Missouri Senate

Introduced

MINIMUM HEALTH PROMOTION STANDARD FOR STATE BUILDINGS

This act requires the Office of Administration, in consultation with the Department of Health and Senior Services to submit a report to the Governor and General Assembly by December 31 2008, detailing the opportunities for the state to implement a minimum health promotion standard for construction or substantial renovation of a state building. SECTION 8.365

HEALTH REVIEW IN THE LEGISLATIVE FISCAL NOTE PROCESS

Under current law, the Oversight Division of the Committee on Legislative Research prepares, except for appropriation bills, a fiscal note for all legislation from the General Assembly before being acted upon. The information includes the cost of the legislation to the state. This act requires the Oversight Division to also submit in the fiscal note, information on how the legislation will impact the health of the citizens in this state. SECTION 23.140

HEALTH CABINET AND HEALTH POLICY COUNCIL

This act creates the Missouri Health Cabinet. The cabinet shall ensure that the public policy of the state relating to health is developed to promote interdepartmental collaboration and program implementation in order that services designed for health are planned, managed, and delivered in a holistic and integrated manner to improve the health of Missourians.

The cabinet is created in the executive office of the Governor and shall meet for its first organizational session no later than October 1, 2008. Thereafter the cabinet shall meet at least six times each year in the different regions of the stats in order to solicit input from the public. The cabinet shall consist of seven members, including the Governor, the director of the Departments of Health and Senior Services, mental health, insurance, financial institutions and professional registration and the commissioner of education. The president pro tem of the Senate, the Speaker of the House, the chief justice of the Supreme Court, the Attorney General, and the Commissioner of the Office of Administration, and the director of Agriculture, or their appointed designees shall serve as ex officio members of the cabinet.

The Governor shall appoint a Health Policy Council to assist the cabinet in its tasks. The council shall replace the MO HealthNet Oversight Committee and the State Boards of Health and Senior Services, which are repealed under the act. The members of the council shall consist of representatives from the health care or health policy field. SECTIONS 26.850 TO 26.856

REPORT ON SHIFTING DEMOGRAPHICS

The Lieutenant Governor, in his or her capacity as the senior advocate for the state, shall coordinate with all the directors of the departments in this state to review their major policies, programs, and structures in light of the state's increasingly older and more diverse population. A policy brief shall be submitted to the Governor and General Assembly by July 1, 2009, and shall highlight critical functions or issue areas that would be affected by shifting demographics and how such issues should be addressed within the next ten years. SECTION 26.900

TAX CREDITS AND DEDUCTIONS

This act provides a tax credit to small employers who do not provide health care coverage for their employees for the contributions they make to their employee's health savings accounts. The amount of the tax credit shall not exceed the actual amount contributed to the employee's account or $500, whichever is less. The amount of the tax credit claimed shall not exceed the amount of the taxpayer's state tax liability for the taxable year for which the credit is claimed, and such taxpayer shall not be allowed to claim a tax credit in excess of $25,000 per taxable year. The tax credit may be carried over to the next 4 succeeding taxable years. SECTION 103.185

This act increases the amount of tax credits available for taxpayers who modify their home to be accessible for disabled people who reside with such taxpayer. Under current law, up to one hundred thousand dollars in tax credits remaining unused under the rebuilding communities tax credit program are allocated for use by taxpayers who modify their homes for disabled persons residing with such taxpayers. This act increases the amount of available tax credits by allocating all unused tax credits under the rebuilding communities tax credit program for use by taxpayers who modify their homes for disabled persons residing with such taxpayers. The rebuilding communities tax credit program is capped at ten million dollars annually. Constructing additional rooms in the dwelling or a new structure on the property are added as a new eligible cost for which the tax credit may be claimed. SECTIONS 135.535 AND 135.562

This provision is substantially similar to SB 717 (2008).

