HCS/SB 94 - This act modifies several provisions relating to health care, including: (1) a diaper bank tax credit; (2) epinephrine products; (3) the "Missouri State Loan Repayment Program"; (4) sexually transmitted infections; (5) doula services; (6) telehealth; (7) Department of Health and Senior Services contracts for public health; (8) forensic examinations of victims of sexual offenses; (9) hospital workplace violence; (10) MO HealthNet coverage of certain clinical pathology services; (11) prenatal tests for certain diseases; (12) child care facility allergy policies; (13) licensure of dentists and dental hygienists; (14) licensure of wholesale drug distributors; (15) insurance coverage of self-administered hormonal contraceptives; (16) insurance coverage of anesthesia services; (17) prior authorization of health care services; (18) air ambulance agreement; and (19) mammograms. DIAPER BANK TAX CREDIT (Section 135.621) Current law authorizes a tax credit for contributions made to diaper banks. This act adds the definition of "national diaper bank" to require such entities to be a member of a national network organization serving all fifty states through which certification demonstrates nonprofit best practices, data-driven program design, and equitable distribution. The tax credit sunsets on December 31, 2024. This act extends the sunset until December 31, 2031. This provision is identical to a provision in the truly agreed to and finally passed SS/SCS/HB 121 (2025), the truly agreed to and finally passed HCS/SS/SB 43 (2025), SCS/SB 95 (2025), HCS/SS/SB 66 (2025), HCS/HB 326 (2025) and is substantially similar to provisions in HB 647 (2025), HB 1522 (2025), SB 671 (2025), HCS/HB 798 (2025), and HCS/HB 1176 (2025). EPINEPHRINE PRODUCTS (Section 167.627, 167.630, 190.246, 196.990, and 321.621) This act changes "epinephrine auto-injector" to "epinephrine delivery device" throughout statute. These provisions are substantially similar to provisions in HCS/SS/SB 7 (2025) and similar to provisions in HB 165 (2025) and HB 553 (2025). This act adds licensed long-term care facilities and child care facilities to the definition of "authorized entity" in current law permitting such entities to stock a supply of epinephrine delivery devices for use in an emergency. These provisions are identical to provisions in HCS/SS/SB 7 (2025) and similar to provisions in the perfected HCS/HB 943 (2025), SB 548 (2025), SCS/SB 317 (2025), and HCS/HB 2824 (2024). THE "MISSOURI STATE LOAN REPAYMENT PROGRAM" (Sections 191.600-615) This act modifies the "Health Professional Student Loan Repayment Program" to be the "Missouri State Loan Repayment Program" or "MOSLRP". MOSLRP shall be for persons who practice in areas of defined need after graduating from an accredited graduate training program in disciplines defined in rule by the Department of Health and Senior Services. MOSLRP shall not include areas of need for chiropractic services, unlike the current "Health Professional Student Loan Repayment Program". At least 35% of appropriated funds each year shall be designated for awards to primary care physicians and general dentists. The standards the Department may establish shall not include enrollment as a full-time student in certain courses of study as in the current program, but shall include authorization to practice certain types of health professions and in areas of defined need. These provisions are identical to provisions in the truly agreed to and finally passed SS#2/HB 419 (2025), the truly agreed to and finally passed CCS/HCS/SS/SB 150 (2025), SCS/HCS/HB 943 (2025), HCS/SS/SB 7 (2025) and HCS/HB 720 (2025) and similar to SB 635 (2025). SEXUALLY TRANSMITTED INFECTIONS (Section 191.648) Currently, a physician may utilize expedited partner therapy, meaning the practice of treating the sex partners of persons with chlamydia or gonorrhea without an intervening medical evaluation or professional prevention counseling, to prescribe and dispense medications for the treatment of chlamydia or gonorrhea even without an established physician/patient relationship. Under this act, certain health care professionals may use expedited partner therapy and such therapy may be used for designated sexually transmitted infections beyond chlamydia and gonorrhea. This act repeals the requirement that antibiotic medications prescribed and dispensed through expedited partner therapy for the treatment of chlamydia or gonorrhea be in pill form. This provision is identical to a provision in HCS/SS/SB 7 (2025), the perfected HCS/HB 943 (2025) and SCS/SB 317 (2025), substantially similar to a provision in truly agreed to and finally passed SS#2/SB 79 (2025), SB 548 (2025), SB 178 (2025), the perfected HCS/HB 2413 (2024), and SB 1445 (2024), and similar to HB 1879 (2024). DOULA SERVICES (Sections 191.708, 208.152, and 208.1400-1425) Under this act, the chief medical officer or chief medical director of the Department of Health and Senior Services, the Department of Mental Health, or the MO HealthNet Division of the Department of Social Services may issue nonspecific recommendations for