CCS SCS HB 2226, HB 1824, HB 1832 & HB 1990 -- REGULATION AND
LICENSING OF CERTAIN PROFESSIONS

This bill changes the laws regarding the Oversight Division of
the Joint Committee on Legislative Research; MO HealthNet
reimbursements; certain professions regulated by the Department
of Insurance, Financial Institutions and Professional
Registration; and hospital premises licenses.

OVERSIGHT DIVISION OF THE JOINT COMMITTEE ON LEGISLATIVE RESEARCH
(Section 23.156, RSMo)

Each employee of the Oversight Division of the Joint Committee on
Legislative Research before entering upon his or her duties is
required to take and file with the Chief Clerk of the House of
Representatives and the Secretary of the Senate an oath to
support the Missouri Constitution, to faithfully demean himself
or herself in office, not to disclose specified information to
unauthorized persons, and not to accept any pay for the discharge
of his or her duties other than that fixed and accorded to the
employee by law.  Anyone violating this provision will be guilty
of a class A misdemeanor.

PAYMENTS FROM THIRD-PARTY PAYERS TO THE MO HEALTHNET DIVISION
(Section 208.215)

The bill changes the laws regarding the authority of the MO
HealthNet Division within the Department of Social Services to
collect payments from third-party payers.  Health benefit plans,
third-party administrators, administrative service organizations,
and pharmacy benefits managers are required to process and pay
properly submitted medical assistance or MO HealthNet subrogation
claims using standard electronic transactions or paper claim
forms for a period of three years from the date services were
provided by an entity.  The entity cannot be required to
reimburse for items or services not covered under MO HealthNet;
cannot deny a claim based solely on the date of submission, the
type or format of the claim form, failure to present proper
documentation of coverage at the point of sale, or failure to
obtain prior authorization; cannot be required to reimburse for
items or services previously submitted to the third-party payer
by the provider or the participant and the claim was properly
denied for procedural reasons; and cannot be required to
reimburse for items or services which are not covered under the
plan offered by the entity against which a claim for subrogation
has been filed.  An entity must reimburse for items or services
to the same extent that the entity would have been liable if it
had been properly billed at the point of sale and the amount due
is limited to what the entity would have paid if it had been
properly billed at the point of sale.  Health benefit plans,
third-party administrators, administrative service organizations,
and pharmacy benefits managers must also pay a subrogation claim
if the state enforces its right to a claim within six years of
the submission of the claim.

The computerized records of the division, if certified by the
division director or his designee, will be prima facie evidence
of proof of moneys expended and the amount of the debt due the
state.

ENDOWED CARE CEMETERIES (Sections 214.160 - 214.550)

The bill:

(1)  Allows a county commission that serves as the trustee of a
trust fund for a cemetery to invest moneys in the fund in
certificates of deposit;

(2)  Repeals the requirement that any court action to grant an
injunction, restraining order, or other order to bring suit
against a cemetery operator upon application by the Division of
Professional Registration within the Department of Insurance,
Financial Institutions and Professional Registration must be
commenced in the county in which the illegal action occurred or
in the county in which the operator resides;

(3)  Requires all contracts sold by cemetery operators for
cemetery services or for graves, cemetery markers, crypts, and
other burial receptacles to meet certain requirements.  If these
requirements are not met, all payments will be recoverable by the
purchaser plus 10% interest and any reasonable collection costs
including attorney fees;

(4)  Requires any person, entity, association, or political
subdivision that purchases, receives, or holds real estate used
for the burial of human remains, excluding a family burial
ground, to notify the Office of Endowed Care Cemeteries within
the department of the name, location, and address of the real
estate before October 1, 2010, or within 30 days of acquiring the
land;

(5)  Exempts cemetery operators from the provisions of
Chapter 436 regarding prearranged funeral contracts for the sale
of cemetery services or for graves, cemetery markers, crypts, and
other burial receptacles but prohibits them from adjusting or
establishing the price of items with the intent of evading the
trust or escrow provisions of the chapter.  Provisions related to
deposits into endowed care trust funds based on the sales price
of certain products are revised;

