| 1 | 1 | | SECONDREGULARSESSION |
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| 2 | 2 | | HOUSEBILLNO.2215 |
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| 3 | 3 | | 102NDGENERALASSEMBLY |
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| 4 | 4 | | INTRODUCEDBYREPRESENTATIVEBROWN(16). |
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| 5 | 5 | | 4770H.01I DANARADEMANMILLER,ChiefClerk |
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| 6 | 6 | | ANACT |
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| 7 | 7 | | Toamendchapter191,RSMo,byaddingtheretosevennewsectionsrelatingtoalternative |
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| 8 | 8 | | therapiesforveterans. |
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| 9 | 9 | | BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows: |
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| 10 | 10 | | SectionA.Chapter191,RSMo,isamendedbyaddingtheretosevennewsections,to |
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| 11 | 11 | | 2beknownassections191.2600,191.2605,191.2610,191.2615,191.2620,191.2625,and |
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| 12 | 12 | | 3191.2630,toreadasfollows: |
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| 13 | 13 | | 191.2600.Sections191.2600to191.2630shallbeknownandmaybecitedasthe |
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| 14 | 14 | | 2"VeteransTraumaticBrainInjuryTreatmentandRecoveryAct". |
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| 15 | 15 | | 191.2605.Asusedinsections191.2600to191.2630,unlessthecontextindicates |
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| 16 | 16 | | 2otherwise,thefollowingtermsmean: |
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| 17 | 17 | | 3 (1)"Alternativetherapies",anytherapiesforaconditionthatarenotconsidered |
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| 18 | 18 | | 4thestandardorconventionaltherapiesforthatconditionincluding,butnotlimitedto, |
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| 19 | 19 | | 5hyperbaricoxygentherapy; |
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| 20 | 20 | | 6 (2)"Commission",theMissouriveteranscommission; |
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| 21 | 21 | | 7 (3)"Facility",apublicorprivatehealthclinic,outpatienthealthclinic, |
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| 22 | 22 | | 8communityhealthcenter,hospital,orotherfacilityauthorizedunderrulesofthe |
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| 23 | 23 | | 9departmentofhealthandseniorservicestoprovidehyperbaricoxygentherapyunder |
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| 24 | 24 | | 10sections191.2600to191.2630; |
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| 25 | 25 | | 11 (4)"Fund",theveteranstraumaticbraininjurytreatmentandrecoveryfund |
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| 26 | 26 | | 12establishedinsection191.2615; |
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| 27 | 27 | | EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis |
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| 28 | 28 | | intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 13 (5)"Healthcarepractitioner",apersonwhoislicensedtoprovidemedicalor |
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| 29 | 29 | | 14otherhealthcareinthisstateandwhohasprescriptiveauthorityincluding,butnot |
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| 30 | 30 | | 15limitedto,aphysician; |
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| 31 | 31 | | 16 (6)"Hyperbaricoxygentherapy"or"therapy",treatmentforposttraumatic |
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| 32 | 32 | | 17stressdisorderortraumaticbraininjurythatisbasedonavalidprescriptionfroma |
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| 33 | 33 | | 18healthcarepractitionerandthatisdeliveredthrough: |
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| 34 | 34 | | 19 (a)AhyperbaricchamberapprovedbytheUnitedStatesFoodandDrug |
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| 35 | 35 | | 20Administration;or |
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| 36 | 36 | | 21 (b)AhyperbaricoxygendevicethatisapprovedbytheUnitedStatesFoodand |
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| 37 | 37 | | 22DrugAdministration; |
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| 38 | 38 | | 23 (7)"Physician",apersonlicensedtopracticemedicineinthisstateunder |
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| 39 | 39 | | 24chapter334; |
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| 40 | 40 | | 25 (8)"Posttraumaticstressdisorder",amentalhealthconditionthatistriggered |