doula services, a medical standing order for prenatal vitamins, or a medical standing order for a purpose promulgated in rule, to terminate as specified in the act. Additionally, this act adds doula services and childbirth education classes for pregnant women and a support person to the list of covered MO Healthnet and "Show-Me Healthy Babies Progam" services, to be reimbursed as described in the act. The Department of Social Services shall study the impact of the childbirth education classes on infant and maternal mortality and shall submit a report to the General Assembly prior to January 1, 2028. These provisions are identical to HCS/HB 1095 (2025). TELEHEALTH (Section 191.1145) Under this act, "telehealth" or "telemedicine" shall include the delivery of health care services through audiovisual and audio-only technologies and shall not be limited only to services delivered via select third-party corporate platforms. These provisions are identical to provisions in the truly agreed to and finally passed SS#2/SB 79 (2025), SCS/HB 825 (2025), SCS/SB 825 (2025), HCS/SS/SB 7 (2025), SCS/SB 317 (2025), and HB 1873 (2024), and substantially similar to provisions in SB 931 (2024), SB 669 (2023), and HB 1098 (2023). DEPARTMENT OF HEALTH AND SENIOR SERVICES CONTRACTS FOR PUBLIC HEALTH (Section 192.021) This act authorizes the Department of Health and Senior Services to contract with a designated Missouri affiliate of the National Network of Public Health Institutes, or a similar or successor entity, in order to assist in carrying out its duties to promote the health and well-being of Missouri residents. Such contracts may include efforts to assist in the delivery of health services throughout the state and the administration of grant funds and related programs. The Department and the designated affiliate shall provide a report to the General Assembly as specified in the act. This provision is identical to SB 549 (2025). FORENSIC EXAMINATIONS OF VICTIMS OF SEXUAL OFFENSES (Section 192.2521) Under this act, a specialty hospital, meaning a hospital other than a general acute care hospital, shall not be required to comply with certain statutory provisions relating to forensic examinations of victims of sexual assault if such hospital has in place a policy for the transfer of such victims to an appropriate hospital with an emergency department. These provisions are identical to provisions in the truly agreed to and finally passed SS#2/SB 79 (2025), SCS/SB 178 (2025), HB 398 (2025), HB 845 (2025), SCS/HCS/HB 943 (2025), HCS/SS/SB 7 (2025), SCS/SB 317 (2025), and HCS/HB 2413 (2024) and substantially similar to SB 1326 (2024). HOSPITAL WORKPLACE VIOLENCE (Section 197.708) Under this act, each hospital shall prominently display a printed sign, in all capital letters, warning that assaulting a health care professional is a serious crime which may be punishable as a class A misdemeanor. This provision is identical to HCS/HB 1213 (2025) and substantially similar to SB 791 (2025). MO HEALTHNET COVERAGE OF CERTAIN CLINICAL PATHOLOGY SERVICES (Section 208.149) This act requires that the fee for the professional component of clinical pathology services shall be paid by MO HealthNet for professional services provided by a hospital-based pathologist for inpatient clinical pathology services rendered to MO HealthNet patients. The reimbursement shall be set at thirty percent of the approved outpatient simplified fee schedule based on Medicare's clinical laboratory fee schedule, as described in the act. This provision is identical to a provision in HB 1599 (2025) and SCS/HCS/HB 943 (2025). PRENATAL TESTS FOR CERTAIN DISEASES (Section 210.030) Currently, a physician or other health care provider shall draw and test a pregnant woman's blood at or soon after her first prenatal examination, with her consent, for syphilis, hepatitis B, or other similar diseases. Under this act, the testing of the pregnant woman's blood shall also occur at the twenty-eighth week of her pregnancy and immediately after birth. Additionally, the test shall include hepatitis C and HIV. If a mother tests positive for syphilis, hepatitis B, hepatitis C, or HIV, the physician or other health care provider shall treat the mother in accordance with the most recent accepted medical practice. Current law requires the Department of Health and Senior Services to work in consultation with the Missouri Genetic Disease Advisory Committee to make rules pertaining to these blood tests. This act repeals the requirement to work with the Committee and requires that the tests be approved or accepted by the U.S. Food and Drug Administration. This provision is substantially similar to provisions in the truly agreed to and finally passed SS#2/SB 79 (2025), HCS/SS/SB 7 (2025), SCS/SB 178 (2025), SCS/SB 317 (2025), and the perfected HCS/HB 943 (2025) and similar to provisions in SB 548 (2025), the perfected HCS/HB 2413 (2024), and similar to SB 1260 (2024). CHILD CARE FACILITY ALLERGY POLICIES (Section 210.225) This act establishes "Elijah's Law". Before July 1, 2027, each licensed child care provider shall adopt a