SAVE THE DATE: Physician Advocacy Day 2026 will be March 3, 2026!
Note: For those who want to hear the results of the session from the horse’s mouth, plan on attending our virtual wrap-up with MSMA and our lobbyists on Sunday, May 18 at 6 PM. Register here!
Last week I unintentionally lied to you and said there would not be a Legislative Report this week. Sorry about that! Our lobbyists were able to pull everything together in time for the weekend. So here it is, a session wrap-up and the last one of the 2025 session!
A Dose of Legislative Wins and Losses – 2025 Edition
Ah…another year of legislative battles where medicine meets politics is in the books! Grab your stethoscopes and let’s take the pulse on what made it through, what flatlined, and what might be revived next session. The First Regular Session of the 103rd General Session had a bit of a bumpy end. The Senate chose the nuclear option, moving the previous question (PQ) on two of the hot topics, majority caucus priority bills from session. First up was HJR 73, which will send language to repeal and replace the new constitutional amendment 3 relating to abortions to a vote of the people. The second bill to receive a PQ repealed and amended new state law regarding minimum wage and paid time off. This effort completely repealed the paid sick leave provisions as well as eliminating the CPI adjustment for minimum wage. These provisions will take effect on August 28. After the Senate went home, the House did what the House does, worked to pass what remained that they had the appetite to pass before calling it quits on Thursday. For now, we breathe an early collective sigh of relief.
Bills that Passed
Abortion Ballot Initiative – HJR 73
In the aftermath of the passage of Amendment 3 (A3) in the fall of 2024, we fully expected the republican super majorities in the House and Senate to respond by putting a question of abortion access back on the ballot for 2026. The new ballot measure curtails much of the abortion access provided under A3 but allows for some exemptions. Those include; rape, incest, fetal anomalies, and medical emergencies.
Cardiac Emergency Response Plan – HB 232 & SB 155
If there’s anything we love more than preventing emergencies, it’s being ready for them. These bills require schools to establish cardiac emergency plans and ensure AEDs are available on campus—because saving lives shouldn’t be optional. Sent to the governor as part of SB 68, this effort is a win for public health and common sense.
Class Action Lawsuits – SB 47
We got a tort bill signed by the governor! This bill changes and updates Missouri Court procedures to match that of the Federal Courts on Class Action litigation. With this change a Court handling a Class Action lawsuit must address whether a class exists before allowing a case to proceed. This is a positive sign for future tort bills.
Funding for Additional Residency Slots – HB 2010
In what feels like a rare but delightful moment of bipartisan commonsense, Missouri’s Graduate Medical Education program received a financial boost—an additional $5.8 million in general revenue to expand residency slots. Yes, that means more future physicians will get the training they need right here, instead of fleeing to states with cushier budgets. Considering these funds could have easily gone to things like education or Medicaid, we’re thrilled the legislature recognized the value of investing in Missouri’s next generation of physicians.
Healthcare Omnibus – SB 79
This bill started off allowing membership organizations to offer a healthcare benefit program. It quickly became an omnibus bill containing; expedited partner therapy, audio-only telehealth parity, forensic exams, extra prenatal testing, MO HealthNet coverage for hearing devices, insurance coverage for 12-month supply of birth control, and patient notification mammography results.
Hyperbaric Oxygen Therapy – HB 262
This bill establishes the Veterans Traumatic Brain Injury Treatment and Recovery Act. Proponents assert that this will assist veterans battling traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) for hyperbaric oxygen therapy. Furthermore the bill created the Veterans Traumatic Brain Injury Treatment and Recovery Fund, which will reimburse healthcare facilities providing hyperbaric oxygen therapy to eligible veterans. In addition, the fund will support clinical research on alternative therapies for TBI and PTSD. Physicians and healthcare facilities seeking reimbursement must meet specific eligibility criteria and requirements, ensuring accountability and quality standards in delivering treatment. The Missouri Veterans Commission will oversee the implementation of this Act, including compiling an annual report detailing the effectiveness of hyperbaric oxygen therapy based on collected treatment data. We say show us the data. There has already been in influx of chiropractors now offering this service.
