Sizing Things Up

We’ve made it to the halfway point of our yearly legislative sausage making adventure. Both the House and the Senate are functioning like well-oiled machines. So far there has been little evidence of the high drama that has plagued our political theater in the past. Instead, we are witnessing a Senate with so much go along to get along and little thoughtful deliberation, bills are passing swiftly. What gives us pause is the number of bills that are getting a lot of love on the floor and passing with multiple amendments. In years past, we would have said those bills were loved to death. Not this year. We are witnessing a culture of “I’ll scratch your back, if you scratch mine.” This increases the chances of success for amendments we consider bad for medicine. We will have our spidey senses dialed up when they come back from break.

Legislative Spring Break is more than just a little time for some R&R, it often serves as the signifying measurement as to whether bills have enough legs to finish the last half of the race. The first half of the session usually goes at a marathon pace, while the last half is more of a sprint. Historically bills need to have made it past committee by this midway marker to have a chance at the finish line. As of close of business both chambers can boast on their work thus far. The House has sent fifty-three bills to the Senate. While the Senate has sent an astonishing thirty-nine bills to the House. Before legislators took some time off, they had already sent six bills to the Governor for approval. That’s a lot!

Major Moves of the Week

Before we get into our progress report on the bills we’ve been telling you about all session, there are a couple major updates from this week. We spent a good portion of the week on guard in house committees. On Tuesday the House Health and Mental Health committee heard HB 710, which would allow adaptive questionnaires to take the place of establishing an in-person physician-patient relationship. Unfortunately, House members are likely to vote this one out of committee when they return. They worry about access and are willing to let people have access to anything – good healthcare practice or not. This is where you can do you part by educating your specific representative about the dangers of this bill.

Speaking of their appetite to let just about anything (or anyone) practice medicine, Wednesday the House committee on Professional Registration heard HB 929, which would allow optometrists to perform eye surgery and deliver injectables to the eye. Like years past, this bill is rather tricky in how it is drafted. It does not say exactly what surgical procedures optometrists will be able to do but rather gives a general authorization to perform surgery and excludes a few surgical procedures. It leaves the rest wide open, especially any new surgeries that come along in the future. Many committee members agree the bill needs reworked; however, they seem more eager to get something, even the bill as drafted passed. We will be working this committee hard.

Even though the middle of the week was rough we rounded it out with momentous success. We saw major movement on both prior authorization reform bills. Senate Bill 230 was voted out of the Senate Insurance Committee with unanimous approval. The House rounded out their first half of session victories by passing HB 618 on Thursday. At least legislators seem eager to push insurance companies out of the practice of medicine. Too bad they seem eager to push non-physicians in!

The State of Medicine Halftime Report

Below is an update of how the things we’ve previously told you about are sizing up.

Scope Expansion Efforts: All in all, there has not been much movement on this front in comparison to years past. The House optometry scope expansion bill was heard in committee this week. The same for the house bill to let augmented intelligence diagnose and treat patients through adaptive questionnaires. Back in February SB 144 and SB 179 that would allow APRNs independent practice were heard in committee. We are hoping to keep them parked in committee as long as possible. So far, it’s been crickets on the others! We remain on high alert for bills that could draw amendments for scope expansion, especially any that would allow APRNs to practice outside of a collaborative practice arrangement.

Title Protection, HB 1130: This bill would ensure patients know who they are talking to in a clinical setting. It has not gained much traction just yet. We will be pushing for hearings.

Covenants-not-to-compete, HB 913 and SB 383: We want physicians to be able to flourish in their careers as they serve patients. These bills would reign in restrictive covenants-not-to-compete employment clauses for not-for-profit entities by enabling physicians to care for patients as they see fit, allow for care continuity, flexibility, and career advancement opportunities. Neither of these bills have had hearings. We are hoping they get some time in the light soon after they return.