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| 41 | 41 | | 26byaterrifyingevent,suchasbyeitherexperiencingorwitnessingalife-threatening |
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| 42 | 42 | | 27event,including,butnotlimitedto,militarysexualtrauma,orasasecondarysequelato |
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| 43 | 43 | | 28bodytrauma; |
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| 44 | 44 | | 29 (9)"Traumaticbraininjury",anacquiredinjurytothebrain.Theterm |
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| 45 | 45 | | 30"traumaticbraininjury"doesnotincludebraindysfunctioncausedbyacongenitalor |
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| 46 | 46 | | 31degenerativedisorderorbirthtrauma; |
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| 47 | 47 | | 32 (10)"Veteran",anindividualwhohasserved: |
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| 48 | 48 | | 33 (a)InanactiveorreservecomponentoftheArmy,Navy,AirForce,Marine |
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| 49 | 49 | | 34Corps,SpaceForce,orCoastGuardoftheUnitedStates; |
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| 50 | 50 | | 35 (b)IntheNationalGuardofanystate;or |
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| 51 | 51 | | 36 (c)Onactiveduty,otherthanfortraining,inanycomponentoftheArmed |
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| 52 | 52 | | 37ForcesoftheUnitedStatesforaperiodofonehundredeightydaysormore,unless |
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| 53 | 53 | | 38releasedearlierbecauseofservice-connecteddisability,andwhowasdischargedor |
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| 54 | 54 | | 39releasedfromtheArmedForcesoftheUnitedStatesunderotherthandishonorable |
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| 55 | 55 | | 40conditions. |
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| 56 | 56 | | 191.2610.Anyfacilityinthisstatethatprovideshyperbaricoxygentherapytoa |
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| 57 | 57 | | 2veteranshallbeeligibleforreimbursementforsuchtherapyfromthecommissionifthe |
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| 58 | 58 | | 3followingconditionsaresatisfied: |
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| 59 | 59 | | 4 (1)Theveteranreceivingthetherapyhasbeendiagnosed,byahealthcare |
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| 60 | 60 | | 5practitioner,withposttraumaticstressdisorderoratraumaticbraininjuryandhas |
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| 61 | 61 | | 6demonstratedthatheorshepreviouslysoughtservicesforposttraumaticstressdisorder |
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| 62 | 62 | | 7oratraumaticbraininjurythroughtheVeteransHealthAdministrationservice |
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| 63 | 63 | | 8deliverysystemor,ifavailabletotheveteran,throughtheprivatehealthinsurance |
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| 64 | 64 | | 9system; |
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| 65 | 65 | | HB2215 2 10 (2)Theveteranreceivingthetherapyvoluntarilyagreedtothetherapy; |
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| 66 | 66 | | 11 (3)Thefacilitycomplieswithapplicablefirecodes,oversightrequirements,and |
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| 67 | 67 | | 12anytreatmentprotocolsrequiredundersections191.2600to191.2630; |
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| 68 | 68 | | 13 (4)Theveteranreceivingthetherapyresideswithinthisstate; |
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| 69 | 69 | | 14 (5)Anyhyperbaricchamberusedtotreattheveteranmeetstheminimum |
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| 70 | 70 | | 15standardsforpatientsestablishedbytheUnitedStatesFoodandDrugAdministration; |
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| 71 | 71 | | 16 (6)ThefacilitycomplieswiththefederalHealthInsuranceandPortability |
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| 72 | 72 | | 17AccountabilityActof1996fortheveteranreceivingthetherapy; |
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| 73 | 73 | | 18 (7)Thefacility'streatmentprotocolsforhyperbaricoxygentherapyarealigned |
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| 74 | 74 | | 19withthemedicalstandardsdemonstratedinpublishedclinicaltrialsforhyperbaric |
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| 75 | 75 | | 20oxygentherapythatoccurredunderthedirectionofaninstitutionalreviewboard; |
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| 76 | 76 | | 21 (8)Thehyperbaricoxygentherapyisdeliveredsolelybyhealthcare |
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| 77 | 77 | | 22practitionersinaccordancewithfederalandstatelaw; |