(6)  Removes the provisions requiring a financial institution
serving as the trustee of an endowed care trust to be located in
Missouri but requires all activities of the trust to be
controlled by Missouri law and all funds held in trust to remain
in Missouri;

(7)  Requires a cemetery operator to notify the division in
writing at least 30 days prior to selling a majority of the
business assets of a cemetery or a majority of its stock.  If the
division does not disapprove, the operator may complete the
transaction;

(8)  Allows, for agreements entered into after August 28, 2010, a
cemetery prearranged merchandise products contract to be canceled
within 30 days of receipt of the executed contract and requires
all payments to be fully refunded with certain exceptions;

(9)  Allows the division to direct a trustee, financial
institution, or escrow agent to suspend the distribution of money
from an endowed care trust fund or escrow account if the cemetery
operator is not licensed, has failed to file an annual report, or
has failed to file a corrective action plan after an audit has
revealed a deficiency.  The cemetery operator may appeal the
suspension; and

(10)  Exempts, if a cemetery was owned by a city, any subsequent
cemetery owner from liability for any deficiency existing prior
to the city's ownership.  Currently, this applies only to a
cemetery in St. Louis City.

LICENSURE OF PRIVATE INVESTIGATORS (Sections 324.1100 - 324.1147)

The bill:

(1)  Requires each member of the Board of Private Investigators
Examiners within the Division of Professional Registration in the
Department of Insurance, Financial Institutions and Professional
Registration to be a resident of the state for at least one year
prior to his or her appointment and to be a registered voter;

(2)  Increases, from two to five years, the term of a board
member and allows him or her to serve consecutive terms;

(3)  Repeals conflicting statutes created by the passage of House
Bill 780 and Senate Bill 308 in 2007 regarding the licensing
exemption for employees of a not-for-profit organization who make
and request criminal background information on behalf of health
care providers and facilities and clarifies that the exemption
for licensure as a private investigator applies to employees of
profit and non-profit organizations making employee background
checks;

(4)  Requires the division to employ board personnel, exercise
all administrative functions, and deposit all fees collected into
the Board of Private Investigators Examiners Fund;

(5)  Specifies that a licensed certified public accountant and
his or her employees are not to be deemed to be engaged in the
private investigator business when performing their duties;

(6)  Removes the exemption for licensure as a private
investigator if an employer-employee relationship exists;

(7)  Clarifies that the exemption for licensure as a private
investigator will apply to any person who does not hold himself
or herself out to the public as a private investigator and is
exclusively employed by or under an exclusive contract with a
state agency or political subdivision;

(8)  Clarifies the exemption for licensure as a private
investigator when a legal process server is conducting
process-serving activities;

(9)  Requires the board, instead of the department, to be
responsible for the background investigation and review of an
applicant but the division, instead of the board, must determine
the form of the license;

(10)  Specifies that an applicant can be denied a license if he
or she has received a suspended imposition of sentence following
a guilty plea to a misdemeanor offense involving moral turpitude
or has been refused a license or had a license revoked or denied
in the state or any other state and prohibits a private
investigator agency from hiring an individual who has received a
suspended imposition of sentence following a plea of guilty to a
misdemeanor offense involving moral turpitude;

(11)  Removes a provision regarding the fee for an individual, an
agency, or an employee of an agency that is issued a license for
less than a year;

(12)  Specifies the procedures for renewing a license;

(13)  Allows the board to establish all fees;

(14)  Requires a licensee to maintain records containing
information relative to his or her employees and copies of
contracts or court orders requiring the destruction, sealing, or
return of certain records; and

(15)  Requires the board to license a private investigator
trainer.  Currently, the board must certify these individuals.

