April 28, 2006

Negotiators from the House and Senate worked throughout the week to resolve differences between the House and Senate versions of the state budget for the fiscal year, which begins July l. Most of the issues in the regular operating budget have been decided. The compromises are ready to be incorporated into new versions of the appropriation bills that will go before the House and Senate next week for ratification. The Missouri constitution requires the budget be enacted by 6 p.m. Fri., May 5. The legislative session adjourns May 12 th.

News this week includes:

Committee Approves Motorcycle Helmet Repeal

 This week, a Senate committee approved by a 5-3 margin a bill allowing those age 21 and older to ride on a motorcycle without wearing a helmet. The bill is House Bill 994. It now advances to Senate floor debate.

Missouri Safety Council, MHA, MSMA and a number of organizations testified against the legislation.

Core Public Health

The House and Senate conferees reduced the core public health functions appropriations to the Governor’s recommendation of $9.027 million. The House had added an additional $200,000.

However, the Senate removed language added in the House obligating a portion of these funds to women’s health services (alternatives to abortions program).

HJR 48

 Representative Bearden’s HJR 48 , a constitutional amendment establishing limits on total state general revenue appropriations is on the House calendar for debate and will remain there for this session.

 Democrats Say Health Insurance Tax Credit Plan Would Not Help Poor

 President Bush in his fiscal year 2007 budget plan proposed a new refundable health insurance tax credit for health insurance premiums paid by low-income households. Democrats on the Joint Economic Committee contend in a policy brief issued April 18 that tax credits to help individuals buy health insurance would do little to help low‑income earners get coverage. The brief argues that the tax credit would cover only a third of the cost of a high-deductible health insurance plan. The brief is available at http://jec.senate.gov/democrats/Documents/Reports/hsas05apr2006.pdf.

Committee Endorses Metabolic Treatment Changes

A Senate committee has approved a Senate Committee Substitute for House Bill 1477. The revised bill would authorize health care providers who are treating a newborn infant to access the Missouri Department of Health and Senior Services’ data on genetic and metabolic screening tests performed on the newborn infant.

The bill also changes the state’s standards for providing dietary formula to children ages 6-18 who need it to treat PKU or related metabolic diseases. It would expand the current formula program to encompass children in households with incomes below 300 percent of the federal poverty level.

Committee Reviews Sexual Assault Treatment Standards

The Senate Judiciary and Civil & Criminal Jurisprudence Committee held a hearing on House Bill 1317 this week. The bill was amended in the House to change the way hospitals and other providers would be reimbursed for conducting forensic medical examinations following a sexual assault. All charges for the examination will be paid by the Missouri Department of Health and Senior Services and the patient may not be billed for the examination itself. The amendment also revises procedures for performing the forensic examination using materials supplied by the Missouri Highway Patrol or state crime laboratories. The amendment is projected to cost the state $2.8 million. Its proponents are working to convince legislators that the cost would be offset by the state’s potential loss of federal grant funds if it does not modify its sexual assault response laws.

Committee Revises Coverage Standards for Clinical Trials and Nonsmoking Workers

 This week, a House committee reviewed and approved a House Committee Substitute for Senate Bill 567. The original bill would require insurers to cover the cost of routine patient care costs associated with Phase II clinical trials for the treatment of cancer. The committee added language to clarify that health insurers and employers may provide employee health insurance coverage that offers lower premiums or deductibles to nonsmoking workers. Also, the new bill would restrict copayments that may be charged for prescription drugs dispensed in multiple dosage amounts.

Tax Deduction for Health Insurance Coverage Advances

 This week, the House gave final approval to the House Committee Substitute for House Bill 1677 and sent the bill to the Senate. It would create a state income tax deduction for health insurance premiums taxpayers pay to insure themselves or their spouses and dependents. The projected state cost is $28 million in the first year of implementation, growing to $84 million in state fiscal year 2009.

On motion of Representative Ervin, HCS HB 1677 was read the third time and passed by the following vote:

Speaker Jetton declared the bill passed.

Budget

 In developing the final version of the Medicaid budget, negotiators chose to fund the new Health Information Technology Fund with $25 million in state funds, as endorsed by the Senate. The House had allocated only $1.7 million in state funds for information technology. Also, the Senate’s allocation of an additional $300,000 to adjust the premium schedule for coverage under the State Children’s Health Insurance Program was included. An additional $3.5 million in state funds was added to increase Medicaid payments to primary care physicians.

 Committee Advances Health Information Confidentiality Bill

 A House committee reviewed and approved a House Committee Substitute for Senate Bill 1041 this week. The bill establishes criminal penalties for possessing or selling personal health information without the patient’s consent. MHA earlier worked with the sponsor to amend the bill to resolve apparent conflicts with the federal HIPAA law.

Liability Limitations for Disaster Responders Advances

 A Senate committee has approved legislation that would limit civil liability of volunteer health practitioners who are deployed by the governor or a state agency to respond to a declared state emergency. The liability protections would not apply to willful or wanton acts or omissions. The bill is the Senate Committee Substitute for House Bill 1118.

Similar language has been incorporated into Senate Bill 820, which was given final Senate approval and sent to the House this week.

Next Week

The Missouri General Assembly is entering the final two weeks of the legislative session. There will be no reports next Friday as it will still be in session. A full write-up of the last two weeks will follow upon adjournment May 12 th.

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