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| 78 | 78 | | 23 (9)Beforeprovidinghyperbaricoxygentherapytotheveteran,thefacility |
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| 79 | 79 | | 24establishedatreatmentplanconsistentwiththerequirementsofsections191.2600to |
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| 80 | 80 | | 25191.2630; |
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| 81 | 81 | | 26 (10)Aprescriptionorderforhyperbaricoxygentherapywasissuedbyahealth |
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| 82 | 82 | | 27carepractitionerbeforethefacilityprovidedthetherapy; |
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| 83 | 83 | | 28 (11)Thefacilityverifiedthatboththefacilityandtheveteranmetthe |
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| 84 | 84 | | 29requirementsundersections191.2600to191.2630forreimbursementbeforeproceeding |
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| 85 | 85 | | 30withthetherapy; |
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| 86 | 86 | | 31 (12)Beforeprovidingthetherapy,thefacilityestimatedthecostsofthetherapy, |
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| 87 | 87 | | 32includingthecostsofcognitivetestingtobeconductedbeforeandafterthetherapy; |
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| 88 | 88 | | 33 (13)Thefacilityretainsintheveteran'shealthcarefileinformationonthetype |
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| 89 | 89 | | 34ofcognitivetestingperformedaswellastheresultsofthecognitivetesting; |
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| 90 | 90 | | 35 (14)Theveteranisnotchargedorbilledforthetherapybythefacilityorany |
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| 91 | 91 | | 36otherentityandisnotliableforthecostsofthetherapyoranyexpensesincurredin |
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| 92 | 92 | | 37accordancewithsections191.2600to191.2630; |
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| 93 | 93 | | 38 (15)Thefacilityandanyhealthcarepractitionersinvolvedinthehyperbaric |
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| 94 | 94 | | 39oxygentherapyagreetocooperatewiththecommissiontoprovideanannualdata |
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| 95 | 95 | | 40summarytreatmentreportsufficienttoassesstheefficacyofalternativetreatment |
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| 96 | 96 | | 41modalitiesfortreatingveteranswithposttraumaticstressdisorderandtraumaticbrain |
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| 97 | 97 | | 42injuries;and |
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| 98 | 98 | | 43 (16)Thefacilityreceivesadvanceapprovalfromthecommissionasdescribedin |
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| 99 | 99 | | 44section191.2615. |
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| 100 | 100 | | 191.2615.1.(1)Thereisherebycreatedinthestatetreasurythe"Veterans |
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| 101 | 101 | | 2TraumaticBrainInjuryTreatmentandRecoveryFund".Thefundshallconsistofany |
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| 102 | 102 | | HB2215 3 3appropriations,gifts,bequests,orpublicorprivatedonationstosuchfund.Thestate |
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| 103 | 103 | | 4treasurershallbecustodianofthefund.Inaccordancewithsections30.170and30.180, |
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| 104 | 104 | | 5thestatetreasurermayapprovedisbursements.Thefundshallbeadedicatedfundand, |
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| 105 | 105 | | 6uponappropriation,moneysinthisfundshallbeusedsolelyforreimbursementsto |
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| 106 | 106 | | 7facilitiesforhyperbaricoxygentherapyprovidedtoveterans,foradministrative |
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| 107 | 107 | | 8expensesincurredbythecommissionindistributingsuchreimbursements,andfor |
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| 108 | 108 | | 9studiesontheuseofalternativetherapiestotreatveteranswithposttraumaticstress |
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| 109 | 109 | | 10disorderandtraumaticbraininjuries. |
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| 110 | 110 | | 11 (2)Notwithstandingtheprovisionsofsection33.080tothecontrary,anymoneys |
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| 111 | 111 | | 12remaininginthefundattheendofthebienniumshallnotreverttothecreditofthe |
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| 112 | 112 | | 13generalrevenuefund. |
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| 113 | 113 | | 14 (3)Thestatetreasurershallinvestmoneysinthefundinthesamemanneras |
