Missouri 2025 Regular Session

Missouri Senate Bill SB664 Compare Versions

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Old	New	Differences
1	1
2	2	FIRST REGULAR SESSION
3	3	SENATE BILL NO. 664
4	4	103RD GENERAL ASSEMBLY
5	5	INTRODUCED BY SENATOR BRATTIN.
6	6	2619S.01I KRISTINA MARTIN, Secretary
7	7	AN ACT
8	8	To amend chapter 191, RSMo, by adding thereto seven new sections relating to alternative
9	9	therapies for veterans.
10	10
11	11	Be it enacted by the General Assembly of the State of Missouri, as follows:
12	12	Section A. Chapter 191, RSMo, is amended by addi ng thereto 1
13	13	seven new sections, to be known as sections 191.2600, 191.2605, 2
14	14	191.2610, 191.2615, 191.2620, 191.2625, and 191.2630, to read 3
15	15	as follows:4
16	16	191.2600. Sections 191.2600 to 191.2630 shall be known 1
17	17	and may be cited as the "Veterans Traumatic Brain Injury 2
18	18	Treatment and Recovery Act". 3
19	19	191.2605. As used in sections 191.2600 to 191.2630, 1
20	20	unless the context indicates otherwise, the following terms 2
21	21	mean: 3
22	22	(1) "Alternative therapies", any therapies for a 4
23	23	condition that are not considered the standard or 5
24	24	conventional therapies for that condition including, but not 6
25	25	limited to, hyperbaric oxygen therapy; 7
26	26	(2) "Commission", the Missouri veterans' commission; 8
27	27	(3) "Facility", a public or private health clinic, 9
28	28	outpatient health clinic, community health center, hospital, 10
29	29	or other facility authorized under rules of the department 11
30	30	of health and senior services to provide hyperbaric oxygen 12
31	31	therapy under sections 191.2600 to 191.2630; 13 SB 664 2
32	32	(4) "Fund", the veterans tr aumatic brain injury 14
33	33	treatment and recovery fund established in section 191.2615; 15
34	34	(5) "Health care practitioner", a person who is 16
35	35	licensed to provide medical or other health care in this 17
36	36	state and who has prescriptive authority including, but not 18
37	37	limited to, a physician; 19
38	38	(6) "Hyperbaric oxygen therapy" or "therapy", 20
39	39	treatment for posttraumatic stress disorder or traumatic 21
40	40	brain injury that is based on a valid prescription from a 22
41	41	health care practitioner and that is delivered through: 23
42	42	(a) A hyperbaric chamber approved by the United States 24
43	43	Food and Drug Administration; or 25
44	44	(b) A hyperbaric oxygen device that is approved by the 26
45	45	United States Food and Drug Administration; 27
46	46	(7) "Physician", a person licensed to practice 28
47	47	medicine in this state under chapter 334; 29
48	48	(8) "Posttraumatic stress disorder", a mental health 30
49	49	condition that is triggered by a terrifying event, such as 31
50	50	by either experiencing or witnessing a life -threatening 32
51	51	event, including, but not limited to, mili tary sexual 33
52	52	trauma, or as a secondary sequela to body trauma; 34
53	53	(9) "Traumatic brain injury", an acquired injury to 35
54	54	the brain. The term "traumatic brain injury" does not 36
55	55	include brain dysfunction caused by a congenital or 37
56	56	degenerative disorder or birth trauma; 38
57	57	(10) "Veteran", any person defined as a veteran by the 39
58	58	United States Department of Veterans Affairs or its 40
59	59	successor agency. 41
60	60	191.2610. Any facility in this state that provides 1
61	61	hyperbaric oxygen therapy to a vetera n shall be eligible for 2
62	62	reimbursement for such therapy from the commission if the 3
63	63	following conditions are satisfied: 4 SB 664 3
64	64	(1) The veteran receiving the therapy has been 5
65	65	diagnosed, by a health care practitioner, with posttraumatic 6
66	66	stress disorder or a traumatic brain injury and has 7
67	67	demonstrated that he or she previously sought services for 8
68	68	posttraumatic stress disorder or a traumatic brain injury 9
69	69	through the Veterans Health Administration service delivery 10
70	70	system or, if available to the veteran, thr ough the private 11
71	71	health insurance system; 12
72	72	(2) The veteran receiving the therapy voluntarily 13
73	73	agreed to the therapy; 14
74	74	(3) The facility complies with applicable fire codes, 15
75	75	oversight requirements, and any treatment protocols required 16
76	76	under sections 191.2600 to 191.2630; 17
77	77	(4) The veteran receiving the therapy resides within 18