Missouri State Loan Repayment Program – SB 635 and HB 720 (passed on SB 150)
We worked closely with the bill sponsor and the Executive Branch to draw down more than twice the current funding in order to assist with health professional loan repayments. In addition, we secured language to guarantee physicians would receive at least 35% of those funds. Currently, physicians are not guaranteed any funding. We are very happy to have expanded and secured a financial resource we hope physicians in Missouri will utilize to help pay down student loan debt.
Bills That Died (Gone, but Not Forgotten)
Adaptive Questionnaires – HB 710 & SB 108
Artificial intelligence diagnosing and treating patients with no physician involvement? We don’t know whether to call that sci-fi or malpractice. Fortunately, our testimony helped change this attempt to replace the doctor-patient relationship with a glorified chatbot. We stand ready to protect the physician-patient relationship when this comes back next year.
Anesthesia Services – HB 1126 and HB 932
This effort would have required insurance coverage for anesthesia services. The language landed in several promising omnibus healthcare bills. Sadly, they all fell victim to the classic legislative tragedy. We will definitely be back with this and other important insurance reforms next year.
Covenants Not-to-Compete – HB 913 & SB 383
Restrictive covenants limit physicians’ ability to practice medicine freely. We introduced bills to change that. Neither bill advanced this session. Expect this fight to continue next year.
Co-pay Accumulator – HB 79 & SB 45
Co-pay accumulator programs can have significant implications for physicians, especially those treating patients with chronic illnesses or high-cost medications. These programs prevent manufacturer co-pay assistance from counting toward a patient’s deductible or out-of-pocket maximum, which can make it more difficult for patients to afford their medications over time. If patients can’t afford their medication due to unexpected costs, they may skip doses or stop treatment altogether, potentially worsening their health outcomes. This, in turn, can create additional burdens on healthcare providers, who must manage complications resulting from non-adherence. Physicians may also need to spend more time navigating alternative treatment options, appealing insurance decisions, or helping patients find financial assistance, which takes away from direct patient care. We will support this again next year.
Doula Services – HB 890
Insurance reimbursement for doula services? An interesting idea. We kept watch to make sure it didn’t birth unintended consequences. It never made it past conception. (Okay – this is a really bad joke – but you have to admit its funny!)
Emergency Room Staffing – HB 1013 & SB 520
One might assume that a physician should always be on staff in an emergency department. Yet, surprisingly, that’s not a given in Missouri. These bills aimed to mandate that a physician be present whenever an ED is open. When seconds matter, you want the most qualified medical professional at the helm. MAOPS threw its full support behind these measures, strongly advocating that emergency departments must be physician-led. With favorable hearings, these bills showed promise, but didn’t quite make it to the finish line this session. However, in a political landscape where access to care is constantly debated, these bills provide a clear answer to lawmakers eager for solutions. Expect us to return next year with renewed vigor—and a serious dose of urgency—to push this over the finish line.
Non-opioid Alternatives – HB 804 & SB 158
In an era where opioid addiction continues to devastate communities, these bills pushed for insurance coverage non-opioid treatment options for acute, subacute, and chronic pain. A small but crucial step in addressing the crisis, these efforts aimed to arm physicians and patients alike with alternative pain management strategies.
Peer Review – HB 830 & SB 107
These bills aimed at extending peer review privileges to physician assistants and emergency services personnel. Peer review is a vital tool for ensuring patient safety, enabling healthcare professionals to assess medical practices and clinical decisions in a collaborative environment free from the looming threat of litigation. These bills did not pass
Psilocybin (Magic Mushrooms) – HB 951 & SB 90
Psychedelics in medicine was once confined to hushed conversations and underground studies. Now it has entered the legislative realm. These bills sought to open the door for clinical trials of psilocybin. While these bills saw movement in committee, they failed to take root beyond that point. Interestingly, the concept sprouted up on the Senate floor during a debate on veteran suicide prevention. While lawmakers ultimately resisted adding psilocybin measures to unrelated legislation, this topic is far from disappearing. We’ll be watching closely to see how this unfolds in future sessions.