policy on allergy prevention and response with a focus on potentially deadly food-borne allergies, as specified in the act. The Department of Elementary and Secondary Education shall develop a model policy or policies before July 1, 2026. This provision is identical to a provision in HCS/SS/SB 7 (2025) and substantially similar to SB 783 (2025) and HB 580 (2025). LICENSURE OF DENTISTS AND DENTAL HYGIENISTS (Sections 332.211, 332.281, and 332.700-760) Current law provides that the Missouri Dental Board ("Board") shall grant without examination a license to a dentist who has been licensed in another state for at least five consecutive years immediately preceding the application for licensure in this state if the Board is satisfied that the qualifications are at least equivalent to the Missouri licensure requirements. Additionally, current law provides that the Board shall grant without examination a license to a dental hygienist who has been licensed in another state for at least two consecutive years immediately preceding the application for licensure in this state if the Board is satisfied that the qualifications are at least equivalent to the Missouri licensure requirements. This act repeals this provision and provides the Board shall waive, within six months, any examination, educational, or experience requirements for licensure to any person who holds a valid current dentist or dental hygienist license issued by another state or territory of the United States or a branch or unit of the Armed Forces of the United States for at least one year if it determines that the person met the minimum requirements of the other state. The Board may require an applicant to take and pass an examination specific to Missouri law. For military spouses with licensure in another state, the Board shall waive such examination, educational, or experience requirements and issue a license within thirty days. The Board shall not waive any examination, educational, or experience requirements for any person who has a revoked license, is currently under investigation or disciplinary action, has a complaint pending, does not hold a license in good standing, has a criminal record which would disqualify from licensure in this state, or does not hold a valid current license in the other jurisdiction on the date of receipt by the Board of his or her application. Additionally, any person who is licensed under this act shall be subject to the Board's jurisdiction and all rules and regulations pertaining to the practice of dentistry and dental hygiene. Finally, this act shall not be construed to waive any requirement for fees of licensure. These provisions are identical to provisions in HCS/SS/SB 7 (2025) and the perfected HB 56 (2025) and substantially similar to provisions in SB 778 (2025) and HB 2075 (2024). This act establishes the Dental and Dental Hygienist Compact ("Compact"), which facilitates the interstate practice of dentistry and dental hygiene and provides for dentists and dental hygienists licensed in a participating state the ability to practice in other participating states. The Compact sets forth the requirements to be met in order for a state to join and the requirements for a dentist or dental hygienist to obtain and exercise the ability to practice in other participating states. The Compact further provides that a dentist or dental hygienist with compact privilege shall function within the scope of practice authorized by the participating state in which they seek to practice and shall be subject to that state's regulatory authority. A dentist or dental hygienist whose privilege in a participating state is encumbered or removed is not eligible for compact privilege in other participating states until the encumbrance or removal has passed and all requirements are met. Additionally, the Compact creates a joint government agency ("Commission") and provides for its powers and duties, including the development and maintenance of a coordinated database and reporting system containing licensure, adverse actions, and investigative information on all licensees and applicants. Furthermore, the Compact shall come into effect on the date in which the seventh state enacts the Compact into law. Any participating state may withdraw from the Compact by repealing the Compact, but such withdrawal shall not take effect until 180 days after the enactment of the repeal. Finally, the Compact shall be binding upon participating states and shall supersede any conflict with state law. These provisions are identical to provisions in HCS/SS/SB 7 (2025) and the perfected HCS/HB 56 (2025) and substantially similar to provisions in SB 327 (2025) and SS/SB 778 (2024). LICENSURE OF WHOLESALE DRUG DISTRIBUTORS (Section 338.333) Under this act, the Board of Pharmacy may permit an out-of-state wholesale drug distributor or third-party logistics provider to be licensed in this state despite not having a license issued by the distributor's or provider's resident state if the distributor or provider has a current and valid drug distributor accreditation from the National Association of Boards of