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| 114 | 114 | | 15otherfundsareinvested.Anyinterestandmoneysearnedonsuchinvestmentsshallbe |
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| 115 | 115 | | 16creditedtothefund. |
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| 116 | 116 | | 17 2.Anyfacilitythatintendstoseekreimbursementfromthefundforhyperbaric |
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| 117 | 117 | | 18oxygentherapyprovidedtoaveteranshallrequestadvanceapprovalfromthe |
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| 118 | 118 | | 19commissionforreimbursementbeforeprovidingsuchtherapy.Uponapprovalbythe |
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| 119 | 119 | | 20commission,thecommissionshallsetasidetheappropriateamountoffundstoensure |
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| 120 | 120 | | 21fullpaymentfortheveteran'stherapy.Ifmoneysremaininginthefundareinsufficient |
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| 121 | 121 | | 22toensurefullpayment,thecommissionshalldenythefacility'srequestforadvance |
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| 122 | 122 | | 23approval. |
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| 123 | 123 | | 24 3.Ifattheendofthesix-monthperiodimmediatelyfollowingthedatethe |
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| 124 | 124 | | 25commissionapprovedthefacility'srequestforadvanceapprovalthefacilityhasnot |
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| 125 | 125 | | 26submittedanybillstothecommissionfortheveteranorprovidedanytherapyforthe |
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| 126 | 126 | | 27veteran,thecommissionshallnotifytheveteranandthefacilitythatthefunding |
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| 127 | 127 | | 28reservedfortheveteranshallexpirewithinthirtydaysifthefacilityfailstonotifythe |
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| 128 | 128 | | 29commissionthattherapyisscheduledorcontinued.Ifthefacilityfailstonotifythe |
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| 129 | 129 | | 30commissionthattherapyisscheduledorcontinuedwithinthirtydays,thecommission |
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| 130 | 130 | | 31shallreleasethefundsreservedfortheveteranandmakethemavailableforanother |
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| 131 | 131 | | 32veteran'stherapyundersections191.2600to191.2630. |
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| 132 | 132 | | 33 4.Afterreceivingadvanceapprovalfromthecommissionandproviding |
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| 133 | 133 | | 34hyperbaricoxygentherapytoaveteraninaccordancewithsections191.2600to |
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| 134 | 134 | | 35191.2630,thefacilityshallnotbilltheveteranforthetherapybutshallsubmitthebill |
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| 135 | 135 | | 36forthetherapytothecommission. |
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| 136 | 136 | | 37 5.Thecommissionshallpaythebillforthetherapyreceivedinaccordancewith |
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| 137 | 137 | | 38subsection4ofthissectionfromthefundwithinforty-fivedaysofreceipt.Ifthecostsof |
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| 138 | 138 | | 39thetherapyexceedtheavailabilityofmoneysremaininginthefund,thefacilityshallnot |
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| 139 | 139 | | HB2215 4 40holdtheveteranresponsibleforanypayment,andthecommissionshallnothaveany |
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| 140 | 140 | | 41obligationtomakepaymentstothefacilityinanamountthatexceedstheamountthat |
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| 141 | 141 | | 42wassetasideuponadvanceapprovalasdescribedinsubsection2ofthissection. |
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| 142 | 142 | | 43 6.Thecommissionshallseekreimbursementforpaymentsmadetofacilitiesfor |
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| 143 | 143 | | 44treatingveteranswithhyperbaricoxygentherapyfromanyofthefollowingentities |
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| 144 | 144 | | 45basedontheefficacyoftreatmentsasdemonstratedinthehealingoftraumaticbrain |
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| 145 | 145 | | 46injuriesthroughhyperbaricoxygentherapybycognitivetesting,brainscans,orother |
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| 146 | 146 | | 47assessmentprotocolsmedicallyacceptedbytheUnitedStatesFoodandDrug |
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| 147 | 147 | | 48AdministrationortheUnitedStatesDepartmentofDefenseundertheWarRisk |
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| 148 | 148 | | 49InsuranceAct,asamended: |
