SB 826
Modifies provisions relating to health care
LR Number:
Last Action:
7/9/2018 - Signed by Governor
Journal Page:
Calendar Position:
Effective Date:
Emergency Clause
House Handler:

Current Bill Summary

CCS/HCS/SS/SCS/SB 826 - This act modifies provisions relating to health care, including: (1) health care records; (2) limitations on prescribing opioids; (3) the disposal of unused controlled substances; (4) the Advisory Council on Rare Diseases and Personalized Medicine; (5) long-acting reversible contraceptives; (6) newborn eye drops; (7) vaccine protocols; (8) prescriptions; (9) maintenance medication; (10) pharmacy benefit managers; and (11) prescription eye drops.

HEALTH CARE RECORDS (Section 191.227)

Currently, patients may request copies of health history or treatment records from providers. This act specifies that a response to such request may include a statement or record that no such health history or treatment record responsive to the request exists.

This provision is identical to a provision in the truly agreed to and finally passed CCS/HCS/SCS/SB 718 (2018) and substantially similar to a provision in the truly agreed to and finally passed CCS/HCS/SB 951 (2018).

LIMITATIONS ON PRESCRIBING OPIOIDS (Sections 195.010 and 195.080)

This act limits certain initial prescriptions of opioid controlled substances to no more than a 7-day supply for the treatment of acute pain. Prior to prescribing the opioid, a practitioner shall consult with the patient regarding the quantity of the opioid and the patient's option to fill the prescription in a lesser quantity, as well as inform the patient of the risks associated with the prescribed opioid. If, in the practitioner's medical judgment, more than a 7-day supply is required to treat the patient, the practitioner may issue a prescription for the quantity needed after noting in the patient's medical record the condition triggering the necessity for a greater quantity and that a nonopioid was not appropriate. The provisions of this act shall not apply to prescriptions for a patient who is currently undergoing treatment for cancer, is receiving hospice care or palliative care, is a resident of a long-term care facility, or is receiving treatment for substance abuse or opioid dependence.

No pharmacy or pharmacist shall be liable or subject to disciplinary action for dispensing or refusing to dispense medication in good faith pursuant to an otherwise valid prescription that exceeds these prescribing limits.

These provisions are substantially similar to SCS/SB 825 (2018).


Under this act, a Drug Enforcement Agency-authorized collector, in accordance with federal regulations, may accept unused controlled substances from ultimate consumers, even if the authorized collector did not originally dispense the drug. This provision shall supercede and preempt any local drug disposal ordinance or regulation.

Additionally, the Department of Health and Senior Services shall develop an education and awareness program regarding drug disposal, including the development of a web-based resource and promotional activities.

These provisions have an emergency clause.

These provisions are identical to provisions in the truly agreed to and finally passed CCS/HCS/SCS/SB 718 (2018) and the truly agreed to and finally passed CCS/HCS/SB 951 (2018) and substantially similar to provisions in SCS/HCS/HB 1618 (2018), HB 2105 (2018), and HCB 15 (2018).


This act establishes an "Advisory Council on Rare Diseases and Personalized Medicine" in the MO HealthNet Division to assist the Drug Utilization Review Board when making recommendations or determinations regarding prior authorization and reauthorization criteria for rare disease drugs and other topics relating to rare diseases. The act specifies the council's membership and requires the council to meet no later that February 28, 2019. The council's recommendations to the board shall be in writing. All members of the council shall sign a conflict of interest statement each year and at least 20% of the members shall not have a conflict of interest with any insurer, pharmaceutical benefits manager, or pharmaceutical manufacturer.

This provision is identical to provisions in the truly agreed to and finally passed SS/HB 1953 (2018), the truly agreed to and finally passed CCS/HCS/SCS/SB 718 (2018), SCS/SB 995 (2018), and a provision in SCS/HCS/HB 1618 (2018) and substantially similar to HB 2407 (2018).


Under this act, any long-acting reversible contraceptive (LARC) prescribed to and obtained for a MO HealthNet participant may be transferred to another MO HealthNet participant if the LARC was not delivered to, implanted in, or used on the original participant, as specified in the act.

This provision is identical to HB 1499 (2018).

NEWBORN EYE DROPS (Section 210.070)

This act modifies existing law regarding the administration of prophylactic eye drops to newborns after delivery by repealing the requirement that the administration of eye drops be reported within 48 hours to the local board of health or county physician. Instead, this act provides that administration of such eye drops shall not be required if a parent or legal guardian objects on grounds that doing so is against the religious beliefs of the parent or legal guardian.

This provision is identical to provisions in the truly agreed to and finally passed CCS/HCS/SCS/SB 718 (2018), the truly agreed to and finally passed CCS/HCS/SB 951 (2018), SB 960 (2018), and HB 2117 (2018).

VACCINE PROTOCOLS (Section 338.010)

This act modifies the minimum age for the administration of certain vaccines, including viral influenza, from twelve years of age to at least seven years of age or the age recommended by the Centers for Disease Control and Prevention, whichever is higher.

Additionally, a pharmacist shall inform the patient that the administration of the vaccine will be entered into the ShowMeVax system. The patient shall attest to the inclusion of such information in the system by signing a form provided by the pharmacist or may indicate that he or she does not want such information entered into the system.

These provisions are similar to SCS/SB 776 (2018).

PRESCRIPTIONS (Section 338.056)

This act modifies current law regarding written prescriptions to permit a pharmacist who receives a prescription for a brand name drug or biological product to select a less expensive generically equivalent drug or interchangeable biological product unless requested otherwise by the patient or prescribing practitioner who indicates that substitution is prohibited, as specified in the act. If an oral prescription is involved, the practitioner or practitioner's agency shall instruct the pharmacist if a generic drug or interchangeable biological product may be substituted.

This provision is substantially similar to a provision in SCS/HCS/HB 1618 (2018) and HB 2395 (2018).


Current law provides that dispensing of maintenance medication based on refills authorized by the physician or prescriber on the prescription be limited to no more than a 90 day supply of the medication and the patient must have already been prescribed the medication for 3 months. This act provides that the supply limitations shall not apply if the prescription is issued by a practitioner located in another state or dispensed to a patient who is a member of the United States Armed Forces serving outside the United States.

This provision is identical to a provision in the truly agreed to and finally passed CCS/HCS/SCS/SB 718 (2018).


Under this act, no pharmacy benefits manager (PBM) shall

include in a contract entered into or modified after August 28, 2018, with a pharmacist or pharmacy a provision requiring a covered person to make a payment for a prescription drug at the point of sale in an amount that exceeds the lesser of the co-payment under the health benefit plan or the amount an individual would pay if payment was in cash. A pharmacy or pharmacist shall have the right to provide to a covered person information regarding the amount of the covered person's cost share for a prescription and other information specified in the act. Additionally, no PBM shall, directly or indirectly, charge or hold a pharmacist or pharmacy responsible for any fee amount related to a claim that is not known at the time of adjudication, unless the amount is the result of improperly paid claims or the charges for administering a plan.

This provision is similar to HB 1542 (2018).


Current law that requires health carriers to provide coverage for early refills of an eye drop prescription is set to expire on January 1, 2020. This act repeals the expiration date.

This provision is identical to a provision in the truly agreed to and finally passed CCS/HCS/SCS/SB 718 (2018).