Pharmacy. This provision is identical to HB 1465 (2025) and SCS/HCS/HB 943 (2025). INSURANCE COVERAGE OF SELF-ADMINISTERED HORMONAL CONTRACEPTIVES (Section 376.1240) This act requires health benefit plans issued or renewed on or after January 1, 2026, that provide coverage for self-administered hormonal contraceptives, as defined in the act, to cover a supply of the contraceptives which is intended to last up to one year. This provision is identical to a provision in HCS/SS/SB 7 (2025), SCS/SB 178 (2025), and the perfected HCS/HB 2413 (2024) and substantially similar to SB 821 (2024) and SB 1321 (2024) and similar to a provision in the truly agreed to and finally passed SS#2/SB 79 (2025), SB 512 (2023), HB 287 (2023), SB 641 (2022), SB 472 (2021), HB 1373 (2021), and SB 346 (2019). INSURANCE COVERAGE OF ANESTHESIA SERVICES (Section 376.1245) Under this act, no health carrier or health benefit plan shall establish, implement, or enforce any policy that imposes a time limit for the payment of anesthesia services provided during a medical or surgical procedure, as described in the act This provision is identical to HCS/HBs 1126 & 932 (2025) and SCS/HCS/HB 94 (2025). PRIOR AUTHORIZATION OF HEALTH CARE SERVICES (Sections 376.2100-2108) This act provides that a health carrier or utilization review entity shall not require health care providers to obtain prior authorization for health care services, except under certain circumstances described in the act. Prior authorization shall not be required unless the health carrier or utilization review entity makes a determination that less than 90% of prior authorization requests submitted by that health care provider in the previous evaluation period, as defined in the act, were or would have been approved. The act establishes separate 90% thresholds for requiring prior authorization for individual health care services or requiring prior authorization for any health care service. The act specifies requirements for notifying the provider of determinations under the act, requires health carriers and utilization review entities to establish an appeals process for determinations under the act, and requires carriers and utilization review entities to maintain an online portal giving providers access to certain information. Lastly, no health carrier or utilization review entity shall deny or reduce payments to a health care provider who had a prior authorization, unless the provider made a knowing and material misrepresentation with the intent to deceive the carrier or utilization review entity, or unless the health care service was not substantially performed. These provisions shall not apply to Medicaid, except with regard to a Medicaid managed care organization as defined by law. The act also does not apply to providers who have not participated in a health benefit plan offered by the carrier for at least one full evaluation period. This act shall not be construed to authorize providers to provide services outside the scope of their licenses, nor to require health carriers or utilization review entities to pay for care provided outside the scope of a provider's license. These provisions are similar to SB 230 (2025), HB 1976 (2024), SB 983 (2024), SB 576 (2023), and HB 1045 (2023). AIR AMBULANCE AGREEMENT (Section 407.324) This act provides that an air ambulance membership organization shall not knowingly sell or renew an air ambulance membership agreement to an individual who is enrolled in MO HealthNet. If an individual who has purchased an air ambulance membership agreement enrolls in MO HealthNet during the duration of the agreement, the enrollee may notify the air ambulance membership organization of the enrollment within 30 days after the effective date of the enrollment. If the enrollee timely notifies the organization of the enrollment, the enrollee may request either a prorated refund or a transfer of the membership to another individual. The organization shall disenroll the enrollee within 30 days of receipt of the notice of the enrollee's enrollment in MO HealthNet unless the enrollee's membership is transferred to another individual in the enrollee's household. All air ambulance membership agreement websites, brochures, and marketing materials shall include certain disclosures as described in the act. If an enrollee believes that an individual or entity violated provisions of the act, the enrollee may file a complaint with the Attorney General. The Attorney General shall have all powers, rights, and duties under the Missouri Merchandising Practices Act regarding violations under the act. This provision is identical to HCS/HB 9991 (2025). MAMMOGRAMS (repeal of Section 192.769) This act repeals a provision of current law requiring the provision of a specific notice to patients upon the completion of a mammogram. These provisions are identical to a provision in the truly agreed to and finally passed SS#2/SB 79 (2025), SB 232 (2025), and provisions in HB 398 (2025), SCS/HCS/HB 943 (2025), HCS/SS/SB 7 (2025), SCS/SB 178 (2025), SCS/SB 317 (2025), HCS/HB 2413 (2024), and SB 1328 (2024). SARAH HASKINS