Forecast for 2020 Legislative Session
Missouri’s 100th General Assembly will convene on January 8, 2020, to begin their second session of legislative work. The Capitol will be abuzz with activity until adjournment on May 15, 2020. In between those dates, your MSMA lobbyists will be tirelessly advocating for physicians and heading off attempts to interfere with your profession. Following is a list of some of the issues we expect to see during the first few months of 2020.
Prescription Drug Monitoring Program
Missouri has been the only state without a statewide prescription drug monitoring program (PDMP) for several years, and it remains to be seen whether our status will finally change in 2020. Prior to 2019, legislation that would authorize a statewide PDMP faced opposition from a couple of devoted legislators. This past year, several more legislators joined the fight against a statewide PDMP, citing concerns about privacy and personal freedom. In the meantime, the St. Louis County PDMP gets rave reviews from many of our members and currently covers over 90% of the state’s prescribers and patients. We look forward to working with Rep. Holly Rehder and Sen. Tony Luetkemeyer on this issue again next year.
Vaping and Vapor Products
In October, Governor Parson called for the Departments of Health and Senior Services, Elementary and Secondary Education, and Public Safety to work together to create a statewide educational campaign to help make known the health risks of vapor products, especially among young people in Missouri. The governor also called on the legislature to work on restricting the sale of illicit vapor products, along with making it harder for minors to obtain vapor products. MSMA supports the governor and state agencies as they seek to decrease vapor product usage in Missouri, and we are eager to see vapor product-related legislation in 2020.
Anti-Vaccination
Throughout the legislative interim, your MSMA advocacy team joined an alliance of health care organizations, physicians, nurses, pharmacists, and concerned citizens called the Missouri Immunization Coalition to stay current on the anti-vaccination movement’s activities around the country. The Coalition is comprised of a diverse group of stakeholders who know the value and public health benefits of vaccines and oppose anti-vaccination legislation.
Small but extremely vocal groups of vaccine-hesitant advocates have been active in California, New York, and almost every state in between during the legislative interim. Missouri, unfortunately, is not immune to anti-vaccination propaganda and has its share of grassroots advocates. Two anti-vaccination bills were proposed and defeated in the state legislature in 2019, but we expect to see more in 2020.
Scope of Practice
In 2020, we expect to see familiar battles in the scope of practice realm. Advance Practice Registered Nurses (APRN) will likely push for independent practice and a license under the Board of Nursing (MSMA opposed both of these provisions in 2019). If independent practice proves impossible to achieve, APRNs will likely try to remove the geographic proximity requirements and expand their scope under the existing statute that governs collaborative practice arrangements instead.
MSMA will likely clash again with the physical therapists on the issue of direct access. In 2019, the physical therapists wanted to treat patients for 10 visits or 21 business days before they had to consult a physician. Since current statute prohibits physical therapists from diagnosing, this proposal would have been irresponsible and, in some cases, dangerous for patients. MSMA fought that legislation last year and will continue to oppose it this year.
The assistant physicians may also return in 2020 with legislation that matches a 2019 bill that would have provided for an alternative pathway to licensure. The 2019 bill would have allowed an assistant physician who has practiced in a collaborative practice arrangement with a physician for five years to practice independently as a physician. MSMA opposed this bill because the assistant physician license was never intended to be an alternative to a medical residency program. It was intended to be a bridge between medical school and residency and a way for medical students who didn’t match with a residency program to gain valuable and meaningful experience working in collaboration with a licensed physician.
Credentialing Reform
In 2019, many physicians and hospital systems expressed their frustration with the medical credentialing process. We’ve heard many stories of credentialing-related disruptions and delays in reimbursement for our members. MSMA plans to work with the Missouri Hospital Association and other healthcare groups in 2020 to support legislation to make the credentialing process smoother and less of a headache for everyone involved.
Tort Reform
Punitive damages legislation unfortunately was sidelined last year, as only a handful of tort reform bills made it through the legislature. 2019’s bill would have raised the burden of proof for punitive damages so that statutory law would match case law. We look forward to working with Sen. Bill White on this topic in 2020.