Prior Authorizations – HB 618 & SB 230
If there’s one bureaucratic hurdle physicians loathe, it’s prior authorizations. These bills aimed to cut through the red tape by allowing physicians with strong prior authorization records to be fast-tracked through the system—a process dubbed as Gold Carding. We worked tirelessly to build a coalition for reform and saw impressive bipartisan support for the House bill, which passed with ease. The House bill received unanimous support in the Senate Insurance Committee as well. This marked a major victory in our ongoing battle against the powerful insurance industry. While we didn’t get final approval this session, momentum is on our side. We’ll keep the pressure on, because reducing administrative headaches for physicians means better care for patients.
Telehealth – HB 825 & SB 94
Telehealth has become a vital tool for expanding access to care. These bills proposed an important update: allowing reimbursement for audio-only telehealth visits. While video calls have become standard in virtual healthcare, phone-only visits remain crucial for patients in rural areas, older populations, or those lacking reliable internet access. These bills maintained the integrity of telehealth by preserving the physician-patient relationship as required under current regulations. None of these proposals gained enough traction to pass.
Title Protection – HB 1013
Who’s treating you? Patients deserve to know. These bills aimed to crack down on misrepresentation in healthcare, ensuring that practitioners accurately disclose their credentials. In an age where midlevel providers increasingly market themselves with titles that blur the lines between physician and non-physician roles, this legislation was an important step toward clarity. We supported the effort, but despite our efforts these bills were never granted a committee hearing. Transparency in healthcare isn’t just a courtesy—it’s a necessity. We’ll continue educating lawmakers on the risks of misleading patients in a clinical setting and the importance of ensuring patients can confidently understand exactly who is providing their care.
Tobacco 21 – HB 344 & SB 231
Missouri lawmakers aimed to override local regulations governing the sale of tobacco, alternative nicotine, and vapor products—an idea that sounds harmless enough until you realize what’s at stake. Local jurisdictions across the state have enacted stricter tobacco laws aimed at keeping these products away from kids. If these bills had passed, those hard-fought local rules would have been erased, replaced by weaker statewide standards. The house of medicine stood firm against this preemption, recognizing the importance of strong tobacco control policies—especially in protecting Missouri’s youth. While both bills received favorable votes in committee, only the House bill was able to cross chambers, meeting its demise in the Senate. We’ll continue advocating for public health policies that prevent tobacco addiction before it starts.
Tort Reform (statute of limitations, collateral source, expert witness)
MAOPS fully supported these efforts, as Missouri’s tort laws have long needed an injection of common sense. For too many years, legislative inertia has stalled meaningful tort reform, leaving physicians vulnerable to prolonged litigation battles. While most of these bills didn’t cross the finish line this session, we’ll be back in the fight next year. Protecting physicians from excessive legal exposure is key to ensuring they can focus on patient care—not legal paperwork.
Workplace Violence – HB 1213
This bill was designed to raise awareness about the seriousness of assaulting healthcare workers in hospital settings. The proposed legislation would require hospitals to display signs warning of the legal consequences of such actions. We see it as a positive first step in equipping healthcare professionals and administrators with tools to prevent workplace violence. Though the bill did not pass, we will bring it back next year.
An Omnibus Year
Years of stalled healthcare efforts due to dysfunction in the Senate, lead to the formation of several healthcare-related omnibus bills. Some bills were even filed as multi-issue bills; others were put together early in the committee process. Legislators clamored all session about their disappointment in the lack of healthcare legislation making is across the finish line and were dedicated to seeing as many issues pass as possible. They worked hard. In the end only one healthcare omnibus bill made it to the governor.
