HCS HB 835 -- HEALTH CARE PROVIDERS

SPONSOR:  Cooper (155)

COMMITTEE ACTION:  Voted "do pass" by the Committee on Health
Care Policy by a vote of 6 to 3.

This substitute changes the laws regarding health care providers.

SURGEON GENERAL

The substitute establishes the Office of the Missouri Surgeon
General within the Department of Health and Senior Services and
requires the Surgeon General to be a physician with a masters
degree in public health or health management training or
commensurate experience with public policy.  The Surgeon
General's duties include serving as chairperson of the State
Board of Health; advising the Director of the Department of
Health and Senior Services on developing strategies to improve
health indicators; creating an Internet web site to promote
healthy lifestyles for Missouri citizens; providing health
information to schools, employers, and private and public
institutions; and promoting public health information, health
literacy, and disease prevention.  The Surgeon General will be
appointed to a four-year term by the Governor with the advice and
consent of the Senate and is required to submit an annual report
on the current overall health of Missouri citizens and any
recommendations for improvements by January 31 of each year to
the Speaker of the House of Representatives, President Pro Tem of
the Senate, and Governor.

HEPATITIS C TESTING PROGRAM

The substitute requires the Department of Health and Senior
Services to establish and oversee a voluntary hepatitis C testing
program for health care providers.  Testing is confidential, and
results may only be disclosed to the facility where the health
care provider offers patient care.

CERTIFICATE OF NEED

The substitute defines "long-term care facilities" for purposes
of the Certificate of Need Program and limits the application of
certificate of need requirements to long-term care facilities.
Currently, certificate of need requirements apply to a broader
range of health care facilities, including hospitals and
long-term care facilities.

WILLING PROVIDERS OF HEALTH CARE

The substitute prohibits health insurers, the Missouri Medicaid
Program, and the federal Medicare Program from discriminating
against any provider located within the geographic coverage area
of a health benefit plan who is willing to meet the terms and
conditions for participation in the health benefit plan.

PHYSICIAN REFERRALS

The substitute prohibits a physician who is referred a patient
for diagnosis by another physician from delegating the diagnosis
to a nurse or nurse practitioner.

HOSPITAL MEDICAL STAFF SELF-GOVERNANCE

The substitute gives hospital medical staff the right to
self-govern when establishing certain provisions of medical
bylaws, rules, or regulations; selecting and removing medical
staff officers; assessing and utilizing medical staff dues;
retaining an attorney; and the initiation and adoption of bylaws,
rules, regulations, or amendments.

The medical staff and hospital governing board will meet to
resolve any dispute arising under the provision.  Once all
administrative remedies have been exhausted, a court of competent
jurisdiction may resolve the dispute.

DEPARTMENT OF HEALTH AND SENIOR SERVICES FUNDS

The substitute creates in the state treasury the Department of
Health and Senior Services Administrative and Cost Allocation
Fund and the Department of Health and Senior Services Disaster
Fund.  The substitute:

(1)  Specifies that the administrative and cost allocation fund
will receive funding by appropriations, deposits, and moneys
transferred or paid to the department in return for goods and
services provided;

(2)  Specifies that the disaster fund will be used during a state
of emergency by the Governor to furnish immediate aid and relief;

(3)  Allows the State Treasurer to serve as custodian and the
department director to serve as administrator over these funds;

(4)  Specifies that moneys in these funds will not lapse to the
credit of general revenue at the end of the biennium, and all
interest earned will be deposited into the fund; and

(5)  Allows any interest earned on the Missouri Public Health
Services Fund to accrue to the fund.

The substitute contains an emergency clause for these provisions.

BIRTH AND DEATH RECORDS

The substitute requires a birth certificate to be filed within
five days, instead of the current seven days, certifying the
place, time, and date of the live birth by a signature or an
electronic process approved by the Department of Health and
Senior Services.

All medical certificates when filing for a certificate of death
can have their accuracy attested to by either a signature or an
electronic process approved by the department.

IMMUNIZATIONS

Effective April 1, 2007, the substitute prohibits immunizations
administered in Missouri to knowingly pregnant women or children
under the age of three from containing more than one microgram of
mercury per five-tenths-milliliter dose.

Effective April 1, 2007, insurers licensed in Missouri that
provide coverage for immunizations on a fee schedule or a
percentage reimbursement basis are required to reimburse for
immunizations not containing mercury.  This reimbursement must be
at the same percentage rate of the usual and customary charges
provided for immunizations containing mercury or other
preservatives prior to April 1, 2007.

FISCAL NOTE:   Estimated Cost on General Revenue Fund of Could
exceed $19,374,279 in FY 2006, Could exceed $19,412,847 in FY
2007, and Could exceed $19,418,907 in FY 2008.  Estimated Cost on
Other State Funds of Could exceed $4,197,995 in FY 2006, FY 2007,
and FY 2008.

PROPONENTS:  Supporters say that the bill creates a state Surgeon
General to coordinate healthy lifestyle programs for the state.
The Surgeon General would help focus attention on improving the
health of all Missourians.

Testifying for the bill were Representative Baker (25); and
Missouri State Medical Association.

OPPONENTS:  There was no opposition voiced to the committee.

Amy Woods, Senior Legislative Analyst

Missouri House of Representatives
93rd General Assembly, 1st Regular Session
Last Updated August 25, 2005 at 1:20 pm