Tanning Bed Prohibition
MSMA has testified in favor of legislation that would ban tanning bed use by anyone under 18 years old for the past several years, and we plan to do so again in 2020. The legislation would also require trained staff members to be present at tanning facilities at all times. In 2019, we joined cancer survivors, families of those affected by skin cancer, dermatologists, pediatricians, and many others to support this legislation.
Medical Marijuana
As medical marijuana dispensaries, cultivation facilities, and processing facilities officially begin operation in 2020, we’ll be keeping an eye on legislation and department rules that could change how these facilities are regulated or the way the state administers the medical marijuana licensing program for patients.
Doctor of the Day
Come spend a day advocating for your profession and your patients in Jefferson City! Every year from January to mid-May, MSMA members from all over the state volunteer their time and services for a day at the Capitol during the legislative session. During your visit, you’ll get to visit with your local elected officials, see the Senate and House chambers, assist legislators and their staff with minor medical ailments, and check in with MSMA’s lobbying team. It’s a great way to become more familiar with the Capitol and get more involved in physician advocacy. Sign up today at msma.org/physician-of-the-day or contact Heidi Geisbuhler at heidi@msma.org for more information. All specialties are welcome and encouraged to volunteer!
White Coat Day 2020
The MSMA White Coat Day is scheduled for Tuesday, March 3, 2020. This advocacy event is a great opportunity to visit the Missouri State Capitol in Jefferson City to advocate on behalf of physicians and patients. Legislators will deliver brief remarks on health care legislation from 9:00-10:00 AM in the first floor rotunda of the Capitol. At noon, MSMA will provide lunch for attendees.
Throughout the rest of the day, we encourage physicians to meet with their local legislators, explore the building, and network with fellow MSMA members. There may be additional meetings and presentations participants wish to attend, as some state medical specialty societies are planning to join the rally that day. All physicians and medical students are welcome to take part, even if you can only visit the Capitol for an hour or two! RSVP today at www.msma.org/white-coat-day.
Contact Us!
If you have any questions about MSMA’s work in the Capitol or would like more information about a particular legislative issue, please don’t hesitate to contact Jeff Howell or Heidi Geisbuhler.
Prescription Drug Monitoring Program
Missouri has been the only state without a statewide prescription drug monitoring program (PDMP) for several years, and it remains to be seen whether our status will finally change in 2020. Prior to 2019, legislation that would authorize a statewide PDMP faced opposition from a couple of devoted legislators. This past year, several more legislators joined the fight against a statewide PDMP, citing concerns about privacy and personal freedom. In the meantime, the St. Louis County PDMP gets rave reviews from many of our members and currently covers over 90% of the state’s prescribers and patients. We look forward to working with Rep. Holly Rehder and Sen. Tony Luetkemeyer on this issue again next year.
Vaping and Vapor Products
In October, Governor Parson called for the Departments of Health and Senior Services, Elementary and Secondary Education, and Public Safety to work together to create a statewide educational campaign to help make known the health risks of vapor products, especially among young people in Missouri. The governor also called on the legislature to work on restricting the sale of illicit vapor products, along with making it harder for minors to obtain vapor products. MSMA supports the governor and state agencies as they seek to decrease vapor product usage in Missouri, and we are eager to see vapor product-related legislation in 2020.
Anti-Vaccination
Throughout the legislative interim, your MSMA advocacy team joined an alliance of health care organizations, physicians, nurses, pharmacists, and concerned citizens called the Missouri Immunization Coalition to stay current on the anti-vaccination movement’s activities around the country. The Coalition is comprised of a diverse group of stakeholders who know the value and public health benefits of vaccines and oppose anti-vaccination legislation.
Small but extremely vocal groups of vaccine-hesitant advocates have been active in California, New York, and almost every state in between during the legislative interim. Missouri, unfortunately, is not immune to anti-vaccination propaganda and has its share of grassroots advocates. Two anti-vaccination bills were proposed and defeated in the state legislature in 2019, but we expect to see more in 2020.
