SB 621 Modifies provisions of law relating to health care
Sponsor: Romine
LR Number: 4556H.07P Fiscal Notes
Committee: Veterans' Affairs and Health
Last Action: 5/13/2016 - In Conference--SS for SB 621-Romine, with HCS, as amended Journal Page:
Title: HCS SS SB 621 Calendar Position: 1
Effective Date: August 28, 2016
House Handler: Barnes

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Current Bill Summary


HCS/SS/SB 621 - This act modifies several provisions relating to health care, including: (1) the "Show-Me Compassionate Medical Education Act", (2) MO HealthNet reimbursement for certain health care providers, and (3) telehealth.

SHOW-ME COMPASSIONATE MEDICAL EDUCATION ACT (Sections 9.154, 191.594, and 191.596)

This act designates August 28, 2016, and thereafter a date designated by a specified committee, as "Show-Me Compassionate Medical Education Day."

Under this act, no medical school in the state shall prohibit, discourage, or otherwise restrict a medical student organization or a medical organization from undertaking or conducting a study of the prevalence of depression or other mental health issues among medical students. Any medical school in this state is prohibited from penalizing, disciplining, or otherwise taking any adverse action against a student or medical student organization in connection with the student's or medical student organization's participation in, planning, or conducting a study of the prevalence of depression or other mental health issues among medical students.

This act permits medical schools in this state to conduct an ongoing multicenter study or studies in order to facilitate the collection of data and implement practices and protocols to minimize stress and reduce the risk for depression among medical students in Missouri. The act establishes the "Show-Me Compassionate Medical Education Research Project Committee". The multicenter study shall, among other specified objectives, collect relevant data and examine the culture of medical schools that may contribute to the risk of depression among students, as well as identify best practices to address the root causes of depression among students.

Any medical school which conducts a study under this act shall prepare an annual report concerning the specified objectives of the study. The reports must be made available annually on each medical school's website and to the Missouri General Assembly.

These provisions are identical to HB 1658 (2016) and provisions in SB 1029 and similar to HCS/HB 867 (2015).

MO HEALTHNET REIMBURSEMENT (Section 208.152)

This act provides that, subject to appropriations, MO HealthNet providers of behavioral, social, and psychophysiological services, including psychologists, shall be reimbursed for the prevention, treatment, or management of physical health problems.

This provisions is identical to SB 972 (2016), HB 1659 (2016), and SB 281 (2015).

TELEHEALTH (Sections 191.1145, 191.1146, 208.670, 208.671, 208.673, 208.675, 208.677, 208.686, 334.108, and 335.175)

This act defines "telehealth" or "telemedicine" as the delivery of health care services by means of information and communication technologies which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient's health care while such patient is at the originating site and the health care provider is at the distant site. Telehealth shall also include the use of asynchronous store-and-forward technology. Any licensed health care provider shall be authorized to provide telehealth services if such services are within the scope of practice for which the health care provider is licensed and are provided under the same standard of care as services provided in person. Additionally, no originating site for shall be required to maintain immediate availability of on-site clinical staff during the telehealth service, unless such is necessary to meet the standard of care for the treatment of the patient's medical condition when the treating health care provider has not previously seen the patient in person in a clinical setting, is not at the originating site, and is not providing coverage for a health care provider with an established relationship with the patient.

Additionally, physicians practicing telemedicine shall ensure that a properly established physician-patient relationship, as described in this act, exists with the person receiving telemedicine services. No health care provider shall prescribe any drug, controlled substance, or other treatment to a patient based solely on a telephone evaluation. However, physicians, or their delegates, on-call physicians, advanced practice registered nurses, physician assistants, or assistant physicians in a supervision agreement may prescribe any drug, controlled substance, or other treatment within his or her scope of practice to a patient based solely on an evaluation over the telephone if a previously-established and ongoing valid physician-patient relationship exists. No health care provider shall prescribe any drug, controlled substance, or other treatment based solely on an Internet request or an Internet questionnaire.

This act specifies the licensed individuals who shall be considered eligible health care providers for the provision of telehealth services for MO HealthNet participants. Additionally, this act specifies the originating sites where a MO HealthNet participant may receive telehealth services.

