0560S.02C
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SENATE COMMITTEE SUBSTITUTE
FOR
SENATE BILL NO. 178
AN ACT
To repeal sections 191.648, 192.769, and 210.030,
RSMo, and to enact in lieu thereof four new sections
relating to health care.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Sections 191.648, 192.769, and 210.030, RSMo,
are repealed and four new sections enacted in lieu thereof, to
be known as sections 191.648, 192.2521, 210.030, and 376.1240,
to read as follows:
191.648. 1. As used in this section, the following
terms mean:
(1) "Designated sexually transmitted infection",
chlamydia, gonorrhea, trichomoniasis, or any other sexually
transmitted infection designated as appropriate for
expedited partner therapy by the department of health and
senior services or for which expedited partner therapy was
recommended in the most recent Centers for Disease Control
and Prevention guidelines for the prevention or treatment of
sexually transmitted infections;
(2) "Expedited partner therapy" [means], the practice
of treating the sex partners of persons with [chlamydia or
gonorrhea] designated sexually transmitted infections
without an intervening medical evaluation or professional
prevention counseling ;
(3) "Health care professional", a m ember of any
profession regulated by chapter 334 or 335 authorized to
prescribe medications .
2. Any licensed physician or health care professional
may, but shall not be required to, utilize expedited partner
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therapy for the management of the part ners of persons with
[chlamydia or gonorrhea ] designated sexually transmitted
infections. Notwithstanding the requirements of 20 CSR
2150- 5.020 (5) or any other law to the contrary, a licensed
physician or health care professional utilizing expedited
partner therapy may prescribe and dispense medications for
the treatment of [chlamydia or gonorrhea ] a designated
sexually transmitted infection for an individual who is the
partner of a person with [chlamydia or gonorrhea ] a
designated sexually tran smitted infection and who does not
have an established physician/patient relationship with such
physician or an established health care professional/patient
relationship with such health care professional . [Any
antibiotic medications prescribed and di spensed for the
treatment of chlamydia or gonorrhea under this section shall
be in pill form].
3. Any licensed physician or health care professional
utilizing expedited partner therapy for the management of
the partners with [chlamydia or gonorrh ea] designated
sexually transmitted infections shall provide explanation
and guidance to [a] each patient [diagnosed with chlamydia
or gonorrhea] of the preventative measures that can be taken
by the patient to stop the [spread] transmission of such
[diagnosis] infection.
4. Any licensed physician or health care professional
utilizing expedited partner therapy for the management of
partners of persons with [chlamydia or gonorrhea ] designated
sexually transmitted infections under this section s hall
have immunity from any civil liability that may otherwise
result by reason of such actions, unless such physician or
health care professional acts negligently, recklessly, in
bad faith, or with malicious purpose.
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5. The department of health and senior services and
the division of professional registration within the
department of commerce and insurance shall by rule develop
guidelines for the implementation of subsection 2 of this
section. Any rule or portion of a rule, as that term is
defined in section 536.010, that is created under the
authority delegated in this section shall become effective
only if it complies with and is subject to all of the
provisions of chapter 536 and, if applicable, section
536.028. This section and chap ter 536 are nonseverable and
if any of the powers vested with the general assembly
pursuant to chapter 536 to review, to delay the effective
date, or to disapprove and annul a rule are subsequently
held unconstitutional, then the grant of rulemaking
authority and any rule proposed or adopted after August 28,
2010, shall be invalid and void.
192.2521. A specialty hospital is exempt from the
provisions of sections 192.2520 and 197.135 if such hospital
has a policy for transfer of a vi ctim of a sexual assault to
an appropriate hospital with an emergency department. As
used in this section, "specialty hospital" means a hospital
that has been designated by the department of health and
senior services as something other than a general acute care
hospital.