ARCHITECTS, ENGINEERS, LAND SURVEYORS, AND LANDSCAPE ARCHITECTS
(Sections 327.031 - 327.411)

The bill:

(1)  Increases the membership of the Missouri Board for
Architects, Professional Engineers, Professional Land Surveyors
and Landscape Architects within the Department of Insurance,
Financial Institutions and Professional Registration from 14 to
15 by adding one more professional engineer;

(2)  Allows a landscape architect to serve as the chairperson of
the board;

(3)  Gives all rights, powers, and duties available to the
members of the architectural and professional engineering
divisions of the board to the members of the professional land
surveying and landscape architectural divisions of the board;

(4)  Allows certain faculty members of an accredited school of
landscape architecture to serve on the board;

(5)  Repeals the requirement that the board cannot summon or
subpoena a witness or documents on a matter under a hearing or
investigation without the advice of the Attorney General;

(6)  Establishes a sequential rotation for the appointment of a
chairperson to the board;

(7)  Limits a chairperson to one, four-year term;

(8)  Authorizes the President of the Missouri Association of
Landscape Architects to fill a board vacancy for a landscape
architect as other state associations are allowed to do for their
professions;

(9)  Allows a person holding an inactive license as a
professional land surveyor to use that title or the initials
"PLS" after his or her name; and

(10)  Requires a licensee to prepare or personally supervise the
preparation of all documents containing his or her personal seal
and to perform services only when he or she is qualified by
education, training, and experience in the specific technical
areas involved.

EXPANDED-FUNCTIONS PERMITS FOR CERTAIN DENTAL ASSISTANTS AND
DENTAL HYGIENISTS (Sections 332.011 and 332.098)

All dental assistants and dental hygienists must obtain a permit
from the Missouri Dental Board within the Department of
Insurance, Financial Institutions and Professional Registration
in order to perform expanded-functions duties.  "Expanded-
functions duties" are defined as reversible acts that would be
considered the practice of dentistry under Section 332.071 that
the board specifies, by rule, may be delegated to a dental
assistant or dental hygienist who possesses an expanded-functions
permit.

Nothing in the bill will be construed as making it unlawful for a
licensed dentist to perform any dental services that would be
considered expanded-functions duties or for dental assistants,
certified dental assistants, or expanded-functions dental
assistants to polish teeth.  The board is prohibited from
establishing any rule allowing the delegation of acts to a dental
assistant which would conflict with the practice of dental
hygiene in Section 332.091.  An expanded-functions permit must be
renewed every five years, and the board is authorized to
establish rules regarding the issuance and renewal of a permit.

PHYSICAL THERAPISTS (Sections 334.100, 334.506, and 334.613)

A physical therapist is authorized to accept a prescription for
treatment from a licensed advanced practice registered nurse.

SUPERVISION REQUIREMENTS FOR PHYSICIAN ASSISTANTS (Section
334.735)

The State Board of Registration for the Healing Arts within the
Department of Insurance, Financial Institutions and Professional
Registration is prohibited from requiring additional supervision
requirements for a physician and physician assistant team prior
to working in a rural health clinic as defined by the federal
Rural Health Clinic Services Act if a waiver has been granted by
the board and the minimum federal supervision standards are met.

A physician assistant cannot prescribe or dispense any drug,
medicine, therapy, or device unless he or she is in a
collaborative agreement with a supervising physician.  Currently,
a physician assistant must consult with his or her supervising
physician.

LICENSURE OF NURSES (Sections 335.075 and 335.081)

An employer of nurses is required to have a system in place for
verifying that the applicant for a position as a registered,
licensed practical, or advanced practice registered nurse has a
current, valid license and for verifying the licensure status at
the time of the nurse's license renewal.

The bill also exempts a person from licensure as a nurse in
Missouri if he or she holds an out-of-state license and is
transporting a patient into, out of, or through the state and the
transport does not exceed 48 hours in the state.

COMPLAINTS AGAINST CERTAIN LICENSED PROFESSIONAL COUNSELORS
(Section 337.528)

The State Committee for Professional Counselors within the
Department of Insurance, Financial Institutions and Professional
Registration is allowed to remove unsubstantiated complaints made
against licensed professional counselors by offenders who have
been ordered into custody, detained, or held by the Department of
Mental Health as sexually violent predators.  Upon the written
request of a licensed professional counselor subject to a
complaint by these offenders prior to August 28, 2010, that did
not result in disciplinary action, the committee and the Division
of Professional Registration within the Department of Insurance,
Financial Institutions and Professional Registration must destroy
all documentation regarding the complaint, notify any other
licensing board that was previously notified of the complaint of
its actions, and send a letter to the licensee clearly stating
that the complaint was unsubstantiated.