Healthcare Omnibus Bills – HB 943, HB 398, SB 7, SB 61 & SB 94
These bills had a varied in the variety of healthcare topics they contained throughout session These issued included but are not limited to: insurance coverage for 12-month supply of oral contraceptives, mammography test result notification, extra prenatal tests, expediated partner therapy, financial guidelines for EMS and hospitals, board requirements for EMS districts, Mo HealthNet coverage for hearing devices, hospital requirements for sexual assault victims, telehealth, and much more.
Scope of Practice Battles
In all scope of practice battles we put patient safety first. Training, experience and expertise matter. We are here to ensure that Missouri’s medical standards remain uncompromised. We were lucky to not see much success on scope expansion bills this year.
Assistant Physicians – HB 1010
This bill proposed an alternative licensure pathway for assistant physicians (APs). APs are medical school graduates who have not yet completed residency or obtained full medical licensure. We do not support licensure pathways for individuals who have not completed an appropriate residency program. This bill died in committee; however we expect to see it return.
APRN Independent Practice – HB 763, HB 392, SB 144 & SB 179
These bills aimed to toss physician oversight out the window, removing collaborative practice entirely—no mileage limits, no familiarity rules, no chart reviews with the ability to prescribe all Schedule II drugs. Hard pass. MAOPS held firm. The House bills never saw the light of day and the Senate proposals didn’t survive committee. This issue is never going away.
CRNAs – SB 522 & SB 545
The push to remove supervision requirements for CRNAs and grant broader access to controlled substances without a DEA license never materialized this session. Bills were filed, but they were never heard in committee. But don’t get too comfortable—they’ll be back next year, and we’ll be ready.
Naturopath Licensure – HB 91
The “Naturopathic Physician Practice Act” sought to create licensure for naturopathic practitioners. It would have granted them powers typically reserved for fully trained and licensed physicians. We took a hard stance against this measure, successfully halting it at its introduction.
Optometry Surgery – HB 929 & SB 219
These bills would allow optometrists to perform surgery and deliver injectables. The Senate bill died after a glorious hearing where an optometrist mentioned she felt comfortable doing laser surgery in the back of her van in parking lot. On the flip side we fought entirely too hard to stop this dangerous idea in the House. Though we picked up opposition from last session, it received a passing vote in committee. It was also added as House amendment to SB 7 on the House floor. We were successful in having the language removed from the conference committee report on SB 7 before it was allowed to move forward. The whole bill ultimately died under its own weight. We know a battle is brewing, especially for optometry scope of practice expansion. Some hard conversations are coming.
Pharmacist Filling Scrips – SB 519
The bill proposed changes to the quantity of medications that pharmacists are authorized to dispense without a current prescription. We are sympathetic to patients’ ability to access their medications, however the bill as drafted was concerning enough for us to force a full-stop on the issue this year. We raised questions about patient safety, continuity of care, and regulatory compliance. While we were able to stop the bill this year, we know it will be back next year.
SAFE Care Act APRNs – SB 83
A quiet but significant effort emerged this session to remove physician collaboration for APRNs working in child advocacy centers across Missouri. These APRNs perform SAFE CARE exams on children suspected of abuse. They also see and treat or refer kids for other medical issues. Instead of filing a transparent bill, proponents slipped the language into SB 83, an otherwise innocuous omnibus child protection bill, hoping it would go unnoticed. Child advocacy center (CACs) administrators argue that finding physician collaborators has become too difficult. They seek to bypass this requirement altogether. But removing physicians from the equation isn’t the right answer. It is a step backward for patient care. We firmly believe that all patients, especially children undergoing sensitive medical evaluations, deserve physician-led care. We worked diligently with the bill sponsor and key legislators to ensure they grasp the nuanced realities of this issue. Our focus remains on safeguarding the integrity of pediatric care. We want to ensure that Missouri’s most vulnerable patients receive the highest standard of medical oversight and protection. We were successful in tabling this bad idea this session. However, we have been told if the CACs continue to struggle to find collaborators, they will be back next session with a much stronger push for this scope expansion.