This act also authorizes a tax credit in an amount equal to the lesser of the actual expenses incurred in purchasing and installing health information technology or five thousand dollars. SECTION 135.675

This act provides an income tax deduction in the amount equal to 100% of the premium paid by the taxpayer during the taxable year for high deductible health plans established and used with a health savings account under the applicable provisions of the Internal Revenue Code to the extent the amount is not deducted on the taxpayer's federal income tax return for that taxable year. SECTIONS 1143.116 AND 143.121

Under this act, every insurance company is exempt from paying premium taxes provided on premiums paid by Missouri residents for high deductible health plans sold or maintained in connection with a health savings account. SECTION 148.372

PHYSICAL EDUCATION

This act requires school districts to comply with physical education requirements by July 1, 2011. Students in kindergarten through grade twelve must participate in daily physical education for the entire school year. Elementary schools will have at least one hundred fifty minutes of physical education per week while middle and high schools will have at least two hundred twenty-five minutes per week. SECTION 167.720

MISSOURI HEALTHY WORKPLACE RECOGNITION PROGRAM

This act requires the Department of Health and Senior Services to develop the Missouri Healthy Workplace Recognition Program for the purpose of granting official state recognition to employers with more than fifty employees for excellence in promoting health, wellness, and prevention. The criteria for awarding such recognition shall include at a minimum whether the employer offers workplace wellness programs; incentives for healthier lifestyles; opportunities for active community involvement and exercise, and encouragement of well visits with health care providers. SECTION 191.1025

INTERNET WEB-BASED PRIMARY CARE ACCESS PILOT PROJECT

This act requires the Department of Health and Senior Services to award a grant to implement an internet web-based primary care access pilot project designed as a collaboration between private and public sectors to connect, where appropriate, a patient with a primary care medical home, and schedule patients into available community-based appointments as an alternative to non-emergency use of the hospital emergency room. The criteria for the grant are specified in the act. SECTION 191.1200

TELEHEALTH

This act expresses the state's recognition of the delivery of health care via telehealth as a safe, practical and necessary practice in the state. By January 1, 2009, the Department of Health and Senior Services shall promulgate quality control rules to be used in removing and improving the service of telehealth practitioners. SECTIONS 191.1250 to 191.1277

COMMUNITY AND FAITH-BASED ORGANIZATIONS

This act requires the Office of Minority Health and the Department of Social Services, through its faith-based liaison, to solicit proposals from such community programs and organizations to develop solutions regarding health and wellness SECTIONS 192.083 AND 660.750

TOBACCO USE PREVENTION, AND CESSATION FUND

This act creates the tobacco use prevention and cessation fund. Beginning fiscal year 2009, payments received from the strategic contribution fund will be deposited into the newly created fund to be used to fund tobacco prevention and cessation programs. SECTION 196.1200

This provision is identical to SCS/SB 946 (2008).

ADVERSE HEALTH EVENTS

Under this act, all licensed hospitals and ambulatory surgical centers must submit reports of serious events and incidents to the Right to Know Committee, which is created under the act. The committee will analyze the collected data to identify trends and recommend changes in healthcare practices and procedures that may be instituted to reduce the number and severity of future serious events and incidents. In addition, the committee will provide individual facilities with detailed reports analyzing data related to their specific facilities or to certain geographic regions and the state as a whole. SECTIONS 197.850 TO 197.880

These provisions are similar to SB 1264 (2008).

MO HEALTHNET

As of July 1, 2009, the MO HealthNet Division shall no longer reimburse health care providers for the treatment of preventable errors, injuries and infections that occur under the providers' care. By December 31, 2008, the division shall compile a list of such errors, injuries and infections. SECTION 208.149

Prescribed medically necessary therapy services, including physical, occupational, and speech therapy, shall be covered under the Mo HealthNet program. SECTION 208.152.