78	78	this state; 19
79	79	(5) Any hyperbaric chamber used to treat the veteran 20
80	80	meets the minimum standards for patients established by the 21
81	81	United States Food and Drug Administ ration; 22
82	82	(6) The facility complies with the federal Health 23
83	83	Insurance and Portability Accountability Act of 1996 for the 24
84	84	veteran receiving the therapy; 25
85	85	(7) The facility's treatment protocols for hyperbaric 26
86	86	oxygen therapy are aligned with the m edical standards 27
87	87	demonstrated in published clinical trials for hyperbaric 28
88	88	oxygen therapy that occurred under the direction of an 29
89	89	institutional review board; 30
90	90	(8) The hyperbaric oxygen therapy is delivered solely 31
91	91	by health care practitioners in acc ordance with federal and 32
92	92	state law; 33
93	93	(9) Before providing hyperbaric oxygen therapy to the 34
94	94	veteran, the facility established a treatment plan 35 SB 664 4
95	95	consistent with the requirements of sections 191.2600 to 36
96	96	191.2630; 37
97	97	(10) A prescription order for hy perbaric oxygen 38
98	98	therapy was issued by a health care practitioner before the 39
99	99	facility provided the therapy; 40
100	100	(11) The facility verified that both the facility and 41
101	101	the veteran met the requirements under sections 191.2600 to 42
102	102	191.2630 for reimbursemen t before proceeding with the 43
103	103	therapy; 44
104	104	(12) Before providing the therapy, the facility 45
105	105	estimated the costs of the therapy, including the costs of 46
106	106	cognitive testing to be conducted before and after the 47
107	107	therapy; 48
108	108	(13) The facility retains in th e veteran's health care 49
109	109	file information on the type of cognitive testing performed 50
110	110	as well as the results of the cognitive testing; 51
111	111	(14) The veteran is not charged or billed for the 52
112	112	therapy by the facility or any other entity and is not 53
113	113	liable for the costs of the therapy or any expenses incurred 54
114	114	in accordance with sections 191.2600 to 191.2630; 55
115	115	(15) The facility and any health care practitioners 56
116	116	involved in the hyperbaric oxygen therapy agree to cooperate 57
117	117	with the commission to provide an annual data summary 58
118	118	treatment report sufficient to assess the efficacy of 59
119	119	alternative treatment modalities for treating veterans with 60
120	120	posttraumatic stress disorder and traumatic brain injuries; 61
121	121	and 62
122	122	(16) The facility receives advance approval f rom the 63
123	123	commission as described in section 191.2615. 64
124	124	191.2615. 1. (1) There is hereby created in the 1
125	125	state treasury the "Veterans Traumatic Brain Injury 2
126	126	Treatment and Recovery Fund". The fund shall consist of any 3 SB 664 5
127	127	appropriations, gifts, bequests, or public or private 4
128	128	donations to such fund. The state treasurer shall be 5
129	129	custodian of the fund. In accordance with sections 30.170 6
130	130	and 30.180, the state treasurer may approve disbursements. 7
131	131	The fund shall be a dedicated fund and, u pon appropriation, 8
132	132	moneys in this fund shall be used solely for reimbursements 9
133	133	to facilities for hyperbaric oxygen therapy provided to 10
134	134	veterans, for administrative expenses incurred by the 11
135	135	commission in distributing such reimbursements, and for 12
136	136	studies on the use of alternative therapies to treat 13
137	137	veterans with posttraumatic stress disorder and traumatic 14
138	138	brain injuries. 15
139	139	(2) Notwithstanding the provisions of section 33.080 16
140	140	to the contrary, any moneys remaining in the fund at the end 17
141	141	of the biennium shall not revert to the credit of the 18
142	142	general revenue fund. 19
143	143	(3) The state treasurer shall invest moneys in the 20
144	144	fund in the same manner as other funds are invested. Any 21
145	145	interest and moneys earned on such investments shall be 22
146	146	credited to the fund. 23
147	147	2. Any facility that intends to seek reimbursement 24
148	148	from the fund for hyperbaric oxygen therapy provided to a 25
149	149	veteran shall request advance approval from the commission 26
150	150	for reimbursement before providing such therapy. Upon 27
