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MASCA Legislative Update: 3/18/2018

Halftime Report: 2018 Legislative Session

The Missouri General Assembly has reached the halfway mark, as they will be on Spring Recess next week before returning for the second half that will end on Friday, May 18th.

Fast Facts on 2018 Missouri Legislative Session

  • Number of Bills Introduced in House & Senate: 2,278

  • Number of Bills Passed out of Committee: 621

  • Number of House Bills Passed by House Chamber: 162

  • Number of Senate Bills Passed by Senate Chamber: 72

  • Number of Bills Passed by House & Senate - Delivered to Governor: 2

Comparison to 2017: At this point last year, the State Senate had only passed a total of 16 bills. While everyone expected the Senate to be in an even tighter gridlock this year, we have been surprised to see that the upper chamber has passed a total of 72 bills thus far. These bills still require approval from the House, but it's a good sign to see the Senate functioning at normal speed. Last year the legislature sent 76 bills to the Governor, the lowest number in modern history.

Status of Top Priorities for MASCA

Workers Compensation Fee Schedule: State Senator Dave Schatz (R-Sullivan) is sponsoring legislation that would change Missouri's workers compensation reimbursement policy by implementing a medical fee schedule with maximum rates that a health-care provider can charge for specific procedures and care. The fees would be set by the state's Division of Workers' Compensation, which would increase or decrease the fee schedule based on the change in the Consumer Price Index. There are forty-four other states that have a fee schedule in place. However, MASCA is working with the national Ambulatory Surgery Center Association (ASCA) and other provider groups to highlight why many of those states have seen a decrease in physician participation, quality of care, and other indirect costs associated with a non-functional workers compensation system. Link to read legislation.

  • STATUS: A public hearing was held on February 20th. MASCA's Christine Frederick testified in opposition, along with over a dozen other provider groups and hospitals. The bill has not been voted on in committee, signaling that it's unlikely to advance past the committee stage this year.

Surprise Billing: A few bills have been debated this year in response to recent policy changes by Anthem and other insurance carriers relating to a) prior authorization for ER visits; and b) surprise billing, which is out-of-network charges at an in-network facility. We are in the midst of negotiations with the insurance lobby, as they are pushing legislation that would link the physician reimbursement rate for "surprise bills" to Medicare and in-network rates. We have partnered with other provider groups to counter with a proposal that bases reimbursement on a percentage of usual and Customary Rates (UCR). Link to bill.

  • STATUS: Two different Senate bills have been passed out of committee and are on the Senate Calendar for debate. There is a strong likelihood that something on this issue will be done this year.

Opioid Prescriptions: In an effort to curb prescription drug abuse, lawmakers are debating legislation that would restrict physicians from prescribing more than a seven day supply of opioids to a new patient. However, a physician can override that limit if they document the reason for additional supply in the patient's medical record. Link to bill.

  • STATUS: This is included in a bill that has been approved by the full Senate and was heard in a House Committee last week.

ASC Caregiver Bill: Requires hospital and ASCs to provide patients with an opportunity to designate a caregiver prior to discharge. Link to bill.

  • STATUS: A House & Senate bill have been filed, but neither has been posted for a public hearing.

Non-Competes: An act to restrict the use and enforcement of non-compete clauses in contracts. This has a significant amount of opposition from the MO Chamber, MO Hospital Association and other business groups. Link to bill.

  • STATUS: Only a House version was filed and it passed the House Workforce Development Committee, but has stalled in the Rules Committee for the last month. At this point, it appears unlikely to advance.

Trending Missouri Political News

Public Polling

Below are results from a statewide public opinion poll conducted March 7-8, 2018 with 900 likely voters by Missouri Scout, a political intelligence and analysis firm:

Do you approve or disapprove of Donald Trump’s job performance as President of the United States?

Approve: 48%

Disapprove: 45%

Unsure: 7%

Possible candidates in the 2018 General Election for United States Senate are the Republican Josh Hawley and the Democrat Claire McCaskill. If the election were held today, for whom would you vote?

Josh Hawley: 47%

Claire McCaskill: 45%

Undecided: 8%


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