February 9, 2007

The General Assembly has finally begun its work schedule at a full pace.

Hearings are being conducted around the clock in both the House and Senate.

News this week includes:

Bills Heard in Committee This Week

• Senate Bill 173, sponsored by Sen. Luann Ridgeway, R-Smithville, was heard in the Senate Seniors, Families and Public Health Committee this week. This act would modify the definition of "health care professional," for purposes of determining who is subject to the protections of the peer review law, to include physical therapists, emergency medical technicians and emergency medical dispatchers.


• House Bill 447, sponsored by Rep. Rob Schaaf, R-St. Joseph, was heard in the House Health Care Policy Committee. This bill would require that the Missouri Medicaid program's benefit payments to providers be of a sufficient amount to cover the reasonable cost of the services provided. The specific fiscal impact of this bill is not yet known, but, if passed, is expected to be substantial.

House Advances Medicaid Provider Fraud Bill

The Missouri House of Representatives debated and approved legislation designed to reduce provider fraud in the Medicaid program this week. House Bill 353 now moves to the Senate.

During several hours of debate, state representatives considered a number of amendments. Some were rejected, such as a move to refashion the bill as a state civil false claims act modeled after the federal law of the same name. Others were approved, including imposing a lifetime ban from the Medicaid program for those convicted of obstructing access to records or information concerning fraudulent activity and apply the bill's anti-fraud requirements and penalties to state employees and state subcontractors delivering or arranging for the delivery of health care.

When the revised bill was brought up for a final vote, some legislators decried the measure as too weak. Others cautioned that the measure was too strong and could drive physicians and other providers from participating in the Medicaid program. However, virtually all felt compelled to support the bill; the bill passed by a margin of 156-2.

The House of Representatives and the Senate appear to have significantly different positions regarding Medicaid fraud legislation. House Bill 353 is a less stringent bill and more responsive to provider concerns than the legislation expected to be debated in the Senate. In 2006, the differences between the chambers proved intractable and the high-profile legislation faltered in the final hours of the legislative session.

Legislators Consider Measure to Protect Tobacco Settlement Funds

The Senate Judiciary and Civil & Criminal Jurisprudence Committee reviewed Senate Bill 242 this week. The bill revises Missouri’s laws that implement the 1998 tobacco settlement agreement between the major tobacco manufacturers and almost all of the states. The settlement agreement called for states to drop their liability claims against the tobacco companies in exchange for long-term payments.

Because of a loophole in the settlement agreement, small tobacco companies with a limited market are able to evade escrow payments designed to keep them from having a competitive price advantage over the major tobacco companies. Missouri is one of two states that have not enacted laws to close this loophole. Legislators’ failure to do so is causing mounting pressure from tobacco companies and others to withhold a portion of Missouri’s tobacco settlement payments.

The committee took no action on the bill, which the committee chair described as "complex and controversial."

Medicaid Waiver Bill Heard in Committee

House Bill 95, sponsored by Rep. David Sater, R-Cassville, was heard in the House Special Committee on Health Insurance this week. If passed, the bill would require the Department of Social Services’ Division of Medicaid Services to apply for certain federal Medicaid waivers. These waivers would allow Missouri’s Medicaid program to subsidize part of the cost of coverage offered by a small employer, as well as allow uninsured working adults without access to employer coverage to purchase benefits. This bill is modeled after a similar program in Oklahoma.

Committee Reviews Health and Mental Health Bills

The Senate Health and Mental Health Committee held a hearing on several bills this week.

• Senate Bill 2 would create state laws designed to protect the confidentiality of "personal health information," with criminal penalties for knowingly obtaining, receiving or selling such information without consent. The bill specifically authorizes health care providers to continue to use and disclose health information as permitted or required by federal or state law.


• Senate Bill 274 would create a Healthcare Technology Fund in the state treasury. Funds in the account would be appropriated to promote electronic medical record and prescribing systems and telemedicine and telemonitoring applications. The fund would be administered by the Department of Social Services.

Senate Judiciary Committee – February 5th

Senate Bill 242 – Nodler

This act modifies the release of certain funds placed in escrow by tobacco product manufacturers in compliance with the 1998 Master Settlement Agreement.

The number of units sold in Missouri is allowed to be taken into consideration for the release of the funds. Certain requirements are established for participating tobacco manufacturers and for nonparticipating tobacco manufacturers relating to the agreement between various tobacco companies and the State of Missouri, 45 other states, the District of Columbia, and five U. S. territories.

All tobacco manufacturers whose cigarettes are sold in Missouri are required to report and certify to the Department of Revenue and the Attorney General's office by April 30th of each year that they are in compliance with the Tobacco Settlement Model Statute currently in Missouri law. In addition to the certification, participating manufacturers must also provide a list of "brand families" of cigarette types. Nonparticipating manufacturers must submit their brand families, the number of units sold for each family at any time during the year, the name and address of any other manufacturer of their brand families in the preceding or current calendar year, and other information to verify compliance with the model statute.

Each nonresident or foreign nonparticipating manufacturer must be registered to do business in the state or maintain an agent within the state for the purpose of service of process relating to the enforcement of the act. By July 31, 2007, the Director of the Department of Revenue must make available for public inspection or publish on the department's website a list of all tobacco product manufacturers that have satisfied the certification requirements established in the act.

Stamping agents (persons authorized to affix cigarette tax stamps to cigarette packages) are required to submit to the director an e-mail address for the receipt of notifications as required by the bill and to submit various reports and documents as required by the department.

Various penalties and actions for failure to comply with the requirements of the act are included. The act contains an emergency clause.

For:

• Joe Maxwell – General Council to Phillip Morris


• Thor Hearne – General Council to Phillip Morris


• Daniel Landon – MHA


• John Dalton – Lewis Rice Fingerish


• Harry Gallagher – RJ Renyolds

Against:

• Chuck Hatfield – Morris Heckert


• Andy Arnold – Dirt Cheep and U-Gas


• Fred Tutenburg and Paul Taylor – Dirt Cheep and U-Gas


• Keith Burdick – Excalibur Tobacco


• Ron Tully – National Tobacco


• Kevin Alderman – Council of Independent Tobacco Manufactures


• David Klarich - Smokers Warehouse

Next Week

Hearings will continue to nominate legislative activity.

House Bills for Perfection

HCS HB 39-Establishes the eligibility requirements of an employed disabled person requesting medical assistance under the federal Ticket to Work and Work Incentives Improvement Act of 1999.

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