FIRSTREGULARSESSION
[PERFECTED]
HOUSEBILLNO.122
103RDGENERALASSEMBLY
INTRODUCEDBYREPRESENTATIVEVEIT.
0178H.01P JOSEPHENGLER,ChiefClerk
ANACT
Torepealsection332.081,RSMo,andtoenactinlieuthereofonenewsectionrelatingtothe
practiceofdentistry.
BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
SectionA.Section332.081,RSMo,isrepealedandonenewsectionenactedinlieu
2thereof,tobeknownassection332.081,toreadasfollows:
332.081.1.Notwithstandinganyotherprovisionoflawtothecontrary,hospitals
2licensedunderchapter197shallbeauthorizedtoemployanyorallofthefollowingoral
3healthproviders:
4 (1)Adentistlicensedunderthischapterforthepurposeoftreatingonhospital
5premisesthosepatientswhopresentwithadentalconditionandsuchtreatmentisnecessaryto
6amelioratetheconditionforwhichtheypresentedsuchasseverepainortoothabscesses;
7 (2)Anoralandmaxillofacialsurgeonlicensedunderthischapterforthepurposeof
8treatingoralconditionsthatneedtobeamelioratedaspartoftreatingtheunderlyingcauseof
9thepatient'smedicalneedsincluding,butnotlimitedto,headandneckcancer,HIVorAIDS,
10severetraumaresultinginadmissiontothehospital,organtransplant,diabetes,orseizure
11disorders.Itshallbeaconditionoftreatmentthatsuchpatientsareadmittedtothehospitalon
12eitheranin-orout-patientbasis;and
13 (3)Amaxillofacialprosthodontistlicensedunderthischapterforthepurposeof
14treatingandsupportingpatientsofaheadandneckcancerteamorothercomplexcareor
15surgicalteamforthefabricationofappliancesfollowingablativesurgery,surgerytocorrect
16birthanomalies,extensiveradiationtreatmentoftheheadorneck,ortrauma-relatedsurgery.
EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 17 2.NopersonorotherentityshallpracticedentistryinMissouriorprovidedental
18servicesas[defined] describedinsection332.071unlessanduntiltheboardhasissuedtothe
19personacertificatecertifyingthatthepersonhasbeendulyregisteredasadentistinMissouri
20ortheboardhasissuedsuchcertificatetoanentitythathasbeendulyregisteredtoprovide
21dentalservicesbylicenseddentistsanddentalhygienistsandunlessanduntiltheboardhas
22issuedtothepersonalicense,toberenewedeachperiod,asprovidedinthischapter,to
23practicedentistryorasadentalhygienist,orhasissuedtothepersonorentityapermit,tobe
24renewedeachperiod,toprovidedentalservicesinMissouri.Nothinginthischaptershallbe
25soconstruedastomakeitunlawfulfor:
26 (1)Alegallyqualifiedphysicianorsurgeon,whodoesnotpracticedentistryasa
27specialty,fromextractingteeth;
28 (2)AdentistlicensedinastateotherthanMissourifrommakingaclinical
29demonstrationbeforeameetingofdentistsinMissouri;
30 (3)Dentalstudentsinanyaccrediteddentalschooltopracticedentistryunderthe
31personaldirectionofinstructors;
32 (4)Dentalhygienestudentsinanyaccrediteddentalhygieneschooltopracticedental
33hygieneunderthepersonaldirectionofinstructors;
34 (5)AdulyregisteredandlicenseddentalhygienistinMissouritopracticedental
35hygieneasdefinedinsection332.091;
36 (6)Adentalassistant,certifieddentalassistant,orexpandedfunctionsdentalassistant
37tobedelegateddutiesasdefinedinsection332.093;
38 (7)Adulyregistereddentistordentalhygienisttoteachinanaccrediteddentalor
39dentalhygieneschool;
40 (8)Apersonwhohasbeengrantedadentalfacultypermitundersection332.183to
41practicedentistryinthescopeofhisorheremploymentatanaccrediteddentalschool,
42college,orprograminMissouri;
43 (9)Adulyqualifiedanesthesiologistornurseanesthetisttoadministerananesthetic
44inconnectionwithdentalservicesordentalsurgery;
45 (10)Apersontopracticedentistryinorfor:
46 (a)TheUnitedStatesArmedForces;
47 (b)TheUnitedStatesPublicHealthService;
48 (c)Migrant,community,orhealthcareforthehomelesshealthcentersprovidedin
49Section330ofthePublicHealthServiceAct(42U.S.C.Section254b);
50 (d)FederallyqualifiedhealthcentersasdefinedinSection1905(l)(42U.S.C.Section
511396d(l))oftheSocialSecurityAct;
52 (e)Governmentalentities,includingcountyhealthdepartments;or
53 (f)TheUnitedStatesVeteransBureau;or
HB122 2 54 (11)AdentistlicensedinastateotherthanMissouritoevaluateapatientorrenderan
55oral,written,orotherwisedocumenteddentalopinionwhenprovidingtestimonyorrecords
56forthepurposeofacivilorcriminalactionbeforeanyjudicialoradministrativeproceeding
57ofthisstateorotherforuminthisstate.
