HB398--HEALTHCARE SPONSOR: Peters COMMITTEEACTION:Voted"DoPass"bytheStandingCommitteeon HealthandMentalHealthbyavoteof16to0. Thisbillmodifiesprovisionsrelatingtohealthcare. EXPEDITEDPARTNERTHERAPY(Section191.648,RSMo) ThebilladdsTrichomoniasis tothelistofsexuallytransmitted diseasesthatifanindividualisdiagnosedwith,aphysicianis allowedtotreattheindividual'ssexpartnerswithoutan interveningmedicalevaluationorprofessionalprevention counseling. Thebillalsoaddsanyothersexuallytransmitted infectiondesignatedasappropriateforexpeditedpartnertherapy bytheDepartmentofHealthandSeniorServicesorrecommendedfor expeditedpartnertherapyinthemostrecentCentersforDisease ControlandPreventionguidelines. Thebillexpandstheuseof expeditedpartnertherapyinsuchcasesfromphysicianstohealth careprofessionalslicensedunderchapters334or3335authorized toprescribemedications. SPECIALTYHOSPITALS(Section192.2521) Thisbillexempts"specialtyhospitals",asdefinedinthebill, fromcertainprovisionsoflawrelatingtoforensicexaminations forvictimsofsexualassault,providedthatthespecialtyhospital hasapolicyfortransferofavictimtoanappropriatehospital withanemergencydepartment. BLOODTESTSFORPREGNANTWOMEN(Section210.030) Thebillmodifiesprovisionsgoverningbloodtestsandmaternal screeningforpregnantwomen.Currently,pregnantwomenareasked totakeabloodtestatthetimeofthefirstprenatalexamination, ornolaterthan20daysafterthefirstprenatalexamination,to screenforsyphilisandhepatitisB,aswellasanyothertreatable diseasesandmetabolicdisordersasareprescribedbythe DepartmentofHealthandSeniorServices. Thisbillrequiresanadditionalbloodsampletobetaken,withthe woman'sconsent,at28weeksofpregnancy,andexpandsthelistof diseasesforscreeningtoincludehepatitisCandHIV.Thebill alsorepealsaprovisionoutliningtheprocedureforalatersample ofawoman'sbloodinanyareaofthestatedesignatedasa syphilisoutbreakarea,andprovidesthatifawomantestspositive forsyphilis,hepatitisBorC,orHIV,oracombinationthereof, thephysicianorpersonprovidingcaremustadministertreatmentin accordancewiththemostrecentacceptedmedicalpracticetotreat suchdiseases. ThebillrepealsareferencetotheMissouriGeneticDisease AdvisoryCommittee,grantingtheDepartmentthesoleauthorityto makerulespertainingtothesetests,providedthatthetestsare ofthetypesapprovedoracceptedbytheUSFoodandDrug Administration. Thebillalsorepealsarequirementthatapproved standardtestsforthesediseasesmustbemadeinaDepartment- approvedlaboratory. SELF-ADMINISTEREDHORMONALCONTRACEPTIVES COVERAGE(Section 376.1240) BeginningJanuary1,2025,thisbillrequiresanyhealthbenefit planinMissouritoreimburseahealthcareproviderordispensing entityforthedispensingofasupplyofself-administeredhormonal contraceptives intendedtolastuptooneyear.Thebillprohibits thecoveragefrombeingsubjecttoanygreaterdeductibleorco- paymentthanothersimilarhealthcareservicesprovidedbythe healthbenefitplan. MAMMOGRAPHY(Section192.679) Thebillrepealsprovisionsrelatingtorequirednoticeprovidedto patientsupontheircompletionofamammogram. ThisbillissimilartoHCSHB2413(2024). PROPONENTS: Supporterssaythatasitrelatestotheyearsupply ofcontraception, thatthiswouldcreateparitybetweenpersonson publichealthinsuranceandpersonsinemployer-sponsoredbenefit plans.Additionally,therearemanyissuesparticularlyaround transportation accessforruralorimpoverishedpeople,andthis typeofpolicyhasnodocumentedevidenceinthe28otherstates thathaveasimilarpolicyinplacethatpremiumsarerisingasa result.Physicianstypicallywritetheprescriptionforayear with30-dayrefills,andthereforewouldnotbetakingdifferent actionontheactualprescribingofthemedication. TestifyinginpersonforthebillwereRepresentative Peters; MissouriStateMedicalAssociation;MissouriAssociationof OsteopathicPhysiciansandSurgeons;M.RyanBarker,St.Louis IntegratedHealthNetwork;MissouriChapteroftheAmericanAcademy ofPediatrics;NationalAssociationofSocialWorkers-MoChapter; ReachHealthcareFoundation;BJCSt.LouisChildren’sHospital;St. LouisCounty;MissouriCenterforPublicHealthExcellence; AssociatedStudentsoftheUniversityofMissouri;ArnieDienoff; MissouriFamilyHealthCouncil;KidsWinMissouri;Children'sTrust Fund;MissouriNursesAssociation;MissouriCoalitionAgainst DomesticandSexualViolence;MalloryRusch,EmpowerMissouri; KristinaGrant;MissouriHospitalAssociation;JenBernstein, NationalCouncilofJewishWomenSt.Louis;ChristineJackson, DO/Mph;TimothyA.Swearengen,MAOPS;DavidBarbe,MD,Missouri StateMedicalAssociation;MissouriRuralHealthAssociation; MissouriPharmacyAssociation;RxOutreach;St.LouisCounty. OPPONENTS: Thosewhoopposethebillsaythatasitrelatestothe insurancerequirementforcontraceptionthatnooneisguaranteeda year'sworthofanykindofservicesuchascableoracellphone plan,andthatinsurancecompanieshavenoguaranteethatamember whogetscoveredforayear'ssupplyofthecontraceptivewould remainamemberforthedurationofthatyear.Noother maintenancemedicationsaregiventhistypeofuniquetreatment. TestifyinginpersonagainstthebillwereAmerica'sHealth InsurancePlans,BlueCrossBlueShieldofKC;LisaPannett. OTHERS:Otherstestifyingonthebillsaythatthereisacost requirementtothis,andthatitisuniquewhencomparedtohow othertermsandmedicationsareissuedbyhealthinsurers. TestifyinginpersononthebillwasMissouriInsuranceCoalition. Writtentestimonyhasbeensubmittedforthisbill.Thefull writtentestimonyandwitnessestestifyingonlinecanbefound underTestimonyonthebillpageontheHousewebsite.