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| 149 | 149 | | 50 (1)TheTricareprogramoftheUnitedStatesDepartmentofDefense; |
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| 150 | 150 | | 51 (2)Appropriatefederalagencies,includingtheVeteransHealthAdministration; |
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| 151 | 151 | | 52and |
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| 152 | 152 | | 53 (3)Anyotherresponsiblethird-partypayer. |
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| 153 | 153 | | 54 7.Thedepartmentofhealthandseniorservicesshallawardfundstoentitiesto |
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| 154 | 154 | | 55studytheuseofalternativetherapiestotreatveteranswithposttraumaticstress |
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| 155 | 155 | | 56disorderandtraumaticbraininjuries. |
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| 156 | 156 | | 191.2620.1.Anyfacilitymayapprovehyperbaricoxygentherapyforaveteran |
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| 157 | 157 | | 2inaccordancewithsections191.2600to191.2630. |
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| 158 | 158 | | 3 2.Alicensingboardshallnotrevoke,failtorenew,suspend,ortakeanyaction |
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| 159 | 159 | | 4againstahealthcarepractitionerbasedsolelyonthehealthcarepractitioner's |
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| 160 | 160 | | 5recommendationstoaveteranregardingaccesstoortreatmentwithhyperbaricoxygen |
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| 161 | 161 | | 6therapy. |
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| 162 | 162 | | 7 3.Nostateagencyshalltakeanyaction,orassistinanyaction,againstahealth |
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| 163 | 163 | | 8carepractitioner'sMedicareorMedicaidcertificationbasedsolelyonthehealthcare |
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| 164 | 164 | | 9practitioner'srecommendationthataveteranhaveaccesstohyperbaricoxygentherapy. |
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| 165 | 165 | | 10 4.Noofficialemployeeoragentofthestateshallblockorattempttoblockaccess |
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| 166 | 166 | | 11tohyperbaricoxygentherapybyaveteranwhomeetsallrequirementstoreceivesuch |
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| 167 | 167 | | 12therapyundersections191.2600to191.2630. |
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| 168 | 168 | | 13 5.Counseling,advice,orrecommendationsprovidedbyahealthcare |
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| 169 | 169 | | 14practitionerconsistentwiththemedicalstandardsofcareshallnotbeconsidereda |
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| 170 | 170 | | 15violationofsections191.2600to191.2630. |
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| 171 | 171 | | 16 6.Hyperbaricoxygentherapymaybeusedunderthedirectionofan |
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| 172 | 172 | | 17institutionalreviewboardwithanationalclinicaltrialnumberforthepurposeof |
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| 173 | 173 | | 18collectingclinicaltrialdata. |
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| 174 | 174 | | 191.2625.1.Anyfacilitythatreceivesreimbursementfromthefundshall: |
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| 175 | 175 | | HB2215 5 2 (1)Providereportsonindividualveteransandgroupsofveteranstothe |
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| 176 | 176 | | 3commissiononmeasuredhealthimprovementsfromacceptedandapprovedcognitive |
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| 177 | 177 | | 4testingprotocols,brainimaging,orothermedicalassessmentsapprovedbytheindustry, |
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| 178 | 178 | | 5theUnitedStatesFoodandDrugAdministration,theUnitedStatesDepartmentof |
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| 179 | 179 | | 6Defense,Tricare,ortheCentersforMedicareandMedicaidServicesconductedbefore |
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| 180 | 180 | | 7andaftertherapy;and |
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| 181 | 181 | | 8 (2)Submitanannualreporttothecommissionwiththefollowinginformation: |
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| 182 | 182 | | 9 (a)Thenumberofveteranswhoreceivedhyperbaricoxygentherapyatthe |
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| 183 | 183 | | 10facility; |
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| 184 | 184 | | 11 (b)Thedemographicsoftheveteranswhoreceivedhyperbaricoxygentherapy |
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| 185 | 185 | | 12atthefacility; |