58 3.Nocorporationshallpracticedentistryasdefinedinsection332.071unlessthat
59corporationisorganizedundertheprovisionsofchapter355or356providedthata
60corporationorganizedundertheprovisionsofchapter355andqualifyingasanorganization
61under26U.S.C.Section501(c)(3)mayonlyemploydentistsanddentalhygienistslicensedin
62thisstatetorenderdentalservicestoMedicaidrecipients,low-incomeindividualswhohave
63availableincomebelowtwohundredpercentofthefederalpovertylevel,andallparticipants
64intheSCHIPprogram,unlesssuchlimitationiscontrarytoorinconsistentwithfederalor
65statelaworregulation.Thissubsectionshallnotapplyto:
66 (1)Ahospitallicensedunderchapter197thatprovidescareandtreatmentonlyto
67childrenundertheageofeighteenatwhichapersonregulatedunderthischapterprovides
68dentalcarewithinthescopeofhisorherlicenseorregistration;
69 (2)AfederallyqualifiedhealthcenterasdefinedinSection1905(l)oftheSocial
70SecurityAct(42U.S.C.Section1396d(l)),oramigrant,community,orhealthcareforthe
71homelesshealthcenterprovidedforinSection330ofthePublicHealthServicesAct(42
72U.S.C.Section254b)atwhichapersonregulatedunderthischapterprovidesdentalcare
73withinthescopeofhisorherlicenseorregistration;
74 (3)Acityorcountyhealthdepartmentorganizedunderchapter192orchapter205at
75whichapersonregulatedunderthischapterprovidesdentalcarewithinthescopeofhisorher
76licenseorregistration;
77 (4)Asocialwelfareboardorganizedundersection205.770,acityhealthdepartment
78operatingunderacitycharter,oracity-countyhealthdepartmentatwhichapersonregulated
79underthischapterprovidesdentalcarewithinthescopeofhisorherlicenseorregistration;
80 (5)Anyentitythathasreceivedapermitfromthedentalboardanddoesnotreceive
81compensationfromthepatientorfromanythirdpartyonthepatient'sbehalfatwhicha
82personregulatedunderthischapterprovidesdentalcarewithinthescopeofhisorherlicense
83orregistration;or
84 (6)AnyhospitalnonprofitcorporationexemptfromtaxationunderSection501(c)(3)
85oftheInternalRevenueCode,asamended,thatengagesinitsoperationsandprovidesdental
86servicesatfacilitiesownedbyacity,county,orotherpoliticalsubdivisionofthestate,orany
87entitycontractedwiththestatetoprovidecareinacorrectionalcenter,assuchtermis
88definedinsection217.010,atwhichapersonregulatedunderthischapterprovidesdental
89carewithinthescopeofhisorherlicenseorregistration.
90
HB122 3 91Ifanyoftheentitiesexemptedfromtherequirementsofthissubsectionareunabletoprovide
92servicestoapatientduetothelackofaqualifiedproviderandareferraltoanotherentityis
93made,theexemptionshallextendtothepersonorentitythatsubsequentlyprovidesservices
94tothepatient.
95 4.Nounincorporatedorganizationshallpracticedentistryasdefinedinsection
96332.071unlesssuchorganizationisexemptfromfederaltaxationunderSection501(c)(3)of
97theInternalRevenueCodeof1986,asamended,andprovidesdentaltreatmentwithout
98compensationfromthepatientoranythirdpartyontheirbehalfasapartofabroader
99programofsocialservicesincludingfooddistribution.Nothinginthischaptershallprohibit
100organizationsunderthissubsectionfromemployinganypersonregulatedbythischapter.
