SB 636 - This act creates the Missouri Health Information Exchange Commission, which shall have the authority to develop a health information organization approval process. The approval process shall include compliance with commonly and equally applied standards relating to interoperability between approved health information organizations; transparency, financial and operational sustainability; and data security. The Commission shall also develop re-approval and investigational processes. Additionally, this act requires the state to end the practice of conveying "state designated entity" status to any health information organization, as well as requiring the state to cease awarding and funding single feasible source vendor contracts to health information organizations operating within the state. Instead, only approved health information organizations shall be qualified to respond to contracting procurement opportunities. The state shall not restrict the availability of or access to any state agency-sponsored data sets. Finally, this act requires approved health information organizations to exchange standard-based clinical summaries for patients and clinical and claims data from any agency within the state with all other approved health information organizations within the state. Failure to do so shall result in the suspension or revocation of approval status and the immediate termination of any contracts, grants, and any other form of state funding. This act is substantially similar to HB 1579 (2016). SARAH HASKINS