Scope of Practice
In 2020, we expect to see familiar battles in the scope of practice realm. Advance Practice Registered Nurses (APRN) will likely push for independent practice and a license under the Board of Nursing (MSMA opposed both of these provisions in 2019). If independent practice proves impossible to achieve, APRNs will likely try to remove the geographic proximity requirements and expand their scope under the existing statute that governs collaborative practice arrangements instead.
MSMA will likely clash again with the physical therapists on the issue of direct access. In 2019, the physical therapists wanted to treat patients for 10 visits or 21 business days before they had to consult a physician. Since current statute prohibits physical therapists from diagnosing, this proposal would have been irresponsible and, in some cases, dangerous for patients. MSMA fought that legislation last year and will continue to oppose it this year.
The assistant physicians may also return in 2020 with legislation that matches a 2019 bill that would have provided for an alternative pathway to licensure. The 2019 bill would have allowed an assistant physician who has practiced in a collaborative practice arrangement with a physician for five years to practice independently as a physician. MSMA opposed this bill because the assistant physician license was never intended to be an alternative to a medical residency program. It was intended to be a bridge between medical school and residency and a way for medical students who didn’t match with a residency program to gain valuable and meaningful experience working in collaboration with a licensed physician.
Credentialing Reform
In 2019, many physicians and hospital systems expressed their frustration with the medical credentialing process. We’ve heard many stories of credentialing-related disruptions and delays in reimbursement for our members. MSMA plans to work with the Missouri Hospital Association and other healthcare groups in 2020 to support legislation to make the credentialing process smoother and less of a headache for everyone involved.
Tort Reform
Punitive damages legislation unfortunately was sidelined last year, as only a handful of tort reform bills made it through the legislature. 2019’s bill would have raised the burden of proof for punitive damages so that statutory law would match case law. We look forward to working with Sen. Bill White on this topic in 2020.
Tanning Bed Prohibition
MSMA has testified in favor of legislation that would ban tanning bed use by anyone under 18 years old for the past several years, and we plan to do so again in 2020. The legislation would also require trained staff members to be present at tanning facilities at all times. In 2019, we joined cancer survivors, families of those affected by skin cancer, dermatologists, pediatricians, and many others to support this legislation.
Medical Marijuana
As medical marijuana dispensaries, cultivation facilities, and processing facilities officially begin operation in 2020, we’ll be keeping an eye on legislation and department rules that could change how these facilities are regulated or the way the state administers the medical marijuana licensing program for patients.
Doctor of the Day
Come spend a day advocating for your profession and your patients in Jefferson City! Every year from January to mid-May, MSMA members from all over the state volunteer their time and services for a day at the Capitol during the legislative session. During your visit, you’ll get to visit with your local elected officials, see the Senate and House chambers, assist legislators and their staff with minor medical ailments, and check in with MSMA’s lobbying team. It’s a great way to become more familiar with the Capitol and get more involved in physician advocacy. Sign up today at msma.org/physician-of-the-day or contact Heidi Geisbuhler at heidi@msma.org for more information. All specialties are welcome and encouraged to volunteer!
White Coat Day 2020
The MSMA White Coat Day is scheduled for Tuesday, March 3, 2020. This advocacy event is a great opportunity to visit the Missouri State Capitol in Jefferson City to advocate on behalf of physicians and patients. Legislators will deliver brief remarks on health care legislation from 9:00-10:00 AM in the first floor rotunda of the Capitol. At noon, MSMA will provide lunch for attendees.
Throughout the rest of the day, we encourage physicians to meet with their local legislators, explore the building, and network with fellow MSMA members. There may be additional meetings and presentations participants wish to attend, as some state medical specialty societies are planning to join the rally that day. All physicians and medical students are welcome to take part, even if you can only visit the Capitol for an hour or two! RSVP today at www.msma.org/white-coat-day.
Contact Us!
If you have any questions about MSMA’s work in the Capitol or would like more information about a particular legislative issue, please don’t hesitate to contact Jeff Howell or Heidi Geisbuhler.