151	151	approval by the commission, the commission shall set aside 28
152	152	the appropriate amount of funds to ensure full payment for 29
153	153	the veteran's therapy. If moneys remaining in the fund are 30
154	154	insufficient to ensure full payment, the commission shall 31
155	155	deny the facility's request for a dvance approval. 32
156	156	3. If at the end of the six -month period immediately 33
157	157	following the date the commission approved the facility's 34
158	158	request for advance approval the facility has not submitted 35 SB 664 6
159	159	any bills to the commission for the veteran or provided any 36
160	160	therapy for the veteran, the commission shall notify the 37
161	161	veteran and the facility that the funding reserved for the 38
162	162	veteran shall expire within thirty days if the facility 39
163	163	fails to notify the commission that therapy is scheduled or 40
164	164	continued. If the facility fails to notify the commission 41
165	165	that therapy is scheduled or continued within thirty days, 42
166	166	the commission shall release the funds reserved for the 43
167	167	veteran and make them available for another veteran's 44
168	168	therapy under sections 191.2600 to 191.263 0. 45
169	169	4. After receiving advance approval from the 46
170	170	commission and providing hyperbaric oxygen therapy to a 47
171	171	veteran in accordance with sections 191.2600 to 191.2630, 48
172	172	the facility shall not bill the veteran for the therapy but 49
173	173	shall submit the bill fo r the therapy to the commission. 50
174	174	5. The commission shall pay the bill for the therapy 51
175	175	received in accordance with subsection 4 of this section 52
176	176	from the fund within forty -five days of receipt. If the 53
177	177	costs of the therapy exceed the availability of moneys 54
178	178	remaining in the fund, the facility shall not hold the 55
179	179	veteran responsible for any payment, and the commission 56
180	180	shall not have any obligation to make payments to the 57
181	181	facility in an amount that exceeds the amount that was set 58
182	182	aside upon advance approval as described in subsection 2 of 59
183	183	this section. 60
184	184	6. The commission shall seek reimbursement for 61
185	185	payments made to facilities for treating veterans with 62
186	186	hyperbaric oxygen therapy from any of the following entities 63
187	187	based on the efficacy of tre atments as demonstrated in the 64
188	188	healing of traumatic brain injuries through hyperbaric 65
189	189	oxygen therapy by cognitive testing, brain scans, or other 66
190	190	assessment protocols medically accepted by the United States 67 SB 664 7
191	191	Food and Drug Administration or the United Sta tes Department 68
192	192	of Defense under the War Risk Insurance Act, as amended: 69
193	193	(1) The Tricare program of the United States 70
194	194	Department of Defense; 71
195	195	(2) Appropriate federal agencies, including the 72
196	196	Veterans Health Administration; and 73
197	197	(3) Any other responsible third -party payer. 74
198	198	7. The department of health and senior services shall 75
199	199	award funds to entities to study the use of alternative 76
200	200	therapies to treat veterans with posttraumatic stress 77
201	201	disorder and traumatic brain injuries. 78
202	202	191.2620. 1. Any facility may approve hyperbaric 1
203	203	oxygen therapy for a veteran in accordance with sections 2
204	204	191.2600 to 191.2630. 3
205	205	2. A licensing board shall not revoke, fail to renew, 4
206	206	suspend, or take any action against a healt h care 5
207	207	practitioner based solely on the health care practitioner's 6
208	208	recommendations to a veteran regarding access to or 7
209	209	treatment with hyperbaric oxygen therapy. 8
210	210	3. No state agency shall take any action, or assist in 9
211	211	any action, against a health c are practitioner's Medicare or 10
212	212	Medicaid certification based solely on the health care 11
213	213	practitioner's recommendation that a veteran have access to 12
214	214	hyperbaric oxygen therapy. 13
215	215	4. No official, employee, or agent of the state shall 14
216	216	block or attempt to block access to hyperbaric oxygen 15
217	217	therapy by a veteran who meets all requirements to receive 16
218	218	such therapy under sections 191.2600 to 191.2630. 17