This act also establishes the Insure Missouri program to administered by the Department of Social Services. SECTIONS 208. 1300 to 208.1345

PREVENTIVE SERVICES

Beginning July 1, 2009, the Missouri consolidated health care plan shall include, as part of its covered benefits, all of the preventive benefits recommended by the federal U.S. Preventive Services Task Force. In addition, on that date, health care services provided under the MO HealthNet program shall cover the same preventive benefits. SECTIONS 103.185 and 208.005

HEALTH INSURANCE

The Department of Insurance, Financial Institutions and Professional Registration shall administer a grant program to assist the start-up of non-profit broker organizations. Eligible participants shall apply to the department for a grant, using a competitive application process prescribed by the department. The department shall award grants not to exceed twenty-five thousand dollars per applicant, with the maximum cumulative total of grants issued per fiscal year not to exceed one hundred thousand dollars. The department shall establish eligibility and give preference to applicants who demonstrate the ability to enhance representation of low-cost health insurance coverage models in the market. This program shall expire in years unless re-authorized by the General Assembly. SECTION 376.025

This act modifies the provisions of Missouri's high risk pool to provide that the twelve-month preexisting condition exclusion period shall not apply for coverage if the person applying for pool coverage has at least three months of uninterrupted prior insurance coverage, so long as the application for pool coverage is made not later than sixty-three days following the loss of such health insurance coverage. SECTION 376.986

Under this act, the director of Insurance, Financial Institutions and Professional Registration is authorized to allow health reimbursement arrangement only plans that encourage employer financial support of health insurance or health related expenses recognized under the rules of the Internal Revenue Service to be approved for sale in connection with or packaged with individual health insurance policies otherwise approved by the director. SECTION 376.1600

Under this act, a health carrier domiciled in another state may offer, sell, or renew a health benefit plan or health insurance policy in Missouri without holding a license or certificate of authority issued by the Department of Insurance, Financial Institutions and Professional Registration. The health carrier may sell a health benefit plan within Missouri under such conditions if it meets the following criteria:

(1) It offers, sells, or renews a health benefit plan in this state that complies with all of the requirements of the domiciliary state applicable to the plan;

(2) It is authorized to issue the plan in the state where it is domiciled and to transact business there; and

(3) It maintains a process to resolve disputes between it and a resident of this state pertaining to the health benefit plan.

If the health carrier meets all the conditions for selling its domiciliary plan within Missouri, it may sell health benefit plans that are exempt from the provisions of Chapter 376. In addition, the health carrier shall not be required to offer or provide state-mandated health benefits required by Missouri law or regulations in health benefit plans or health insurance policies sold to Missouri residents. The health carrier shall be subject to regulation by the director with regard to enforcement of the contractual benefits under the policy or health benefit plan, including the requirements regarding the prompt payment of claims for benefits and the procedure for the denial of benefits.

Each written application for participation in a health benefit plan offered by a health carrier domiciled in another state shall contain language alerting the applicant that the policy is primarily governed by the laws of another state and that the policy is subject to the rating laws of that state. Each plan or policy shall also contain a statement that the benefits of the policy or plan are governed primarily by the laws of a state other than Missouri. The statement shall notify the applicant or insured that while the plan may provide the applicant a more affordable health insurance policy, it may also provide fewer health benefits than those normally included as state mandated health benefits in policies in Missouri.

The act requires the director to prepare a disclosure form prior to January 1, 2009, that is easily understood and that summarizes the benefits a health benefit plan is required to include under Missouri law and regulations and the benefits that may be waived under this act. The applicant or the contract holder shall sign the disclosure form, specifying the benefits he or she waives and indicating that the plan has explained the contents of the disclosure and that he or she understands them, before the health benefit plan may be issued, amended, or renewed without one or more of the state-mandated health benefits. SECTIONS 376.1603 TO 376.1615

The director shall study and recommend to the general assembly changes to remove any unnecessary application and marketing barriers that limit the entry of new health insurance products into the Missouri market. The director shall examine state statutory and regulatory requirements along with market conditions which create barriers for the entry of new health insurance products and health insurance companies. The director shall also examine proposals adopted in other states that streamline the regulatory environment to make it easier for health insurance companies to market new and existing products. The director shall submit a report of his or her findings and recommendations to each member of the general assembly no later than January 1, 2009. SECTION 376.1618.

ADRIANE CROUSE