101 5.Adentistshallnotenterintoacontractthatallowsapersonwhoisnotadentistto
102influenceorinterferewiththeexerciseofthedentist'sindependentprofessionaljudgment.
103 6.Anot-for-profitcorporationorganizedundertheprovisionsofchapter355and
104qualifyingasanorganizationunder26U.S.C.Section501(c)(3),anunincorporated
105organizationoperatingpursuanttosubsection4ofthissection,oranyotherpersonshouldnot
106directorinterfereorattempttodirectorinterferewithalicenseddentist'sprofessional
107judgmentandcompetentpracticeofdentistry.Nothinginthissubsectionshallbeso
108construedastomakeitunlawfulfornot-for-profitorganizationstoenforceemployment
109contracts,corporatepolicyandproceduremanuals,orqualityimprovementorassurance
110requirements.
111 7.Allentitiesdefinedinsubsection3ofthissectionandthoseexemptedunder
112subsection4ofthissectionshallapplyforapermittoemploydentistsanddentalhygienists
113licensedinthisstatetorenderdentalservices,andtheentityshallapplyforthepermitin
114writingonformsprovidedbytheMissouridentalboard.Theboardshallnotchargeafeeof
115anykindfortheissuanceorrenewalofsuchpermit.Theprovisionsofthissubsectionshall
116notapplytoafederallyqualifiedhealthcenterasdefinedinSection1905(l)oftheSocial
117SecurityAct(42U.S.C.Section1396d(l)).
118 8.Anyentitythatobtainsapermittorenderdentalservicesinthisstateissubjectto
119disciplinepursuanttosection332.321.Iftheboardconcludesthatthepersonorentityhas
120committedanactorisengaginginacourseofconductthatwouldbegroundsfordisciplinary
121action,theboardmayfileacomplaintbeforetheadministrativehearingcommission.The
122boardmayrefusetoissueorrenewthepermitofanyentityforoneoranycombinationof
123causesstatedinsubsection2ofsection332.321.Theboardshallnotifytheapplicantin
124writingofthereasonsfortherefusalandshalladvisetheapplicantofhisorherrighttofilea
125complaintwiththeadministrativehearingcommissionasprovidedbychapter621.
126 9.AfederallyqualifiedhealthcenterasdefinedinSection1905(l)oftheSocial
127SecurityAct(42U.S.C.Section1396d(l))shallregisterwiththeboard.Theinformation
HB122 4 128providedtotheboardaspartoftheregistrationshallincludethenameofthehealthcenter,the
129nonprofitstatusofthehealthcenter,siteswheredentalserviceswillbeprovided,andthe
130namesofallpersonsemployedby,orcontractingwith,thehealthcenterwhoarerequiredto
131holdalicensepursuanttothischapter.Theregistrationshallberenewedeverytwenty-four
132months.Theboardshallnotchargeafeeofanykindfortheissuanceorrenewalofthe
133registration.Theregistrationofthehealthcentershallnotbesubjecttodisciplinepursuantto
134section332.321.Nothinginthissubsectionshallprohibitdisciplinaryactionagainsta
135licenseeofthischapterwhoisemployedby,orcontractswith,suchhealthcenterforthe
136actionsofthelicenseeinconnectionwithsuchemploymentorcontract.
137 10.Theboardmaypromulgaterulesandregulationstoensurenot-for-profit
138corporationsarerenderingcaretothepatientpopulationsassetforthherein,including
139requirementsforcoverednot-for-profitcorporationstoreportpatientcensusdatatotheboard.
140Theprovisionsofthissubsectionshallnotapplytoafederallyqualifiedhealthcenteras
141definedinSection1905(l)oftheSocialSecurityAct(42U.S.C.Section1396d(l)).
142 11.Allnot-for-profitcorporationsorganizedoroperatedpursuanttotheprovisionsof
143chapter355andqualifyingasanorganizationunder26U.S.C.Section501(c)(3),orthe
144requirementsrelatingtomigrant,community,orhealthcareforthehomelesshealthcenters
145providedinSection330ofthePublicHealthServiceAct(42U.S.C.Section254b)and
146federallyqualifiedhealthcentersasdefinedinSection1905(l)(42U.S.C.Section1396d(l))
147oftheSocialSecurityAct,thatemploypersonswhopracticedentistryordentalhygienein
148thisstateshalldosoinaccordancewiththerelevantlawsofthisstateexcepttotheextentthat
149suchlawsarecontraryto,orinconsistentwith,federalstatuteorregulation.
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