Emergency Department Physicians, HB 1013 and SB 520: Patients want and expect to see a physician, especially in an emergency. These bills would require emergency departments to be staffed with a physician. These bills will ensure patients have access to physicians, especially in an emergency and especially in rural areas. The House Bill has received a hearing. The Senate bill was slated to be heard this week but was delayed due to scheduling conflicts.

Tort Reform: The tort reform stingray corvette convertible has been pulled out of the garage and is sailing down the open road. They are blowing the cobwebs out with speedy maneuvers on bills related to collateral sources, statute of limitations, class action, and expert witnesses. We love to feel the wind whip through our hair on all of these issues. We are all gas and no brakes!

Collateral Source (HB 69 and SB 268): These bills have had committee hearings.

Statute of limitations (HB 68): This bill has passed the House and it awaiting a hearing in the Senate General Laws Committee.

Class action (SB 47): This bill has been debated and given first round approval in the Senate.

Expert Witness (HB 263 and SB 238): The House bill has had a hearing and is in line for a vote in committee. The Senate bill has been heard and approved by committee. It should be up for prime time in the Senate soon.

Health professional loan repayment program, (HB 720): We worked closely with the bill sponsor and DHSS to draw down more than twice the funding for a program to assist with loan repayments for healthcare professionals from the federal government. We were able to secure language to guarantee physicians would receive at least 35% of the funds for loan repayment. 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 or pay off their student loan debt for years to come. This bill was voted out of committee on March 5.

Audio-only Telehealth, (HB 825 and SB 94): These bills would add audio only to the definition of telehealth. The Senate bill passed the with consent status and awaits action in the House. The House bill is awaiting initial approval of the whole House.

Healthcare Omnibus Bills: This session legislators picked up where they left off on the omnibus healthcare bills they had in the works last year. One such set of bills deals with women’s healthcare. It includes updates to mammogram notification requirements, expediated partner therapy, additional prenatal tests, getting victims of sexual abuse to the right facilities, and 12-month supply of birth control. The other omnibus healthcare bills are mostly updates for EMS services and boards, ambulance districts, financial and investment obligations of hospitals, cochlear hearing aids, disabled parking placards, vaccines, prenatal testing, expedited partner therapy and much, much more. Don’t worry – we made the necessary changes to protect the practice of medicine and patients before these got our blessing and moved forward.

Women’s Healthcare Omnibus (HB 398 and SB 178)

Healthcare Omnibus (HB 943 and SB 317)

Alternative Therapies (HB 829 and SB 90): These bills would allow veterans who are 21 years of age or older and suffering from PTSD, depression, substance-abuse or other mental health disorders to take magic mushrooms while under the care of a healthcare professional and within the confines of a clinical study.  The House bill has been approved at the committee level, while the Senate bill has only had a hearing.

Tobacco 21 (HB 344 and SB 231): At face value bills to set the statewide age to 21 or higher for purchase of tobacco and vape products sounds like a good idea. In reality, these bills are efforts by the tobacco industry to stop more strictive local regulations. These bills have passed out of committee.

Abortion (A3 reform): There has been no action taken on bills to send language to the ballot to change the newly passed Amendment 3.

Transgender language to remove the sunset on these therapies and procedures was added to a bill relating to sunsets in the Senate and has been sent to the House for approval.

 Since next week is Spring Break for the General Assembly, there will be no Weekly Legislative Update. Expect your next update on Friday, March 28. Happy Spring!

SAVE THE DATE: Physician Advocacy Day 2026 will be March 3, 2026!

Our advocacy efforts never end! We have very few folks signed up to serve as Doctor of the Day. Med Students are welcome to participate too! If you have some down time between now and early May, please consider volunteering to come join us at the Capitol to advocate some more for your profession and your patients! We want them to continue to see White Coats in the Capitol.

Join MAOPS in Jefferson City for the Annual Convention!

The annual convention is a little over one month away! Join us in Jefferson City April 24 – 27 at the Courtyard Marriott for CME, social events, and a whole lot of fun! Learn more about the conference and register here.