219	219	5. Counseling, advice, or recommendations provided by 18
220	220	a health care practitioner consistent with the me dical 19
221	221	standards of care shall not be considered a violation of 20
222	222	sections 191.2600 to 191.2630. 21 SB 664 8
223	223	6. Hyperbaric oxygen therapy may be used under the 22
224	224	direction of an institutional review board with a national 23
225	225	clinical trial number for the purpose of c ollecting clinical 24
226	226	trial data. 25
227	227	191.2625. 1. Any facility that receives reimbursement 1
228	228	from the fund shall: 2
229	229	(1) Provide reports on individual veterans and groups 3
230	230	of veterans to the commission on measured health 4
231	231	improvements from accepted and approved cognitive testing 5
232	232	protocols, brain imaging, or other medical assessments 6
233	233	approved by the industry, the United States Food and Drug 7
234	234	Administration, the United States Department of Defense, 8
235	235	Tricare, or the Centers for Medicare and Medicaid Services 9
236	236	conducted before and after therapy; and 10
237	237	(2) Submit an annual report to the commission with the 11
238	238	following information: 12
239	239	(a) The number of veterans who received hyperbaric 13
240	240	oxygen therapy at the facility; 14
241	241	(b) The demographics of the veterans who received 15
242	242	hyperbaric oxygen therapy at the facility; 16
243	243	(c) The number of actual hyperbaric oxygen therapy 17
244	244	dives by veterans completed at the facility; 18
245	245	(d) Cognitive test results of veterans who received 19
246	246	hyperbaric oxygen therapy at the facility; and 20
247	247	(e) Any testimonials provided by veterans voluntarily. 21
248	248	2. (1) Before January first each year, the commission 22
249	249	shall prepare a report detailing each treatment of 23
250	250	hyperbaric oxygen therapy provided to a veteran i n 24
251	251	accordance with sections 191.2600 to 191.2630, the provider 25
252	252	type for each treatment provided, the number of veterans 26
253	253	treated or served, the treatment outcomes for the veterans 27
254	254	treated or served, and a detailed accounting of the moneys 28 SB 664 9
255	255	used in the fund during the immediately preceding fiscal 29
256	256	year. 30
257	257	(2) The commission shall submit the report prepared 31
258	258	under subdivision (1) of this subsection to the governor, 32
259	259	the president pro tempore of the senate, the speaker of the 33
260	260	house of representatives, a nd the director of the department 34
261	261	of health and senior services. 35
262	262	3. Before January thirtieth each year, the department 36
263	263	of health and senior services shall submit to the governor a 37
264	264	report containing: 38
265	265	(1) Findings and recommendations related t o the 39
266	266	administration of sections 191.2600 to 191.2630; 40
267	267	(2) Findings and recommendations from any studies 41
268	268	funded under section 191.2615 regarding the efficacy of 42
269	269	alternative therapies to treat posttraumatic stress disorder 43
270	270	and traumatic brain inju ries; and 44
271	271	(3) Recommendations on budgetary, legislative, or 45
272	272	regulatory changes needed to expand access to alternative 46
273	273	therapies for veterans with posttraumatic stress disorder 47
274	274	and traumatic brain injuries. 48
275	275	191.2630. The commission and the department of health 1
276	276	and senior services shall jointly promulgate all necessary 2
277	277	rules and regulations for the administration of sections 3
278	278	191.2600 to 191.2630. Any rule or portion of a rule, as 4
279	279	that term is defined in section 536.010, that is created 5
280	280	under the authority delegated in this section shall become 6
281	281	effective only if it complies with and is subject to all of 7
282	282	the provisions of chapter 536 and, if applicable, section 8
283	283	536.028. This section and chapter 536 are nonseverable and 9
284	284	if any of the powers vested with the general assembly 10
285	285	pursuant to chapter 536 to review, to delay the effective 11
286	286	date, or to disapprove and annul a rule are subsequently 12 SB 664 10
287	287	held unconstitutional, then the grant of rulemaking 13
288	288	authority and any rule proposed or adopted after August 28, 14
289	289	2025, shall be invalid and void. 15
290	290	