210.030. 1. Every licensed physician, midwife,
registered nurse and all persons who may undertake, in a
professional way, the obstetrical and gynecological care of
a pregnant woman in the state of Missouri shall, if the
woman consents, take or cause to be taken a sample of venous
blood of such woman at the time of the first prenatal
examination, or not later than twenty days after the first
prenatal examination, another sample at twenty -eight weeks
of pregnancy, and another sample immediately after birth and
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subject such [sample] samples to an approved and standard
serological test for syphilis [, an] and approved serological
[test] tests for hepatitis B, hepatitis C, human
immunodeficiency virus (HIV), and such other treatable
diseases and metabolic disorders as are prescribed by the
department of health and senior services. [In any area of
the state designated as a syphilis outbreak area by the
department of health and senior services, if the mother
consents, a sample of her venous blood shall be taken later
in the course of pregnancy and at delivery for additional
testing for syphilis as may be prescribed by the department ]
If a mother tests positive for syphilis, hepatitis B,
hepatitis C, or HIV, or any combination of such diseases,
the physician or person providing care shall administer
treatment in accordance with the most recent accepted
medical practice. If a mother tests positive for hepatitis
B, the physician or person who professional ly undertakes the
pediatric care of a newborn shall also administer the
appropriate doses of hepatitis B vaccine and hepatitis B
immune globulin (HBIG) in accordance with the current
recommendations of the Advisory Committee on Immunization
Practices (ACIP). If the mother's hepatitis B status is
unknown, the appropriate dose of hepatitis B vaccine shall
be administered to the newborn in accordance with the
current ACIP recommendations. If the mother consents, a
sample of her venous blood shall be taken. If she tests
positive for hepatitis B, hepatitis B immune globulin (HBIG)
shall be administered to the newborn in accordance with the
current ACIP recommendations.
2. The department of health and senior services
shall[, in consultation with the Missouri genetic disease
advisory committee,] make such rules pertaining to such
tests as shall be dictated by accepted medical practice, and
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tests shall be of the types approved or accepted by the
[department of health and senior services. An approved and
standard test for syphilis, hepatitis B, and other treatable
diseases and metabolic disorders shall mean a test made in a
laboratory approved by the department of health and senior
services] United States Food and Drug Administration . No
individual shall be denied testing by the department of
health and senior services because of inability to pay.
3. All persons providing care under this section shall
do so pursuant to the provisions of section 431.061.
376.1240. 1. For purposes of this section, terms
shall have the same meanings as ascribed to them in section
376.1350, and the term "self -administered hormonal
contraceptive" shall mean a drug that is composed of one or
more hormones and that is approved by th e Food and Drug
Administration to prevent pregnancy, excluding emergency
contraception. Nothing in this section shall be construed
to apply to medications approved by the Food and Drug
Administration to terminate an existing pregnancy.
2. Any health benefit plan delivered, issued for
delivery, continued, or renewed in this state on or after
January 1, 2026, that provides coverage for self -
administered hormonal contraceptives shall provide coverage
to reimburse a health care provider or dispen sing entity for
the dispensing of a supply of self -administered hormonal
contraceptives intended to last up to one year.
3. The coverage required under this section shall not
be subject to any greater deductible or co -payment than
other similar health care services provided by the health
benefit plan.
[192.769. 1. On completion of a
mammogram, a mammography facility certified by
the United States Food and Drug Administration
(FDA) or by a certification agency approved by
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the FDA shall provide to the patient the
following notice:
"If your mammogram demonstrates
that you have dense breast
tissue, which could hide
abnormalities, and you have other
risk factors for breast cancer
that have been identified, you
might benefit from supplemental
screening tests that may be
suggested by your ordering
physician. Dense breast tissue,
in and of itself, is a relatively
common condition. Therefore,
this information is not provided
to cause undue concern, but
rather to raise your awareness
and to promote discussion with
your physician regarding the
presence of other risk factors,
in addition to dense breast
tissue. A report of your
mammography results will be sent
to you and your physician. You
should contact your ph ysician if
you have any questions or
concerns regarding this report.".
2. Nothing in this section shall be
construed to create a duty of care beyond the
duty to provide notice as set forth in this
section.
3. The information required by th is
section or evidence that a person violated this
section is not admissible in a civil, judicial,
or administrative proceeding.
4. A mammography facility is not required
to comply with the requirements of this section
until January 1, 2015. ]