The Missouri House has approved a bill that backers say will save Missourians money on prescription drugs.
Representative Lynn Morris (photo; Tim Bommel, Missouri House Communications – click for larger version)
The sponsor of House Bill 1542, Representative Lynn Morris (R-Nixa), has been working at his pharmacy since 1977. He said what many don’t know is that pharmacy benefits managers have pharmacists sign agreements that prevent them from telling customers when a drug’s out-of-pocket cost is less than the copay on their insurance plans, unless the customer asks about it. Morris said that almost never happens because customers assume the cost through their insurance plans or networks will be the cheapest to them.
HB 1542 would eliminate those agreements, which Morris called, “gag orders.”
Representative Tracy McCreery (photo; Tim Bommel, Missouri House Communications – click for larger version)
The bill was broadly supported, having been sent to the Senate on a 138-7 vote. Representative Tracy McCreery (D-St. Louis) said there should be nothing keeping pharmacists from being up front with customers.
Morris said pharmacists agree to these “gag orders” as part of the contracts they sign with those managers. Without signing such a contract a pharmacist cannot participate in the insurance programs handled by that manager. He said that’s an issue for any pharmacist, but it’s especially critical for rural pharmacists, for whom the loss of any part of a customer base could mean closing the business.
Other provisions in HB 1542 would bar benefits managers from charging what Morris called “clawback” fees, or any fees related to a claim that has not been disclosed up front. It would also prohibit benefits managers from keeping pharmacists from making statements to government officials or committees.
HB 1542 has been sent to the Senate. Morris said similar legislation has been passed in other states or is pending.
An increased focus on issues concerning foster care in Missouri has resulted in a bill containing 11 different reforms meant to make life better for children who are in, and who leave, that care.
Representative Jim Neely chairs the House Special Committee to Improve the Care and Well-Being of Young People and sponsors HCB 11, a comprehensive foster care reform bill. (photo; Tim Bommel, Missouri House Communications – click for larger version)
Neely, a doctor, said improving the lives of children has been his priority since a young girl who’d been abused came into his office about ten years ago.
Neely said some of the things HCB 11 would change in Missouri law are “quick” or “simple” fixes that could have significant impacts, especially in situations in which foster children have been described as, “falling through the cracks.”
HCB 11 includes language that would update background checks on foster families so that the Children’s Division would know immediately if a foster parent is charged with a crime that would disqualify him or her from being a foster parent. Current law only allows checks every two years.
Representative Sonya Anderson (photo; Tim Bommel, Missouri House Communications – click for larger version)
HCB 11 would also expand assessment and treatment services for children in foster care. It would require such services for all children in foster care – currently it is required only for those under the age of ten – and would require that those services be completed in accordance with the American Academy of Pediatrics’ periodicity schedule. Currently children are screened every two years.
The original sponsor of that language is Representative Lauren Arthur (D-Kansas City), who said it would ensure that children in foster care receive more appropriate care, and the comprehensive screenings will in turn save the state money by catching medical conditions earlier and aiding in preventative care.
Representative Lauren Arthur (photo; Tim Bommel, Missouri House Communications – click for larger version)
Current law prevents Missouri Social Services workers from investigating reports of abuse of Missouri children in foster care if the abuse doesn’t occur in Missouri, and prevents them from communicating with counterparts in other states about abuse or potential abuse. Christofanelli said his bill would remove those barriers and fix what he called a, “bureaucratic technicality.”
Some lawmakers expressed concerns with the portion of the bill because other states might release information about abuse claims – particularly unsubstantiated claims – that Missouri would not release. They expressed a desire to see that concern addressed before the bill could become law.
The House is prepared to vote on whether to send HCB 11 to the Senate. The bill is broadly supported, including by Columbia Democrat Martha Stevens, who sits on the Special Committee to Improve the Care and Well-Being of Young People.
– Allow more time for a case management plan to be developed for a child entering foster care (found in House Bill 1637 sponsored by Representative Neely)
– Allow foster children aged 16 years and older to open a checking or savings account with the consent of the Children’s Division or juvenile court, giving them the ability to cash paychecks and better access to jobs (found in House Bill 1715 sponsored by Representative Don Phillips, R-Kimberling City)
– Make closed under law any records regarding placement of children into foster care or kinship placements, and specify who can access those records and when (found in House Bill 1966 sponsored by Representative Robert Cornejo, R-St. Peters)
– Allow a child who is homeless or in the custody of the Children’s Division, but the whereabouts of his or her immunization records is unknown, to be enrolled in school for up to 30 days while efforts are made to find those records, and if needed, another 30 days after that for the child to get caught up on immunizations (found in House Bill 2139 sponsored by Representative Lynn Morris, R-Nixa)
– Define when juvenile courts have jurisdiction over a child under 21, streamlining situations in which a child is in a safe situation but juvenile court involvement is interfering with the family (found in House Bill 1728 sponsored by Representative Bill Lant, R-Pineville)
– Create the “Trauma-Informed Care for Children and Families Board” to encourage cooperation between agencies that deal with children and utilize trauma-informed treatment programs (found in House Bill 2217 sponsored by Representative Cora Faith Walker, D-Ferguson)
The Missouri House has given initial approval to a proposed tracking system for prescription drugs that backers hope will fight opioid abuse in Missouri. Specifically it aims to help stop “doctor shopping;” the practice of going to multiple doctors seeking multiple prescriptions for valuable and addictive medications.
This is the fifth session in which Representative Holly Rehder has sponsored PDMP legislation. (photo; Tim Bommel, Missouri House Communications)
House Bill 90 would make Missouri the 50th state to enact a prescription drug monitoring program (PDMP). The electronic registry would take information on those who prescribe, use, or dispense prescription drugs.
Rehder said it was that fear that caused her to raise her children “differently,” but when her daughter was given a prescription for opioid painkillers after cutting her thumb at work, she became addicted.
Before giving the bill first-round approval, the House changed it so that by 2020, pharmacists will have to report information to the registry in real-time.
Opponents say a PDMP creates a government database and poses a threat to the privacy of anyone using prescription drugs.
Representative Rick Brattin questioned the PDMP legislation offered by a fellow Republican, but voted for the bill on perfection. (photo; Tim Bommel, Missouri House Communications)
Harrisonville Republican Rick Brattin also argued PDMPs must not be effective because they exist in all other states, yet President Donald Trump has launched a task force to fight opioid addiction.
Brattin and others offered other changes to HB 90 saying it needed to be strengthened, in part because similar versions have stalled in the state Senate in past years. Rehder urged legislators to reject them, saying that over the five years she’s handled the issue, stakeholders including law enforcement and medical experts have helped develop the language she’s proposing. Those amendments were then rejected.
Another favorable vote would send the bill to the Senate, where in past years it has been stopped primarily by Senator Rob Schaaf (R-St. Joseph), who has his own PDMP proposal which cleared that chamber early this month.