This act addresses the use of asynchronous store-and-forward technology in the practice of telehealth services for MO HealthNet participants. "Asynchronous store-and-forward" is defined in the act as the transfer of a patient's clinically important digital samples, such as still images, videos, audio, and text files, and relevant data from an originating site through the use of a camera or similar recording device that stores digital samples that are forwarded via telecommunication to a distant site for consultation by a consulting provider without requiring the simultaneous presence of the patient and the patient's treating provider. The Department of Social Services, in consultation with the Departments of Mental Health and Health and Senior Services, shall promulgate rules governing the use of asynchronous store-and-forward technology in the practice of telehealth in MO HealthNet. The act also specifies reimbursement for asynchronous store-and-forward services for the treating provider and the consulting provider.

This act establishes the "Telehealth Services Advisory Committee" to advise the Department of Social Services and to propose rules relating to telehealth services through asynchronous store-and-forward technology. The act specifies the committee members, appointments, and other terms.

This act establishes a statewide home telemonitoring program for the MO HealthNet program. Home telemonitoring services are health care services that require scheduled remote monitoring of data related to a patient's health. The act specifies the individuals for whom home telemonitoring services may be made available. If the Department of Social Services determines that home telemonitoring is not cost effective, the Department may discontinue the program and stop providing reimbursement through MO HealthNet for such services.

These provisions are substantially similar to provisions in SS/SCS/SB 621 (2016), HB 1923 (2016) and HCS/SCS/SB 230 (2015).

This act has an emergency clause for a certain provisions.

SARAH HASKINS

HA 1: ESTABLISHES THE PERINATAL ADVISORY COUNCIL

HA 2: ESTABLISHES THE DESIGNATED HEALTH CARE DECISION-MAKER ACT

HA 3: ALLOWS FOR WORKFORCE DATA COLLECTION AND ANALYSIS OF HEALTH CARE PROVIDERS IN THE STATE

HA 4: ESTABLISHES THE MISSOURI PALLIATIVE CARE AND QUALITY OF LIFE INTERDISCIPLINARY COUNCIL

HA 5: ESTABLISHES THE CONTROLLED SUBSTANCES ABUSE PREVENTION FUND

HA 6: MODIFIES COLLABORATIVE PRACTICE ARRANGEMENT REQUIREMENTS FOR REGISTERED PROFESSIONAL NURSES REGARDING GEOGRAPHY AND THE NUMBER OF NURSES WITH WHOM A PHYSICIAN MAY ENTER INTO AN AGREEMENT

HA 7: MODIFIES PROVISIONS OF LAW RELATING TO IMMUNIZATIONS

HA 1 TO HA 7: CHANGES THE SURVEY REQUIREMENTS FOR HOSPICES FROM ANNUALLY TO EVERY 3 YEARS

HA 8: ESTABLISHES THE HEALTH CARE COST REDUCTION AND TRANSPARENCY ACT; ESTABLISHES THE PREDETERMINATION OF HEALTH CARE BENEFITS ACT

HA 9: MODIFIES PROVISIONS OF LAW RELATING TO INSPECTIONS OF CERTAIN X-RAY SYSTEMS

HA 1 TO HA 9: MODIFIES PROVISIONS OF LAW RELATING TO THE RATE A HEALTH CARRIER MAY ACCEPT AS PAYMENT IN FULL FROM AN INDIVIDUAL NOT USING INSURANCE

HA 2 TO HA 9: ESTABLISHES THE HEALTH CARE COST REDUCTION AND TRANSPARENCY ACT

HA 10: MODIFIES PROVISIONS OF LAW RELATING TO INVESTING OF MUNICIPAL HOSPITAL FUNDS; MODIFIES CERTIFICATE OF NEED LAW FOR HOSPITALS OPERATED BY THE STATE AND MEDICAL EQUIPMENT

HA 1 TO HA 10: PROVIDES PAID PARENTAL LEAVE FOR STATE EMPLOYEES; MODIFIES PROVISIONS OF LAW RELATING TO INVESTING OF COUNTY HOSPITAL FUNDS; MAKES TECHNICAL CHANGES TO THE UNDERLYING ACT