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| 186 | 186 | | 13 (c)Thenumberofactualhyperbaricoxygentherapydivesbyveterans |
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| 187 | 187 | | 14completedatthefacility; |
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| 188 | 188 | | 15 (d)Cognitivetestresultsofveteranswhoreceivedhyperbaricoxygentherapyat |
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| 189 | 189 | | 16thefacility;and |
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| 190 | 190 | | 17 (e)Anytestimonialsprovidedbyveteransvoluntarily. |
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| 191 | 191 | | 18 2.(1)BeforeJanuaryfirsteachyear,thecommissionshallprepareareport |
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| 192 | 192 | | 19detailingeachtreatmentofhyperbaricoxygentherapyprovidedtoaveteranin |
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| 193 | 193 | | 20accordancewithsections191.2600to191.2630,theprovidertypeforeachtreatment |
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| 194 | 194 | | 21provided,thenumberofveteranstreatedorserved,thetreatmentoutcomesforthe |
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| 195 | 195 | | 22veteranstreatedorserved,andadetailedaccountingofthemoneysusedinthefund |
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| 196 | 196 | | 23duringtheimmediatelyprecedingfiscalyear. |
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| 197 | 197 | | 24 (2)Thecommissionshallsubmitthereportpreparedundersubdivision(1)of |
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| 198 | 198 | | 25thissubsectiontothegovernor,thepresidentprotemporeofthesenate,thespeakerof |
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| 199 | 199 | | 26thehouseofrepresentatives,andthedirectorofthedepartmentofhealthandsenior |
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| 200 | 200 | | 27services. |
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| 201 | 201 | | 28 3.BeforeJanuarythirtietheachyear,thedepartmentofhealthandsenior |
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| 202 | 202 | | 29servicesshallsubmittothegovernorareportcontaining: |
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| 203 | 203 | | 30 (1)Findingsandrecommendationsrelatedtotheadministrationofsections |
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| 204 | 204 | | 31191.2600to191.2630; |
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| 205 | 205 | | 32 (2)Findingsandrecommendationsfromanystudiesfundedundersection |
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| 206 | 206 | | 33191.2615regardingtheefficacyofalternativetherapiestotreatposttraumaticstress |
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| 207 | 207 | | 34disorderandtraumaticbraininjuries;and |
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| 208 | 208 | | 35 (3)Recommendationsonbudgetary,legislative,orregulatorychangesneededto |
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| 209 | 209 | | 36expandaccesstoalternativetherapiesforveteranswithposttraumaticstressdisorder |
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| 210 | 210 | | 37andtraumaticbraininjuries. |
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| 211 | 211 | | HB2215 6 191.2630.Thecommissionandthedepartmentofhealthandseniorservicesshall |
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| 212 | 212 | | 2jointlypromulgateallnecessaryrulesandregulationsfortheadministrationofsections |
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| 213 | 213 | | 3191.2600to191.2630.Anyruleorportionofarule,asthattermisdefinedinsection |
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| 214 | 214 | | 4536.010,thatiscreatedundertheauthoritydelegatedinthissectionshallbecome |
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| 215 | 215 | | 5effectiveonlyifitcomplieswithandissubjecttoalloftheprovisionsofchapter536and, |
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| 216 | 216 | | 6ifapplicable,section536.028.Thissectionandchapter536arenonseverableandifany |
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| 217 | 217 | | 7ofthepowersvestedwiththegeneralassemblypursuanttochapter536toreview,to |
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| 218 | 218 | | 8delaytheeffectivedate,ortodisapproveandannularulearesubsequentlyheld |
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| 219 | 219 | | 9unconstitutional,thenthegrantofrulemakingauthorityandanyruleproposedor |
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| 220 | 220 | | 10adoptedafterAugust28,2024,shallbeinvalidandvoid. |
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| 221 | 221 | | âś” |
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| 222 | 222 | | HB2215 7 |
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