LICENSURE OF SOCIAL WORKERS (Sections 337.600, 337.603, 337.615,
337.618, and 337.643)

The bill:

(1)  Limits the time period that a practitioner of master social
work, if supervised, may engage in practices reserved to a
clinical social worker or an advanced macro social worker to no
more than 48 consecutive months for the purpose of obtaining a
license as a clinical social worker or an advanced macro social
worker;

(2)  Repeals the provisional license for clinical social workers;
and

(3)  Revises the definition of "qualified advanced macro
supervisor," "qualified baccalaureate supervisor," and "qualified
clinical supervisor" to be a licensed social worker who has
supervised in the field of social work for at least five years.
Currently, supervision is required for at least five
uninterrupted years.

MARITAL AND FAMILY THERAPISTS (Sections 337.700, 337.703,
337.705, 337.706, 337.715, 337.718, 337.727, and 337.739)

The State Committee for Marital and Family Therapists within the
Department of Insurance, Financial Institutions and Professional
Registration is authorized to issue a provisional license to a
person who is a graduate of a specified acceptable higher
education institution with at least a master's degree in marital
and family therapy, or its equivalent, and meets all requirements
of a licensed marital and family therapist other than the
specified required supervised clinical experience if he or she is
supervised by a qualified person as defined by rule of the
committee.

Any official, employee, board, commission, or agency of the state
and any county, municipality, school district, or other political
subdivision of the state is prohibited from discriminating
between persons licensed as marital and family therapists when
establishing rules or when requiring or recommending services
that legally may be performed by these therapists.

LICENSURE OF WHOLESALE DRUG DISTRIBUTORS (Sections 338.333,
338.355, and 338.337)

A wholesale drug distributor who distributes drug-related devices
in this state is not required to obtain a license from the State
Board of Pharmacy within the Department of Insurance, Financial
Institutions and Professional Registration for out-of-state
distribution sites owned by the distributor if:

(1)  The distributor has one or more distribution sites in
Missouri and these sites are licensed as a distributor;

(2)  The distributor's out-of-state distribution sites are in
compliance with their respective state's licensing laws; and

(3)  The distributor's out-of-state distribution sites deliver
the devices only to the licensed distributor's in-state
distribution site.

A Missouri wholesale drug distributor receiving shipments of
devices from a licensure-exempt, out-of-state facility will be
responsible for all shipments received.

RESIDENTIAL CARE FACILITIES (Sections 344.010 and 344.020)

The Missouri Board of Nursing Home Administrators within the
Department of Insurance, Financial Institutions and Professional
Registration is authorized to issue a separate license to the
administrator of a residential care facility which was licensed
as a residential care facility II on or before August 27, 2006,
if it continues to meet all licensure standards for a residential
care facility II in effect as of that date.

Anyone licensed to operate a residential care facility is not
authorized to operate an intermediate care or skilled nursing
facility.

DISCIPLINARY ACTIONS AGAINST CERTAIN HEALTH CARE PROFESSIONALS
(Sections 383.130 and 383.133)

Home health agencies, nursing homes or facilities, or certain
entities employing or contracting with licensed health care
professionals are added to the list of health care providers that
must report to the appropriate health care professional licensing
authority any disciplinary action against a health care
professional or the voluntary resignation of a professional
against whom any complaints or reports have been made which might
have led to disciplinary action.

HOSPITAL PREMISES LICENSES (Section 1)

The bill allows an applicant for or a holder of a hospital
license to define or revise the premises of a hospital campus to
include tracts of property which are adjacent except for a common
street or highway and its accompanying public right-of-way.

Missouri House of Representatives
95th General Assembly, 2nd Regular Session
Last Updated September 14, 2010 at 3:13 pm