Telehealth and Collaborative Practice Reform Bills Advance

Several pieces of legislation supported by MARHC are moving forward in the Missouri legislature.

The two telehealth bills, SB 621 and HB 1923, are nearing final passage. SB 621, sponsored by Sen. Gary Romine (R-Farmington), was passed by the House with amendments this week. It will return to the Senate and then to conference committee to work out the differences between the House and Senate versions. HB 1923, sponsored by Rep. Jay Barnes (R-Jefferson City), was recently passed by the Senate Veterans Affairs and Health Committee.

Both of these bills will expand patient access to healthcare services by modernizing Missouri's telehealth regulations. They include a general authorization for providers to offer services via telehealth as long as the standard of care is equal to a face-to-face encounter and the services are within their scope of practice. SB 621 and HB 1923 also enable providers in rural health clinics to receive Medicaid reimbursement for serving as distant sites in a telehealth encounter. These bills would also allow Medicaid reimbursement for telehealth services in which patients are located in their home, school, or a Child Advocacy Center. MARHC understands the challenges of providing healthcare in rural Missouri. We have actively supported this legislation to enable RHCs to more fully utilize modern technology to provide quality care in their communities.

A physician licensure bill (HB 1816) was amended on the House floor with language that would waive the mileage requirements for APRN collaborative practice agreements and allow physicians to supervise up to five APRNs. The current limit is three. This amendment is identical to Rep. Lyle Rowland's (R-Cedarcreek) HB 1697, which MARHC has supported. HB 1816 passed the House 128 to 24 and was heard in the Senate Financial and Governmental Organizations and Elections Committee. It remains to be seen whether the APRN language will be removed in the Senate. Rep. Rowland's language has been added to several other bills moving through the legislature, including SB 621.

The House Select Insurance Committee recently passed SB 865, sponsored by Sen. David Sater (R-Cassville). This bill would require health carriers to offer medication synchronization services and allow pharmacists to dispense up to a 90-day supply of maintenance medication. It also includes rate review provisions that would require carriers to file rates with the Department of Insurance. The department would designate rates as reasonable or unreasonable and make information on unreasonable rates available to the public. SB 865 is now on the calendar for a vote in the House.

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