for three consecutive years may file a rate increase in the fourth year in an amount not to exceed a twenty-five percent increase without being required to submit a complete rate application under paragraph (b) of this subdivision;

(3) The director of insurance shall promulgate rules setting forth standards that insurers shall adhere to in calculating their rates. Such rules shall:

(a) Establish a range within which an expected rate of return shall be presumed reasonable;

(b) Establish a range within which categories of expenses shall be presumed reasonable;

(c) Establish a range for the number of years of experience an insurer may consider in determining an appropriate loss development factor;

(d) Establish a range for the number of years of experience an insurer may consider in determining an appropriate trend factor;

(e) Establish a range for the number of years of experience an insurer may consider in determining an appropriate increased limits factor;

(g) Establish the extent to which an insurer may apply its subjective judgment in projecting past cost data into the future;

(h) Establish any other standard deemed reasonable and appropriate by the director;

(4) The director shall require an insurer to submit with any rate change application:

(a) A comparison, in a form prescribed by the director, between the insurer's initial projected incurred losses and its ultimate incurred losses for the eight most recent policy years for which such data is available;

(b) A memorandum explaining the methodology the insurer has used to reflect the total investment income it reasonably expects to earn on all its assets during the period the proposed rate is to be in effect. The director shall disapprove any rate application that does not fully reflect all such income;

(5) The director shall notify the public of any application from an insurer seeking a rate increase of fifteen percent or more, and shall hold a hearing on such application within forty-five days of such notice. The application shall be deemed approved ninety days after such notice unless it is disapproved by the director after the hearing;

(6) If after a hearing the director finds any rate of an insurer to be excessive, the director may order that the insurer discontinue the use of the rate and that the insurer refund the excessive portion of the rate to any policyholder who has paid such rate. The director shall not be required to find that a reasonable degree of competition does not exist to find a rate excessive.

3. For insurers required to file pursuant to paragraph (b) of subdivision (2) of subsection 2 of this section, if there is insufficient experience within the state of Missouri upon which a rate can be based with respect to the classification to which such rate is applicable, the director may approve a rate increase that considers experiences within any other state or states which have a similar cost of claim and frequency of claim experience as this state. If there is insufficient experience within Missouri or any other states which have similar cost of claim and frequency of claim experience as Missouri, nationwide experience may be considered. The insurer in its rate increase filing shall expressly show the rate experience it is using.

4. All information provided to the director under this section shall be available for public inspection.

5. The remedies set forth in this chapter shall be in addition to any other remedies available under statutory or common law.

6. Any rule or portion of a rule, as that term is defined in section 536.010, RSMo, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536, RSMo, and, if applicable, section 536.028, RSMo. This section and chapter 536, RSMo, are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536, RSMo, to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2005, shall be invalid and void.

383.205. For all medical malpractice insurance policies written for insureds in the state of Missouri, the ratio between the base rate of the highest-rated specialty and the base rate of the lowest-rated specialty shall be no more than a ratio of six-to-one.

383.210. In determining the premium paid by any health care provider, a medical malpractice insurer shall apply a credit or debit based on the provider's loss experience, or shall establish an alternative method giving due consideration to the provider's loss experience. The insurer shall include a schedule of all such credits and debits, or a description of such alternative method in all filings it makes with the director of insurance. No medical malpractice insurer may use any rate or charge any premiums unless it has filed such schedule or alternative method with the director of insurance and the director has approved such schedule or alternative method. A debit shall be based only on those claims that have been paid on behalf of the provider.

383.215. On or before March first of each year, every insurer providing medical malpractice insurance to a health care provider shall file the following information with the director of insurance:

(a) The number of new claims reported during the preceding calendar year, and the total amounts of reserve for such claims and for allocated loss adjustment expenses in connection with such claims;

(b) The number of claims closed during the preceding year, and the amount paid on such claims, detailed as follows:

a. The number of claims closed each year with payment, and the amount paid on such claims and on allocated loss adjustment expenses in connection with such claims;

b. The number of claims closed each year without payment, and the amount of allocated loss adjustment expenses in connection with such claims;

(2) Information regarding judgments, payment, and severity of injury in connection with judgements:

(a) For each judgment rendered against an insurer for more than one hundred thousand:

b. The category of injury suffered by the plaintiff. Injuries shall be categorized as follows:

Category 2: Temporary insignificant injury, including lacerations, contusions, minor scars, and rash.

Category 3: Temporary minor injury, including infections, missed fractures, and falls in hospitals.

Category 4: Temporary major injury, including burns, left surgical material, drug side effects, and temporary brain damage.

Category 5: Permanent minor injury, including loss of fingers, and loss or damage to organs.

Category 6: Permanent significant injury, including deafness, loss of limb, loss of eye, and loss of one kidney or lung.

Category 7: Permanent major injury, including paraplegia, blindness, loss of two limbs, and brain damage.

Category 8: Permanent grave injury, including quadriplegia, severe brain damage, and any injury requiring lifelong care or having a fatal prognosis.

(3) Information on each rate change implemented during the preceding five-year period by state and medical specialty;

(a) Written premiums and paid losses for the preceding year, and earned premiums and incurred losses for the preceding year, with specifics by medical specialty;

(a) Written premiums and paid losses for the preceding year, and earned premiums and incurred losses for the preceding year, with specifics as follows:

d. As to all insureds with three or more incidents within the preceding five-year period;